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t,Qontractor <br /> CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION 5 <br /> CONTRACTOR: Allied Construction Associates, Inc. <br /> ADDRESS: t Colby Avenue <br /> Everett STATE:WA ZIP: 98201 DATE: May 11, 2009 <br /> CITY: PROJECT NO: N/A <br /> PROJECT: Everett Animal Shelter FINAL AMOUNT $4,044,305.49 <br /> DATE WORK COMPLETE: March 25, 2009 (including WSST) <br /> CONTRACTOR'S CERTIFICATION <br /> I, the undersigned, having first been duly sworn, certify that the above final amount isthereofproper not charge <br /> for <br /> work <br /> and <br /> performed and material furnished to the City of Everett,that the same or any part <br /> that I am authorized to sign for the claimant;at the above finalI have not ramoduntri purchased atn, ad correct <br /> any statement showiment or ng froma <br /> ll <br /> any employee of the City; I further certifyd final <br /> the monies due me from the City ofrelease this <br /> th contract;Cityy ofEverett from ny and all claims of Iwhatsoeve un <br /> tI and understand the same and that hereby <br /> nature which I may have, arising out of the performance of said contract,which are not set forth in said final <br /> amount. at°°�!Aio J,►t <br /> ° f4,i0 <br /> zi <br /> __ I Ak _ .,. TITLE I ��` <br /> CONTRALTO .0t ..„" <br /> ut qq � s <br /> -��•sc i•e� a d om to before me this Notary Public n and for day of the ate of Wa hin Z �,��, . <br /> resi•, g at S ,• 70 41, 1 stis.4. ®o` <br /> iiiiiin <br /> PROPERTY MANAGEMENT DEPARTMENT CERTIFICI( ��tt <br /> w <br /> I Certify the above final amount to be <br /> APPROVED Date: 5 i g 6 <br /> Based upon actual work performed and <br /> To be true and correct. I ,,�� P <br /> 1P Or Al'. dik_ <br /> Project Manager, Chris Lark Facilities Director, Carlton Gipson <br /> ADMINISTRATION USE ONLY <br /> Date of AcceptanceBy: <br /> Mayor, Ray Stephenson <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 /> 13 <br />