Laserfiche WebLink
CITY <br /> CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> DATE: June 19, 2019 ADDRESS: 609 N. Hill Boulevard <br /> CONTRACTOR: Interwest Construction, Inc. CITY/STATE: Burlington, WA 98233 <br /> PROJECT TITLE: Wetmore Avenue Stormwater Bypass WORK ORDER NO. UP-3704 <br /> DATE WORK COMPLETE: December 14, 2018 FINAL AMOUNT: $855,514.18 <br /> Including 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 contract, hich are not set forth in said estimate. <br /> 29(/ <br /> X X President <br /> CONTRACTOR TITLE <br /> Interwest Construction, Inc. ouiiii►►►ii� <br /> 0 KAY ii <br /> Subscribe• and sworn to before me this 20th day of June. 2019 �.. .--.4,��Ss1oH A it,* <br /> Nota 'ub x 4 (2,4 ri! )06(4/Ltt .7--co: <br /> moo. <br /> • : _ <br /> In and for the State of Washington, residing at Bellingham ��9�.'��iyF,s 20 0.Q,. <br /> Ca <br /> PUBLIC WORKS DEPARTMENT CERTIFICATION <br /> I Certify the attached final estimate to be <br /> based upon actual measurements and to <br /> be true and11?-),A27,,a <br /> correct. APPROVED Date: /0-Z1- zc►/ <br /> X X d.,._._. ., .----- <br /> Construction Manager PuWorks Director <br /> Tom Fuchs Ryan Sass <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 <br />