2010/03/31 Council Agenda Packet

4 CITY OF EVERETT FINAL CONTRACT VOUCHER CERTIFICATION CONTRACTOR: ® Corstone Contractors, Inc. ADDRESS: P.O. Box 2280, 1910 Bickford Ave, Ste A CITY: ®Snohomish STATE: ®Washington ZIP:98291 DATE:March 2, 2010 PROJECT: Fire Station No. Four-Exterior Building Envelope Repairs PROJECT NO:N/A DATE WORK COMPLETE: March 1, 2010 FINAL AMOUNT$355,641.88 (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 and rstand t same and tha •ereby release the City of Everett from any and all claims of whatsoever nature is I m ha'- nsin. out of the performance of said contract,which are not set forth in said final amo,nt �': ckS CONTRACTOR TITLE L. da of y r i�f'C:112010. �7.Tcribed nd s ore be a me this y " i'Ui� '. 21 tary Public in and for the State of Washington residinga�k��51n ( , ; . PROPERTY MANAGEMENT DEPARTMENT CERTIFICATION . Certify the above final amount to be APPROVED Date: � I7 f 10 Based upon actual work performed and To be true and correct. 21M--Project Manager, ub (47 Cepy en Sanchez Facilities Director, Ca ton Gipson ADMINISTRATION USE ONLY Date of Acceptance By: Mayor, Ray Stephanson 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. 9