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CITY OF EVERETT CITY <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> CONTRACTOR: Faber Construction ADDRESS: 131 East Grove Street <br /> CITY: Lynden STATE: WA 98264 DATE: June 4, 2018 <br /> PROJECT TITLE: Sewer Regulators R4 & R39 Modifications <br /> WORK ORDER NO. UP 3633 <br /> DATE WORK COMPLETE: May 11, 2018 FINAL AMOUNT: $1,155,037.44 <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 the 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 final estimate is a true and correct statement showing all the <br /> monies due me from the City of Everett under this contract; that I have carefully examined said final estimate and <br /> unders .nd he same and that I hereby release the City of Everett from any and all claims of whatsoever nature <br /> which I p:y ha e, arising out of the performan e of said contract, which are not set forth in said estimate. <br /> X �� X Itagti1 <br /> CO ' ! TOR TITLE j NA , <br /> Fabe onstruction -,` M.A0oo <br /> Subscribed and sworn to before • <br /> .0 S• TAR yin' <br /> me this 99' day s Q2v/� •• e <br /> X Notary Public %( '• UBI <br /> in and o the State of Washington, residing at 11.7,1 It? V1 . <br /> PUBLIC WORKS DEPARTMENT CERTIFICATION <br /> I Certify the attached final APPROVED Date: $' 1.4 14 <br /> estimate to be based upon actual <br /> measurements�� and to be true and correct. <br /> X ifsh✓ .��cL X acttalvA6(ewAL.% <br /> Construction Manager Utilities Director <br /> Tom Fuchs Paul Kaftanski <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 />