2007/01/17 Council Agenda Packet

CITY OF EVERETT FINAL CONTRACT VOUCHER CERTIFICATION CONTRACTOR:Signal Electric, Inc. ADDRESS: P.O. Box 6209 CITY: Kent STA IL: WA 98064-6209 DATE: December 12, 2006 PROJECT TITLE: 2005 Signal Improvement Project WORK ORDER NO. PW3226 DATE WORK COMPLE I'F: November 17, 2006 FINAL AMOUNT: $ 357,794.00 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 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 and that I hereby release the City of Everett from any and all claims of whatsoever nature which I may have, ari ' out of the performance of said contract, which are not set forth in said estimate. CON O� R TITLE V icL Signal Electric, Inc. Subscribed and sworn to before me-tljis /5 day of , c. .� .— %� -- ------ Notary Public in and for the State of Washington, residing at /c -{-est PUBLIC WORKS DEPARTMENT CERTIFICATION I Certify the attached final APPROVED Date: (2-72-7'96 estimate to be based upon actual measurements and to be true and correct. Xa, X �� Esc – 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 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 1E-71© I /I r 1� levL J DEC 2 i 200E J CITY OF EVERETT 5 Construction M,l3natiement