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. f1 <br /> CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> CONTRACTOR: N tcm Construction <br /> ADDRESS: 12806 Possession Lane <br /> CITY: NEdmonds STATE: ®Washington ZIP: 98026 DATE: January 8, 2009 <br /> PROJECT: Senior Activity Center Exterior Renovation PROJECT NO: N/A <br /> DATE WORK COMPLETE: January 7, 2009 FINAL AMOUNT$529,269.15 <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 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 above final amount is a true and correct statement showing all <br /> the monies due me from the City of Everett under this contract; that I have carefully examined sfinal amount <br /> and understand the same and that I hereby release the City of Everett from any and all claims ofwhatsoever <br /> nature which I may have, arising out of the performance of said contract, which are not set forth }j ������.,� <br /> amount. acid:�' t y.. .S <br /> 4/, #411,± 0 <br /> pe TRACTOR TITLE ; : PUBUC <br /> rcribed and pworn to before me this day of A.4i4et 22003.. ;�` ••°���si2o�?.•'' <br /> • <br /> ,� / . /���1z-"��, Notary Public in and for the Stat Washington, ''� WASN.C��`�� <br /> residing at____ _,2,94/62,41-, <br /> PROPERTY MANAGEMENT DEPARTMENT CERTIFICATION <br /> I f <br /> Certify the above final amount to be _ APPROVED Date: -- _1-_/JO(z_q <br /> Based upon actual work performed and <br /> T. be true and correct. <br /> xilaf, <br /> Project Manager, Rub- 'Sanchez Facilities Director, a <br /> '= Gipson <br /> ADMINISTRATION USE ONLY <br /> Date of Acceptance By: <br /> Mayor, Ray Stephanson <br /> INSTRUCTIONS <br /> The Affidavit of Wages Paid must be prepared bythe 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 /> 6 <br />