KLB Construction 3/9/2020 - Laserfiche WebLink

CITY OF EVERETT FINAL CONTRACT VOUCHER CERTIFICATION CITY CONTRACTOR: KLB Construction, Inc. ADDRESS: PO Box 158 CITY: Mukilteo STATE: WA 98275 DATE: June 3, 2019 PROJECT TITLE: West Marine View Drive Utilities WORK ORDER NO. UP 3588 DATE WORK COMPLETE: May 24, 2019 FINAL AMOUNT: $1,341,841.43 (includes WSST) CONTRACTOR'S CERTIFICATION I, the undersigned, having first been duly sworn, certify that the attached bill is a proper charge for work performed and material furnished to the City of Everett, that the same or any part thereof has not been paid, and that I am authorized to sign for the claimant; that I have not rented or purchased any equipment or materials from any employee of the City; I further certify that the attached final estimate is a true and correct statement showing all the monies due me from the City of Everett under this contract; that I have carefully examined said final estimate and understand the same and that I hereby release the City of Everett from any and all claims of whatsoever nature w 'eh I may ave, isin out of the performance of said contract, which are not set forth in said estimate. X (N X C C R TITLE c,E52 SO,Q, KLB Construction, Inc. �oN \sS'ON Subscribed and sworn to before `' NOTARY FN Z i day of - .101q PUBLIC X Notary Public � o -I 202 2 in and for the State of Washington, residing at tt✓� i� __de nor WASHY` PUBLIC WORKS DEPARTMENT CERTIFICATION I Certify the attached final APPROVED Date: 2_)7'Z�-) D estimate to be based upon actual measurements and to be true and correct. X ig;In X Construction Manager Utilities D ector Tom Fuchs Ryan Sass INSTRUCTIONS The Affidavit of Wages Paid must be prepared by the prime contractor, all subcontractors, and all subcontractor's agents and forwarded with the Final Contract Voucher Certification. Contractor's Claims, if any, must be included and the Contractor's Certification must be labeled indicating a claim attached. Revised 9/94