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IPlease verify the above amounts and the receipt of the following from the <br />contractor prior to making final payment. <br /> <br />I1. <br /> 2. Affidavit for Payment of State Taxes <br /> 3. Letter of Consent from surety firm. <br /> <br />Certificate of Claims Payment (Lien Waiver), <br /> <br />(Minn. State Tax Form 134), <br /> <br />Certification by Contractor: I certify that all items and <br />amounts shown are correct for the work completed to date. <br /> <br />BUCK BLAC~R39P, INC. <br /> <br />signed: <br /> <br />Title: <br />Date: <br /> <br />I <br />I <br />I <br /> <br />I <br />I <br /> <br />CITY OF RAMSEY <br /> <br />Signed: <br /> <br />Title: <br /> <br />Date: <br /> <br />IFile: RA7:02-16 <br /> <br /> <br />