2003/12/03 Council Agenda Packet

CITY OF EVERETT 3 FINAL CONTRACT VOUCHER CERTIFICATION CONTRACTOR: Environ Con Trucking,Inc. ADDRESS: P 0 Box 740 CITY: Mukilteo STATE: WA 98275 DATE: November 13,2003 PROJECT TITLE: 10th Street Improvements WORK ORDER NO. 2959 DATE WORK COMPLETE: October 6, 2003 FINAL AMOUNT: $ 124,919.61 - 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 dup 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 tbity of Everett from any and all claims of whatsoever nature iC whi _� . •-, : 's' g out of the performance said contract, which are not set forth in said estimate. X � X CONTRA TITLE' Enviro 1 -i. I ►'' ' h.k• Inc. Subs; O -• •w i fore ' �� _ ,.........w. ,,, ,,.._ il• otary Public in .n iojT .; ;;• N'",/,''Pington, residing at �� ,f 14% . OF WASt . PUBLIC WORKS DEPARTMENT CERTIFICATION I Certify the attached final APPROVED Date: % " —li-A3 estimate to be based upon actual measure.- - is and t be true and correct. k_ X ) .‘91-z-174 Con.ruction 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 J