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CITY OF EVERETT <br /> f FINAL CONTRACT VOUCHER CERTIFICATION <br /> CONTRACTOR: PELLCO CONSTRUCTION INC. <br /> ADDRESS: 23105 58TH AVENUE WEST <br /> CITY: MOUNTLAKE TERRACE STATE: WA ZIP: 98043 DATE: NOVEMBER 26, 2008' <br /> PROJECT: COLLEGE STATION PROJECT NO:TR-NETC <br /> DATE WORK COMPLETE: MARCH 10, 2008 FINAL AMOUNT$2,266,125.71 <br /> (including WSST) <br /> CONTRACTOR'S CERTIFICATION <br /> I, the undersigned, having first been duly sworn, certify that the above final amount is a proper charge for work <br /> performed and material furnished to the City of Everett, that the same or any part thereof has 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 above final amount is a true and correct statement showing all the <br /> monies due me from the City of Everett under this contract;that I have carefully examined said final amount and <br /> understan• the same and that I hereby release the City of Everett from any and all claims of whatsoever nature <br /> •"ch I ,I- kr"ve,.'I *, . out of the performance of said contract which are not set forth in said final amount. <br /> it," // // / 3 ie•-i <br /> Ml HA. J LLITTERI TITLE <br /> Subscricri•:: and sworn to before me this / day of at-4— , 2008'. <br /> 4111M <br /> ie Notary Public in and for the State of Washington, <br /> ' .c'Gr./el /6"3 Notary Public <br /> ,rf-Le.c' ( cp 2 ' Z State of Washington <br /> BRFNDA P PFI I ITTFRI <br /> MY COMMISSION EXPIRES <br /> TRANSPORTATION & TRANSIT SERVICES DEPART 1. NT CEP ITATIpt 0 <br /> I certify th- ... e final amount to be APPROVED Date: /2—/ C-`-g <br /> based u••n ac al work performed and <br /> to bene ?pi. <br /> if <br /> 2 <br /> G D• ToddjteTransportation&T4.:.--- <br /> Project ervices Director,Thomas E.Hingson <br /> ADMINISTRATION USE ONLY <br /> Date of Acceptance By: <br /> Mayor,Raymond A.Stephanson <br /> INSTRUCTIONS <br /> The Affidavit of Wages Paid must be prepared by the prime contractor, all subcontractors, and all subcontractor's <br /> agents and forwarded with 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 <br /> attached. <br /> C) <br /> Ci <br />