2006/09/27 Council Agenda Packet

L11 T Vr r v t tci l 1 4 FINAL CONTRACT VOUCHER CERTIFICATION )NTRACTOR: Stripe Rite, Inc. ADDRESS: P 0 Box 1724 TY: Aurburn STATE: WA 98071 DATE: August 23, 2006 OJECT TITLE: 2006 Pavement Marking WORK ORDER NO. PW3245 ATE WORK COMPLETE: July 24, 2006 FINAL AMOUNT: $ 43,742.50 CONTRACTOR'S CERTIFICATION the undersigned, having first been duly sworn, certify that the attached bill is a proper charge for work performed d material furnished to the City of Everett, that the same or any part thereof has not been paid, and that I am thorized to sign for the claimant; that I have not rented or purchased any equipment or materials from any iployee of the City; I further certify that the attached final estimate is a true and correct statement showing all the Dnies due me from the City of Everett under this contract; that I have carefully examined said final estimate and tderstand the same and that I hereby release the City of Everett from any and all claims of whatsoever nature rich I ma hav- a ' ` : e t of the performance of said contract, which are not set forth in said estimate. � X ON RACT R TITLE 5ORG1 t t tl� NV- `vino► "' ripe Rite, Inc. _ .e � ► ibscribed and sworn to before ; , •' g e this Ste' day of 1 s. IDC-\( - %, p�0v'`0 t H • • Notary Public s''rlh$4-04,, and for the State of Washington, residing at (nl G (koY, t�}F} , 14 llif,,TF OF\\`. PUBLIC WORKS DEPARTMENT� CERTIFICATION i ertify the_ attached final APPROVED j ROVED Date: l ' 13 timate to base upon actual easurements and to be true and correct. 114 Construction Manager Utilities Director Tom Fuchs Tom Thetford INSTRUCTIONS le Affidavit of Wages Paid must be prepared by the prime contractor, all subcontractors, and all subcontractor's ;ents and forwarded with the Final Contract Voucher Certification. Dntractor's Claims, if any, must be included and the Contractor's Certification must be labeled indicating a claim tached. evised 9/94 7