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2010/02/03 Council Agenda Packet
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2010/02/03 Council Agenda Packet
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Council Agenda Packet
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2/3/2010
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CITY OF EVERETT <br />FINAL CONTRACT VOUCHER CER'17.thICATION <br />CONTRACTOR: Thomco Construction, Inc. <br />CITY: Lake Stevens STATE: WA 98258 <br />PROJECT 'IT1'LE: Broadway @ Beverly Blvd. Improvements <br />DATE WORK COMPLETE: November 25, 2009 <br />ADDRESS: 13700 44`h St. NE <br />DATE: December 18, 2009 <br />WORK ORDER NO. 2966 <br />FINAL AMOUNT: $1,475,473.76 <br />CONTRACTOR'S CERTIFICATION <br />I, the undersigned, having first been duly sworn, certify that the attached bill is a proper charge for work performed <br />and material furnished to the City of Everett, that the same or any part thereof has not been paid, and that I am <br />authorized to sign for the claimant; that I have not rented or purchased any equipment or materials from any <br />employee of the City; I further certify that the attached final estimate is a true and correct statement showing all the <br />monies due me from the City of Everett under this contract; that I have carefully examined said final estimate and <br />understand the same and that I hereby release the City of Everett from any and all claims of whatsoever nature <br />which I may have, arising out of the performance of said contract, which are not set forth in said estimate. <br />X CO4/49(4Ge9 <br />TOR TITLE <br />Thomco Construction Inc. <br />Subscribed and sworn to before <br />me this day of ANu.M-'{ 201 v <br />X Viima a iiletj Notary Public <br />in and for the State of Washington, residing at <br />PUBLIC WORKS DEPARTMENT CERTIFICATION <br />I Certify the attached final APPROVED Date: <br />estimate to be based upon actual <br />measurements51/ <br />and to be true and correct. <br />X atA/X <br />Construction Manager Public Works Director <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 9/94 <br />9 <br />
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