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CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION CITY <br /> CONTRACTOR: R.L.Alia Company ADDRESS: 107 Williams Avenue S. <br /> CITY: Seattle STATE: WA 98057 DATE: April 12, 2018 <br /> PROJECT TITLE: Hayes Street Regulator& CSO Controls (SR01, SR02 & SR03) <br /> WORK ORDER NO. UT3398-31 <br /> DATE WORK COMPLETE: April 11, 2018 FINAL AMOUNT: $3,104,509.11 <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, <br /> and that I am authorized to sign for the claimant; that I have not rented or purchased any equipment or <br /> materials from any employee of the City; I further certify that the attached final estimate is a true and correct <br /> statement showing all the monies due me from the City of Everett under this contract; that I have carefully <br /> examined said final estimate and understand the same and that I hereby release the City of Everett from any <br /> and all claims of whatsoever nature which I may have, arising out of the performance of said contract, which <br /> are not set forth in said estimate. `owls��iii <br /> x X Pg t.S t A E-nt i ` ihkeitoM <br /> CONTRACTOR TITLEe-11; <br /> R.L.Alia CompanyMP • NOTARY s <br /> N PUBLIC rt ` <br /> Subscribed and sworn to before �s,*• 4/2120, <br /> •.,`4` <br /> me his 1*niday of APRIL 2l1 °• �F•~• ••' t��•`� <br /> X .,.../ / , Istotary Public �Ii�Op WAS `�``` <br /> in and .r the State of Washington, residing at K inti (ov,v <br /> PUBLIC WORKS DEPARTMENT CERTIFICATION <br /> I Certify the attached final APPROVED Date: trl2./r' <br /> estimate to be based upon actual <br /> measurements and to be true and rrect. <br /> Xij X <br /> Construction Manager U lfties~'rector <br /> Tom Fuchs Paul Kaftanski <br /> INSTRUCTIONS <br /> The Affidavit of Wages Paid must be prepared by the prime contractor, all subcontractors, and all <br /> subcontractor's 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 <br /> claim attached. <br /> Revised 9/94 <br />