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CITY OF EVERETT CITY <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> CONTRACTOR: Stellar J Corporation ADDRESS: 1363 Down River Drive <br /> CITY: Woodland STATE: WA 98674 DATE: July 5, 2018 <br /> PROJECT TITLE: WFP Portal #1 Replacement Project <br /> WORK ORDER NO. UP 3602 <br /> DATE WORK COMPLETE: June 18, 2018 FINAL AMOUNT: $763,848.10 (includes WSST) <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 /> understand the same and that I hereby release the City of Everett from any and all claims of whatsoever nature <br /> which I may have, arising o of the •erformance of said contract, which are not set forth in said estimate. <br /> X . l/ — X /'o `G Gl" e�// ,�/e ��a�N0umugnnti <br /> �''�. <br /> CO-'‘'- ' � ' �R TITLE .aa`� .Q••GRi4 ,y <br /> tellar . 1 orat': I�•O`a�MENtFA/Cisy <br /> •Q NOTAR►. 9ta• s <br /> Subscribed and sworn to before _` :� --w - (': i <br /> m this() ,157;06t:Feb 20 i PUBI.UG A <br /> Notary Public ) / II � d 1 OW <br /> i and for the tate a.shington, residing at WC /�G/�4 T ,41e* F WASH����•. <br /> iu►n siiimooa <br /> PUBLIC WORKS DEPARTMENT CERTIFICATION <br /> I Certify the attached final APPROVED Date: <br /> estimate to be based upon actual <br /> measurements and to be true and correct. <br /> XZ1/ 74uN X /2"----- <br /> Construction anager Utilitiesirector <br /> Tom Fuchs Ryan Sass <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 />