2005/08/10 Council Agenda Packet

4 CITY OF EVERETT FINAL CONTRACT VOUCHER CERTIFICATION CONTRACTOR: Award Construction ADDRESS: 4326 Pacific Hwy CITY: Bellingham STA 1'h: WA 98226 DATE: July 14, 2005 PROJECT TITLE: Transmission Line#2 Replacement, Ph 8-A WORK ORDER NO. UP3183 DATE WORK COMPLETE: June 15, 2005 FINAL AMOUNT: $ 1,338,121.29 CONTRACTOR'S CERTIFICATION [, 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 .nd that I hereby release the City of Everett from any and all claims of whatsoever nature which I may ha ' g out of the performance of said contract, which are not set forth in said estimate. X \ )• _ J „f/ X 1?f1-S P CONTRAC OR / TITLE Award Construction •-P pFULz • im S�ON F�.o 9 i, Subscribed and sworn to .efore _o7OAgy 9V/ iio me th' :.o d y f �i.�l y ,,, — �4- �►I �1 �_ Notary Public = PUMA 144 in and for the State of Washington, residing at /If,c1,2-.--N viPt • yr.,,9_30.0��0• � nF wrS' PUBLIC WORKS DEPARTMENT CERTIFICATION [ Certify the attached final APPROVED Date: I i / .-stimate to be based upon actual measureme'ntts and to be true and correct. i Q 2<z-irl, X Construction Manager Utilities Director Tom Fuchs Tom Thetford INSTRUCTIONS the 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. Tontractor's Claims, if any, must be included and the Contractor's Certification must be labeled indicating a claim attached. devised 9/94