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CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> DATE: December 13, 2016 ADDRESS: 4027 4th St SE. <br /> CONTRACTOR: IMCO General Construction Inc. CITY/STATE: Everett,WA 98201 <br /> PROJECT TITLE: Water Pollution Control Facility Phase Cl WORK ORDER NO. 3412-17 <br /> DATE WORK COMPLETE: November 30, 2015 FINAL AMOUNT: $21,700,644.05 <br /> Exclusive of State Sales Tax <br /> CONTRACTOR'S CERTIFICATION <br /> I, the undersigned, having first been duly sworn, certify that the attached bill is a proper charge for work <br /> performed and material furnished to the City of Everett, that the same or any part thereof has not been <br /> paid, and that I am authorized to sign for the claimant; that I have not rented or purchased any equipment <br /> or materials from any employee of the City; I further certify that the attached final estimate is a true and <br /> correct statement showing all the monies due me from the City of Everett under this contract; that I have <br /> carefully examined said final estimate and understand the same and that I hereby release the City of <br /> Everett from any and all claims of whatsoever nature which I may have, arising out of the performance of <br /> said contract, which are not set forth in said estimate. <br /> 2V1 ,�� p.Y -. <br /> X x WC.0 I O t ..... �,O <br /> CONT CT f7 •.•�gS1OH •••• <br /> Tt��GV MbeVl�� TITLE G• a <br /> IMCO enera Construction, Inc. ; :c_OTq� -•? <br /> I •• • ,o''"' }": • <br /> Subscribed and sworn to before me this day of Jik4(L1 r 2017 : c1; V8L`G <br /> X d1/),(9-81'/A--' ---Vt*Ot•201"b*.A. ° <br /> Notary POc F WASH <br /> in and for the State of Washington, residing at <br /> -eG(r v h.d m �� <br /> PUBLIC WORKS DEPARTMENT CERTIFICATION <br /> I Certify the attached final estimate to be <br /> based upon actual measurements and to <br /> be true and correct. APPROVED Date: a I <br /> xI flf <br /> r_ x <br /> ole-rt Manager Public Worlire for <br /> John Nottingham Dave Davis <br /> INSTRUCTIONS <br /> The Affidavit of Wages Paid must be prepared by the prime contractor, all subcontractors, and all <br /> subcontractor's 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 <br /> claim attached. <br /> Revised 6/2012 <br />