2009/06/03 Council Agenda Packet

City CITY OF EVERETT FINAL CONTRACT VOUCHER CERTIFICATION 5 CONTRACTOR: Allied Construction Associates, Inc. ADDRESS: 3927 Colby Avenue CITY: Everett STATE:WA ZIP: 98201 DATE: May 11, 2009 PROJECT: Everett Animal Shelter PROJECT NO: N/A DATE WORK COMPLETE: March 25, 2009 FINAL AMOUNT$4,044,305.49 (including WSST) CONTRACTOR'S CERTIFICATION I,the undersigned, having first been duly sworn, certify that the above final amount 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 above final amount 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 amount and understand the same and that I hereby release the City of Everett from any and all claims of whatsoever nature which I may have, arising out of the performance of said contract,which are not set forth in said final amount. CONTRACTOR TITLE s / � `,sc ie ad om to before me this 17 day of fl , 200/_. o.,% rc Notary Public in and for the State of WashinIIC resi•, g at " S i' AseakAk Sly/.wil..Utta±4. PROPERTY MANAGEMENT DEPARTMENT CERTIFICAN I Certify the above final amount to be APPROVED Date: 5/,a ( o Based upon actual work performed and To be true and correct. d .,i1 Project Manager, Chris Lark Facilities Director, Carlton Gipson ADMINISTRATION USE ONLY Date of Acceptance By: Mayor, Ray Stephenson 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