2010/02/10 Council Agenda Packet

CITY OF EVERETT FINAL CONTRACT VOUCHER CERTIFICATION U CONTRACTOR: Corstone Contractors,LLC ADDRESS: PO Box 2280 CITY: Snohomish STATE: WA 98291 DATE: January 21,2010 PROJECT TITLE: Swift BRT Northern Terminal WORK ORDER NO. SWIFT-TER-C DATE WORK COMPLETE: January 8,2010 FINAL AMOUNT: $21,154.52 • 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 which I may have, arising out of the performance of said contract,which are not set forth in said estimate. /Mg CORSTONE CONTRACTORS,LLC X A In X t6/12-z Q_ CO '`r'CTOR TITLE NOTARY K• 7-'90� P a. 4 Subscribed and sworn to before me this l day of uULa L tO No.7-A v' m X Notary Public 1-,,, 3_0'r,2ie 0 in and for the State of Washington,residing at aft F)V\rwk, G/ TRANSPORTATION SERVICES DEPARTMENT CERTIFICATION I Certify the att.shed final APPROVED Date: l 1-2 —I estimate to b- ,ased upo actual measuremeE and to b- ue an• correct. /� X e._ P -� X 6 City 'roject Manag- Transporta on ervices Director George Baxter Thomas Hingson 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. 6