2011/01/26 Council Agenda Packet

CITY OF EVERETT FINAL CONTRACT VOUCHER CERTIFICATION CONTRACTOR: Granite Construction ADDRESS: 1525 East Marine View Drive CITY: Everett STATE: WA 98201 DATE: January 3, 2011 PROJECT TITLE: ARRA Hot Mix Asphalt Overlay 2010 WORK ORDER NO. PW3400 DATE WORK COMPLETE: December 30, 2010 FINAL AMOUNT: $ 589,414.62 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, wh' • -- - .ot set forth in said estimate. �pNZE/�q �� X P(C? 1.41RE C 67szJty" ;. 0 , 5 TITLE %r S Y-' 0 Granite Construction �� o ��J��,� i ti Subscribed and sworn to before 0 o Q.� Q�� me this _d .xy ay of Jn . .O/( X € �l Notary Public STATE OF,,,, in and for the State ofVashington, residing at <!c��ii ! PUBLIC WORKS DEPARTMENT CERTIFICATION I Certify the attached final APPROVED Date: estimate to be based upon actual measurements and to be true and correct. X ,n/-,,,,,1, 41A- X Construction Manager Public Wor s Director Tom Fuchs 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 44