2004/12/15 Council Agenda Packet

FINAL CONTRACT VOUCHER CERTIFICATION 0 'ONTRACTOR: Mer-Con. Inc. ADDRESS:P O Box 1303 'TTY: Maple Valley STATE: WA 98038 DATE: September 28, 2004 v 'ROJECT TITLE: East Everett Pedestrian Walkway, Stage 2 WORK ORDER NO. PW2696-2 )ATE WORK COMPLETE: September 1, 2004 FINAL AMOUNT: $ 241,284.80 CONTRACTOR'S CERTIFICATION , the undersigned, having first been duly sworn, certify that the attached bill is a proper charge for work performed nd material furnished to the City of Everett, that the same or any part thereof has not been paid, and that I am uthorized to sign for the claimant; that I have not rented or purchased any equipment or materials from any mployee of the City; I further certify that the attached final estimate is a true and correct statement showing all the nonies due me from the City of Everett under this contract; that I have carefully examined said final estimate and inderstand the same and that I hereby release the City of Everett from any and all claims of whatsoever nature vI ay have, arisin out of the performance of said contract, which are not set forth in said estimate. vhich r CTOR TITLE _O�P MSR�� vier-Con, Inc. �• ,�'1 �S `ONq;-..o�►► ;II, c `• d •nd swo t'. be ore p5 NOTARY V,; ►►/ `1 • .y.of L.,. .. i :0 --- : S �(� Notary Public �, //►� i PUBLIC ' a,d for the State of Washington,residing at '' /L' v f i / /II1 y Sr,9.p�,.•:' ‘‘ WAS PUBLIC WORKS DEPARTMENT CERTIFICATION Certify the attached final APPROVED Date: Z_l--(:71-/ stimate to be based upon actual neasure -id's and to .e true and correct. Con ction Manager Utilities Director Terry Henke Tom Thetford INSTRUCTIONS 'he Affidavit of Wages Paid must be prepared by the prime contractor, all subcontractors, and all subcontractor's gents and forwarded with the Final Contract Voucher Certification. :ontractor's CIaims, if any, must be included and the Contractor's Certification must be labeled indicating a claim ttached. revised 9/94 h 5