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• <br /> 5 CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> CONTRACTOR: Service Electric Company ADDRESS: 1615 1st Street <br /> CITY: Snohomish STATE: WA 98290 DATE: November 10,2011 <br /> PROJECT TITLE: Evergreen Swift Stations and TSP, GCA 6129 WORK ORDER NO. TRTSPI-TRT-C <br /> DATE WORK COMPLETE: October 28, 2011 FINAL AMOUNT: $555,201.72 <br /> • <br /> • CONTRACTOR'S CERTIFICATION <br /> I, the undersigned, having first been duly sworn, certify that the attached bill is a proper charge for work performed <br /> and material furnished to the City of Everett, that the same or any part thereof has not been paid, and that I am <br /> authorized to sign for the claimant; that I have not rented or purchased any equipment or materials from any <br /> employee of the City; I further certify that the attached final estimate is a true and correct statement showing all the • <br /> monies due me from the City of Everett under this contract; that I have carefully examined said final estimate and <br /> understand the same and that I hereby release the City of Everett from any and all claims of whatsoever nature <br /> which I may have, arising out of the performance of said contract,which are not set forth in said estimate. <br /> x / �A _ x Cry Pm -T" <br /> CONTRACTOR TITLE <br /> Service Electric Company SHARON M. CARD <br /> STATE OF WASHINGTON <br /> Subscribed rd sworn to before <br /> me this'r 3 day of �0V� ,�t. 1.0i 1 NOTARY --•-- PUBLIC • <br /> ltA Notary Public / My Commission Expires 3-23-2013 <br /> in and for the State of Washington,residing at 1-4AG ,�JBVen.$ <br /> PUBLIC WORKS DEPART NT CERTIFICATION <br /> I Certify the attached final APPROVED Date: L C3 Com- <br /> estimate to be based upon actual <br /> measurements and to be true and correct. <br /> X x <br /> Construction Manager Public Wo s Dire, .r <br /> Tom Fuchs Dave Davis <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 /> Revised 9/94 <br /> • <br /> 14 <br />