2005/02/02 Council Agenda Packet

CITY OF EVERETT REVISED FINAL CONTRACT VOUCHER CER I'ThTCATION IONTRACTOR: Pacific Crest Construction ADDRESS: 13619 Mukilteo Speedway IITY: Mukilteo STATE: WA 98037 DATE: January 10, 2005 3ROJECT TITLE: WPCF Maintenance Building WORK ORDER NO. UP2993 DATE WORK COMPLETE: December 3, 2004 FINAL AMOUNT: $ 2,267,446.37 CONTRACTOR'S CERTIFICATION [, the undersigned, having first been duly sworn, certify that the attached bill is a proper charge for work performed mnd 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 ponies due me from the City of Everett under this contract; that I have carefully examined said final estimate and inderstans sa • :nd •,.t I hereby release the City of Everett from any and all claims of whatsoever nature which j(hav=, ansin:'t of the performance of said contract, which are not set forth in said estimate. KV X ?/1i5/./7 Ce>c C I, TRACTOR TITLE Pacific Crest Construction ,aU�►�+rnr�iyg . o L. Ally ubscri.ed �� t. ��'•� z- S is ' f 02 Ke /.�.. ,M-272:/",„„::_. ry Pary Public in and foraheI State" Wash i don, residing at1(/(7)'[/'&/ • s 1A401, Of w S�,M��,,• "%pis""'"o PUBLIC WORKS DEPARTMENT CERTIFICATION [ Certify the attached final APPROVED Date: ( 0-6) estimate to be based upon actual measurements and to be true and correct. K X Construction Manager Utilities Director 'Fefry-Henke Torn F uCH s Tom Thetford INSTRUCTIONS Me 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. 2ontractor's Claims, if any, must be included and the Contractor's Certification must be labeled indicating a claim attached. devised 9/94 5