2016/06/01 Council Agenda Packet

CITY OF EVERETT FINAL CONTRACT VOUCHER CERTIFICATION • DATE: February 8,2016 ADDRESS: PO Box 742478 CONTRACTOR: Granite Construction CITY/STATE: Los Angeles, CA PROJECT TITLE: 2015 Hot Mix Asphalt Overlay WORK ORDER NO. PW3596 DATE WORK COMPLETE: January 7,2016 • FINAL AMOUNT: $ 4,970,297.57 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 ay have, arising out of the performance of said contract, which are not set forth in said e al-. 1L� X ONTRACT 1 R , ' TITLE Granite Const uc ion ` Subscrib d sworn to efore me this day of aQ-G1� ,2011D X P ) Notary PublNotary tufic`' ' " State of Washington Lc\c\.00Od_in and for the State of Washington,residing at emission Expires 06-08-2018 PUBLIC WORKS DEPARTMENT CERTIFICATION I Certify the attached final estimate to be f based upon actual measurements and to �f be true and correct. APPROVED Date: / X1,11\1\‘(C-1-4144-1 JOIr UtU° Construction Manager Public Works Director Tom Fuchs Dave Davis 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 80