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CITY <br /> CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> DATE: April 7, 2017 ADDRESS: 15714 Country Club Drive <br /> CONTRACTOR: McClure and Sons, Inc. CITY/STATE: Mill Creek, WA 98012 <br /> PROJECT TITLE: Puget Sound Outfall No. 6 Reroute WORK ORDER NO. UP 3583 <br /> DATE WORK COMPLETE: March 24, 2017 FINAL AMOUNT: $ 804,860.30 <br /> Exclusive of State Sales Tax <br /> CONTRACTOR'S CERTIFICATION <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 <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 /> whatso-ver nature which I may have, arising out of the performance of said contract, which are not set forth in <br /> said .te. <br /> x x Pit 51 <br /> C I I RAC OR TITLE <br /> McClure and Sons,Inc. <br /> Subscribed and sworn to before me this <br /> G7 day of J h tte , 2017 .�` ����•,.�CC�.SRF <br /> /� <br /> • <br /> x �i, /(J`( Q,L,, ;• <br /> •NOTAL PUBLIC <br /> �� • <br /> . 'ublic • COMM.EXPIRES <br /> e. <br /> in an• for the State of Washington, residing at /`�'/i c?,eeA ) � 74- z M 10,2020 <br /> • <br /> , ' <br /> . <br /> sr�•• ••cic <br /> ‘44- <br /> PUBLIC WORKS DEPARTMENT CERTIFICATION <br /> I Certify the attached final estimate to be <br /> based upon actual measurements and to <br /> be true and correct. APPROVED Dat-: <br /> X ..OrAze.2..., <br /> Construction Manager Public Work. i irector <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 6/2012 <br />