2009/05/27 Council Agenda Packet

CITY OF EVERETT REVISED FINAL CONTRACT VOUCHER CERTIFICATION 441 CONTRACTOR: KLB Construction ADDRESS: PO Box 158 CITY: Mukilteo STATE: WA 9827.5 DATE: May 5, 2009 PROJECT TITLE: Combined Sewer Replace"I" & Water Replace"J" WORK ORDER NO. 3263 &3264 DATE WORK COMPLETE: September 30, 2008 FINAL AMOUNT: $ 3,464,175.83 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 wh'c I ma ave, ;sing out of the performance of said contract, which are not set forth in said estimate. X .46 ill P/14/ )(PRESIDENT CO ' P ` R TITLE KLB."onstruction 5,:• 1-ey Public State of Washington Subscribed and sworn t• before DALYN M. RANDALL me s s ..i 44, MY COMMISSION EXPIRES Notary Public ' i�Irt' July �, 2011 in and f• the tate of Washington, residing % inz s_ st&wAha PUBLIC WORKS DEPARTMENT CERTIFICATION _6 ICertify the attached final APPROVED Date: ;�^ estimate to be based upon actual measurements and to be true and correct. X 2 L X 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. 12