2010/06/16 Council Agenda Packet

15 CITY OF EVERETT FINAL CONTRACT VOUCHER CERTIFICATION CONTRACTOR: B & L Utility Inc. ADDRESS: 7101 Sexton Road CITY: Snohomish STATE: WA 98290-6252 DATE: May 3, 2010 PROJECT TITLE: Sewer System Capacity Improvements "J" WORK ORDER NO. UP3270-2 DATE WORK COMPLETE: April 28, 2010 FINAL AMOUNT: $1,901,457.16 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. X— X—PJMg i Aje4 A P. LIFE CONTRACTOR TITLE B & L Utility Inc.r Q- � F _ Subscribed and sworn to before X me this ;: i -", day of Nla)y fo A X otary Public in and for the State of Was ington, residing at -7 t o r S-e>i-F-ah Road( L n ohom ohoi a WA TF OF W�S� PUBLIC WORKS DEPARTMENT CERTIFICATION I Certify the attached final APPROVED Date: estimate to be based upon actual ents and to be true and correct. 0 ;Jlucchs X tion Manager Public Work irecto Dave Davis 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. Revised 9/94 138