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2013/10/16 Council Agenda Packet
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2013/10/16 Council Agenda Packet
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Council Agenda Packet
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10/16/2013
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1t . <br /> CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> DATE: Sept. 19, 2013 ADDRESS: 1525 E Marine View Dr: <br /> CONTRACTOR: Granite Construction CITY/STATE: Everett WA 98201 <br /> PROJECT TITLE: Everett HMA Overlay 2012 WORK ORDER NO. PW 3468 <br /> DATE WORK COMPLETE: March 26,2013 FINAL AMOUNT: $1,342,561.03 <br /> • (Exclusive of State Sales Tax) <br /> • <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 paid, and <br /> that I am authorized to sign for the claimant; that I have not rented or purchased any equipment or materials <br /> from any employee of the City; I further certify that the attached final estimate is a true and correct statement <br /> showing all the monies due me from the City of Everett under this contract; that I have carefully examined said <br /> final estimate and understand the same and that I hereby release the City of Everett from any and all claims of <br /> whatsoever nature which I may have, arising out of the performance of said contract, which are not set forth in <br /> said estimate. <br /> x • x W. w,a )4 <br /> CON RACTOR TITLE • <br /> Granite Construction <br /> a <br /> Subscribed and sworn to before me this 2 day of do ik,i-- ,2013 Gr10NZF; <br /> �,�a. —e viz•-• 0 ExPiRFs y <br /> Notary Public ctoO,�P� <br /> in and for the State of Washington, residing at U ,,01" <br /> oc' <br /> `9 <br /> Tq/OF X? <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 Dat- <br /> X a77,27 ..L X. /I <br /> A A Am. <br /> Construction Manager Public orks i irector <br /> Tom Fuchs Dave Davis <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 6/2012 • <br /> 52 <br />
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