2006/03/08 Council Agenda Packet

• CITY OF EVERETT FINAL CONTRACT VOUCHER CERTIFICATION CONTRACTOR: S. D. Deacon Corp of Washington ADDRESS: 2375 130th Ave NE#200 CITY: Bellevue STATE:WA ZIP: 98005 DATE: February 15, 2006 PROJECT: Everett Mall Station PROJECT NO: N/A DATE WORK COMPLETE: December 9, 2005 FINAL AMOUNT$183,927.18 (including WSST) CONTRACTOR'S CERTIFICATION I, the undersigned, having first been duly sworn, certify that the above final amount 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 above final amount 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 amount and understand the same and that I hereby release the City of Everett from any and all claims of whatsoever nature which I may have, arising out of the performance of said contract, which are not set forth in said final amount. P S/AraC/ T CONTRACTOR TITLE ,‘\\\‘‘‘‘‘‘Iiii bscribed sw. n to b-fore me thiso3Y.0 day of Frkciory, 200 `'`� ��g` %1,4 � if Notary Public in and for the Stale of Wfshington, r o�Agt „s ,,� TRANSPORTATION SERVICES DEPARTMENT CERTIFI�`Jic'I` 14%„,,,,s‘' Ii', OF W P,r'� I Certify the above final amount to be APPROVED Date: Based upon actual work performed and To be true and correct. - P c . eer, Joel Garnica Transit Director, Paul Kaftanski ADMINISTRATION USE ONLY Date of Acceptance By: Ray Stephanson 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. 9