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{ <br /> 1 <br /> 1 <br /> CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION F <br /> DATE: June 21,2013 ADDRESS: 131 E Grove St. <br /> CONTRACTOR: Faber Construction Corp. CITY/STATE: Lynden WA 98264 1 <br /> PROJECT TITLE: Water Main Replacement"Q"- Broadway WORK ORDER NO. UP 3612 <br /> DATE WORK COMPLETE: April 11, 2017 FINAL AMOUNT: $ 751,505.96 <br /> Exclusive of State Sales Tax <br /> I <br /> CONTRACTOR'S CERTIFICATION 1 <br /> 1 <br /> I, the undersigned, having first been duly sworn, certify that the attached bill is a proper charge for work <br /> performed and material furnished to the City of Everett, that the same or any part thereof has not been paid, and <br /> that I am authorized to sign for the claimant; that I have not rented or purchased any equipment or materials <br /> from any employee of the City; I further certify that the attached final estimate is a true and correct statement F <br /> showing all the monies due me from the City of Everett under this contract; that I have carefully examined said <br /> final estimate and understand the same and that I hereby release the City of Everett from any and all claims of <br /> whatsoever na - hich I i ay have, arising out of the performance of said contract, which are not set forth in <br /> said estimate. <br /> i <br /> i <br /> X 1.,1k . x Ci Vres\�,vrf' 1 <br /> CONT TILE ��p� tiii <br /> �,,4�IT gyp, � <br /> Faber Con ruction Corp. .1► <br /> ,)� NOTARY * <br /> Subscribed and sworn to before me this 2.2. day of il <br /> J UNS , 2017 PUBLIC . h <br /> p • * 186020 * . E !r <br /> 0MY COMMISSION <br /> Xanclerill' 9RES otarPublic _ EXPI <br /> o606/27/2020 �Z� <br /> in and for the State of Washington,residing at 6w2 N ICICLES STREET �� O 'WAS% II <br /> rERWDALSt W 18-2'42 <br /> PUBLIC WORKS DEPARTMENT CERTIFICATION <br /> I Certify the attached final estimate to be <br /> based upon actual measurements and to O. <br /> •be true and correct. APPROVED P ate: Z C . <br /> t1 <br /> X .-ZeL X. 11F1E. <br /> Construction Manager Public ;'r Director W <br /> Tom Fuchs Dave Davis <br /> t <br /> i{ <br /> I: <br /> INSTRUCTIONS li <br /> li <br /> The Affidavit of Wages Paid must be prepared by the prime contractor, all subcontractors, and all subcontractor's 1 <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 I <br /> attached. <br /> Revised 612012 1 <br /> 1 <br /> i <br />