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CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> CONTRACTOR:Schwetz Construction, Inc. <br /> ADDRESS: P.O. Box 449 <br /> CITY: Sedro-Woolley STATE: WA DATE: 02/22/08 <br /> PROJECT TITLE: Grand Avenue Park Renovation PROJECT NO. 354 5000000026 650 <br /> DATE WORK COMPLETED: 02/20/08 FINAL CONTRACT AMOUNT: $373,093.53 <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 <br /> that I am authorized to sign for the claimant; that I have not rented or purchased any equipment or materials from <br /> any employee of the City; I further certify that the attached final statement is a true and correct statement showing all <br /> the moneys due me from the City of Everett under this contract; that I have carefully examined said final statement <br /> and understand the same and that I hereby release the City of Everett from any and all claims of whatsoever nature <br /> which I may have, arising out of the performance of said contract, which are not set forth in said statement. <br /> X kky ' . '' a . , x Prest a,>°kt CJ46 c� imaAA�L�(e r <br /> CONTRACTOR `' TITLE ,,.\\;'�.'`: Iii J <br /> x.��(� Fps g,! <br /> Subscribecland sworn to before = U;1' $�° � 'a, <br /> me this 1 l a of Ytla v�h a ooh o�OT'��� ` <br /> X r Notary Public - <br /> in and kit'the State of Washington, residing (PS A = : <br /> at 1<a r=f Cbu vt % (igL\G <br /> 1'I�iF ASH,„;2 <br /> PARKS AND RECREATION DEPARTMENT CERTIFICATION <br /> APPROVED Date: 3 1 -o g <br /> I Certify the attached final <br /> statement to be true and correct <br /> to the11best of my knowledge. <br /> X ) x a t <br /> 4.4 <br /> Project Director of Parks and ecreation <br /> Henry Schroder Paul Kaftanski <br /> ADMINISTRATION USE ONLY <br /> Date of Acceptance By: X <br /> MAYOR <br /> Ray Stephanson <br /> Approved as to Form <br /> X <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 /> Revised 11-0 <br />