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S~~. "A" - IMi~REr~?S: <br /> SC~ZEt~ "B" - TE~S ~': <br /> S~5~J3LE "C" - pA\rfNG: <br /> C.O. ~I: <br /> C.O. ~2: <br /> Field <br /> <br /> TOTAL ATL <br /> Less Pay EstLmate No. I, 2, 3, 4 & 5: <br /> <br />WE ~ ~ PA~ OF: <br /> <br />Please verity the above ammmts and t25e receipt of the folic~.irg.. ~rom <br />the con~ractor prior to ~]~[ng final payment. <br /> <br />1. Ce~ificate of Claims Pasq~_nt (Lien Waiver), <br />2. Affidavit for lma)n~ent of State Taxes (¥J3%n. S~ate Tax Po~. 13~ ), <br />3. Letter of Consent Irom ~aret-y firm. <br /> <br />$44,66S.07 <br /> <br /> 8£,93C.00 <br /> $951.00 <br /> $869.70 <br /> <br />$106,880.97 <br /> <br />Certifi~tion b5~ Contractor: I ceftin, ~hat all items and am~ants <br />~hown are co.~rect for the work completed to date. <br /> <br />W.B. MYI.TA~R, INC. <br /> <br />sigr~a: <br /> <br />Title: <br /> <br />~SON A~ ~TkqRSON ASSOC/3~, INC. <br /> <br />Sicrned: <br /> = <br /> <br />Title: <br /> <br />~E CITY OF R~EY <br /> <br />Signed: <br /> <br />Title: <br /> <br />D~te: <br /> <br />File: RA7:02-9 <br /> <br /> <br />