Merrell Bros Inc. 12/9/2021 - Laserfiche WebLink

CITY OF EVERETT FINAL CONTRACT VOUCHER CERTIFICATION DATE: October 1st, 2021 ADDRESS: 8811 W. 500 N. CONTRACTOR: MERRELL BROS, INC. CITY/STATE: Kokomo, IN 46901 PROJECT TITLE: 2021BIOSOLIDS &BACKWASH SOLIDS WORK ORDER NO. UT 3752 REMOVAL FINAL AMOUNT: $712,177 DATE WORK COMPLETE: April 20, 2021 Exclusive of State Sales Tax 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 which I may have, arising out of the performance of said contract,which are not set forth in said estimate. X X .� .D o, COIT t'RACTOR TITLE MERRELL BROS, INC. ,,,, ,,•,`oR,i JAC 1,,, Subscribed and sworn to before me this 1S day of OCTD -- 2 •�,:w�'a�o'SO� t,in X c Notary P lic Ntt , N •*,�,,arun - * in and for the State of n, residing at '.,7j; •'�Exirir++9.:•• n _4 into ®� PUBLIC WORKS DEPARTMENT CERTIFICATION I Certify the attached final estimate to be based upon actual measurements and to be true and corre t. APPROVED Date: 1(-05- X /0Z1 X_ Project Manager Publi Works Director Mike Robinson 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 6/2012