2004/05/26 Council Agenda Packet

C11'Y U14 EVI K1;Tr 3 FINAL CONTRACT VOUCHER CER'1'1hICATION CONTRACTOR: Marshbank Construction ADDRESS: P 0 Box 97 CITY: Lake Stevens STATE: WA 98258-0097 DATE: March 5, 2004 PROJECT 1'1'1LE: 112th St.-Evergreen to Airport WORK ORDER NO. 2939 DATE WORK COMPLETE: March 4, 2004 FINAL AMOUNT: $ 1,723,053.93 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 anyequipment 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 m have, 'ng out of the performance of said contract, which aregat ►4-th in said estimate. �-- PfeS p sA C CTOR TITLE s�=�� +.o cy,'•,� Marshbank Construction �; N=rARy .5 :0 i ZS cn� PUBLIC Subscribed and sworn o before e this •ay of Ali • i,.�li&11 r OWL otary Public ►'h,�F tNASN�NG'� i d for the State of Washington,residing at 'UU^`�-� � (kb - %:::•••• PUBLIC WORKS DEPARTMENT CERTIFICATION I Certify the attached final APPROVED Date: 5—j 7--ey estimate to be based upon actual measure,•is and to be true and correct. X k '111 1., die•T_ - X 16t9 467ft 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 10