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CI1'Y OF EVERETT <br /> 3 FINAL CONTRACT VOUCHER CERIIFICATION <br /> 7ONTRACTOR: J. Fletcher Creamer& Son, Inc. ADDRESS: 101 E Broadway <br /> ITTY: Hackensack STATE: NJ 07601 DATE: October 4,2004 <br /> 'ROJECT TITLE: Repair of Crosstown Pipe Lining WORK ORDER NO. 2880 <br /> )ATE WORK COMPLE 1'E: September 24, 2004 FINAL AMOUNT: $ 985,701.09 <br /> CONTRACTOR'S CERTIFICATION <br /> the undersigned, having first been duly sworn, certify that the attached bill is a proper charge for work performed <br /> and material furnished to the City of Everett, that the same or any part thereof has not been paid, and that I am <br /> authorized to sign for the claimant; that I have not rented or purchased any equipment or materials from any <br /> mployee of the City; I further certify that the attached final estimate is a true and correct statement showing all the <br /> nonies due me from the City of Everett under this contract; that I have carefully examined said final estimate and <br /> mderstand the same and t,at - ;reby re.-ase the City of Everett from any and all claims of whatsoever nature <br /> which may have 3 ,,( of e p- -'► ance of said contract, which are not set forth in said estimate. <br /> 49/41r, <br /> Kti__ y�/ %!i, y , x J. Fletcher Creamer, Jr. , Pres. <br /> 20 TRACTOR ITLE <br /> (. /etcher Creamer & Sons,Inc. <br /> RAFFAELLA BELLINI <br /> NOTARY PUBLIC STATE OF NEW JERSEY <br /> subscribed and sworn to before MY COMMISSION EXPIRES SEPT.20,2007 <br /> ne i is 26th d;y of October 2004 ID#2292025 <br /> K _,1 , , i I 1 + 1 .. ' Notary Public <br /> n a ►/for the otate of Wathiagtotan,residing at 329 Morningside Ter. , Teaneck, NJ .07666 <br /> New Jersey <br /> PUBLIC WORKS DEPARTMENT CERTIFICATION JJ <br /> Certify the attached final APPROVED Date: l 1---(G <br /> :stimate to be based upon actual <br /> neasure .- •is and to be rue and correct. <br /> K ► t x ` 12 <br /> Const ion Manager Utilities Director <br /> Terry enke Torn Thetford <br /> INSTRUCTIONS <br /> [he Affidavit of Wages Paid must be prepared by the prime contractor, all subcontractors, and all subcontractor's <br /> Tents and forwarded with the Final Contract Voucher Certification. <br /> contractor's Claims, if any, must be included and the Contractor's Certification must be labeled indicating a claim <br /> ittached. <br /> tevised 9/94 <br /> 5 <br />