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7 , <br /> CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> DATE: October 16,2015 ADDRESS: 3134 268t St.NW <br /> CONTRACTOR: Taylor's Excavators CITY/STATE: Stanwood WA 98292 <br /> PROJECT TITLE: Stormwater Facility Access Retrofit WORK ORDER NO. UT 3464 <br /> DATE WORK COMPLETE: April 6, 2015 FINAL AMOUNT: $338,171.97 <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 /> whatsoever nature which I may have, arising out of the performance of said contract, which are not set forth in <br /> said est <br /> iair ._444k . <br /> X • X (laud witAiNI- <br /> CONTRACTOR T° TITLE <br /> Tayloi's Excavators <br /> /� s .Subscribed and sworn to before me this c' day of £L`7J bk- , 2015 (C°----AN <br /> �,0 loss1Q�l'F O <br /> 4107".qy � <br /> NotSr Public _ f 5, 1,:7081/c <br /> in 11 d r the State of Washington,residing at j s O? ,( <br /> w�SHiN9 <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 Date: /7 A \71.71/1 <------ <br /> . j ,ii/ <br /> X „Ps1:1-71:-4ser— .1,4— X / A(if if III V <br /> Construction Manager Public/Whrks Iliector • k-' <br /> Tom Fuchs Dave Davis <br /> • <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 /> Co�vi_1a ior;s Clain if any, must C,: incluI [ __-di ;I e Connectors Cerdifca!ie roust be labeled indicaii � _ claim <br /> _ _ 42 <br />