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3 CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> CONTRACTOR:Landmark Strutures Mgmt. ADDRESS: 1665 Harmon Road <br /> CITY: Fort Worth STATE: TX 76177 DATE: March 10,2010 <br /> PROJECT 1'1`1'LE: Casino Water Tank Project WORK ORDER NO. 3029-2 <br /> DATE WORK COMPLETE: 3/10/2010 FINAL AMOUNT: $14,464,600.46 <br /> CONTRACTOR'S CERTIFICATION <br /> I, 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 they claimant; that I have not rented or purchased any equipment or materials from any <br /> employee of the City; I further certify that the attached fmal estimate is a true and correct statement showing all the <br /> monies due me from the Ci of Everett under this contract; that I have carefully examined said fmal estimate and <br /> unders , e- 1: i at I ereby release the City of Everett from any and all claims of whatsoever nature <br /> w •:.' ' o • the performance of said contract,which are not set forth in said estimate. <br /> Chris Lamon X Vice President <br /> CONT' • CTOR TITLE <br /> Landmark Structures I,L.P. by Landmark Structures Management,Inc.,General Partner <br /> Subscribed and sworn to before <br /> me tl-k 5th day of ' •ril,2010. *C-1:4* NOURYPUBOC <br /> X 4, ,,t. e� '�' , Notary Public Fik4"cfroPP% <br /> svJEOFgla20t2 <br /> in and for the State of Te residing at Fort Worth,Tarant County,Texas. Carm. <br /> PUBLIC WORKS DEPARTMENT CERTIFICATION <br /> I Certify the attached final APPROVED Date: A"� ~ CO <br /> estimate to be based upon actual <br /> measurements and to be true and correct. <br /> xcalitixL X �. <br /> Construction Manager Public Works D. etor <br /> Tom Fuchs Dave Davis <br /> INSTRUCTIONS <br /> The Affidavit of Wages Paid must be prepared by the prime contractor, all subcontractors, and all subcontractor's <br /> agents 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 /> attached. <br /> Revised 9/94 <br /> 6 <br />