2003/01/15 Council Agenda Packet

till Y Ur t,Vt Kt 1-1 REVISED FINAL CONTRACT VOUCHER CERTIFICATION • CONTRACTOR: M T Electric, Inc. ADDRESS: P 0 Box 696 CITY: Snoqualmie STATE: WA 98065-0696 DATE: December 20, 2002 PROJECT TITLE: HES Signal Improvements WORK ORDER NO. PW2771, 2919, 2920 DATE WORK COMPLETE: November 15, 2002 FINAL AMOUNT: $ 373,702.50 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 %rte— X CONT ' :e OR TITLE M T Electric,Inc. Subscribed and sworn to before THOMAS V. JUDGE day oqo02 NOTARY PUBLIC M4 Notary Public in and for the State of Washington, residing at _r_TA SOF.• INGTON APRIL 9, 2003 PUBLIC WORKS DEPARTMENT CERTIFICATION I Certify the attached final APPROVED Date: ( _1 03 estimate to be based upon actual measure'jts and t• be true and correct. byr-k Con, s ction Manager Utilities Director Terry Henke Tom Thetford 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