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CITY OF EVERETT <br /> 3 FINAL CONTRACT VOUCHER CERTIFICATION , <br /> CONTRACTOR: Advanced Construction, Inc. <br /> ADDRESS: 4640 Campus Place, Suite 150 <br /> CITY:Mukilteo STATE: WA DATE:November 20, 2007 <br /> PROJECT TITLE: PROJECT NO. S 1/_ <br /> DATE WORK COMPLETED: //6/07 FINAL CONTRACT AMOUNT: $895,950.22 (includes sales tax) <br /> CONTRACTOR'S CERTIFICATION <br /> I, the undersigned, having first been duly sworn, certify that the attached statement is a proper charge for work <br /> performed and material furnished to the City of Everett, that the same or any part thereof has not been paid, and that <br /> I am authorized to sign for the claimant; that I have not rented or purchased any equipment or materials from any <br /> employee of the City; I further certify that the attached final statement is a true and correct statement showing all the <br /> moneys due me from the City of Everett under this contract; that I have carefully examined said final statement and <br /> understand the s.• e and that I hereby release the City of Everett from any and all claims of whatsoever nature which <br /> I may have, .1;ill, out of the performance of said contract, which are of set forth in said statement. <br /> x 40 <br /> —,01 <br /> x P4--,, ,,, <br /> CONTRACTOR <br /> TITLE <br /> Subscribed apd sworn to before <br /> me th. c0 a f , 1i.- (2,012.7______— <br /> ai- ruNota y Public Notary Public <br /> for he State of Washington, reslatgof Washington <br /> an n <br /> at fiker9 Hain a }- i,ziiy,Q1,, LINDA G. BURKHERt <br /> MY COMMISSION EXPIRES <br /> September 29, 2011 <br /> PARANSVITTEFREUREVIENT CERTIFICATION <br /> APPROVED Date: /Z! 3/0 <br /> I Certify the attached final <br /> statement to be true and correct <br /> to the best of my knowledge. <br /> X. - -- _ Xgu.,,,(fr.„,,› <br /> roject Manager Director of PaaRecreation <br /> Russell Dance Paul Kaftanski <br /> ADMINISTRATION USE ONLY <br /> Date of Acceptance By: X <br /> MAYOR <br /> Ray Stephanson <br /> Approved as to Form <br /> X v <br /> City Attorney <br /> INSTRUCTIONS <br /> The Affidavit of Wages Paid must be prepared by the prime contractor,all subcontractors, and all subcontractor's agents and forwarded with <br /> the Final Contract Voucher Certification. <br /> Contractor's Claims, if any, must be included and the Contractor's Certification must be labeled indicating a claim attached. <br /> C Revised 11-03 <br /> v <br />