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5 <br /> CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> DATE: September 24, 2018 ADDRESS: 15714 Country Club Drive <br /> CONTRACTOR: McClure&Sons, Inc. CITY/STATE: Mill Creek,WA 98012 <br /> PROJECT TITLE: Three Lakes Valve Bypass WORK ORDER NO. UP-3611 <br /> DATE WORK COMPLETE: February 2, 2018 FINAL AMOUNT: $1,306,828.14 <br /> Includes Washington 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 <br /> paid, and that I am authorized to sign for the claimant;that I have not rented or purchased any equipment <br /> or materials from any employee of the City; I further certify that the attached final estimate is a true and <br /> correct statement showing all the monies due me from the City of Everett under this contract; that I have <br /> carefully examined said final estimate and understand the same and that I hereby release the City of <br /> Everett from any and all claims of whatsoever nature which I may have, arising out of the performance of <br /> said coi ct,which a not set forth in said estimate. <br /> X X PRESIDENT t.°'.,4c LUtdE °°01i, <br /> Cel ; ' QCT R TITLE �oov� <br /> McClure&Sons Inc. a Q�Quc °®° <br /> Np'C 1gy p\FEES a <br /> Subscribed and sworn to before me this ./7 day of Cha. , 20 8 ° CO �o o <br /> ° <br /> rtS lo,�° ° <br /> x <br /> • <br /> N4-a Public e��4 °SPATEOF�P�,a°`t� <br /> In and for the State of Washington,residing at `0°8F°IE OF <br /> M /( ()Pee . l)/9 <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: `�� <br /> X , X <br /> Construction Manager Pub is Works 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 <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 6/2012 1 6 <br />