Laserfiche WebLink
9 <br /> 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 /> ` +SYN ,/ <br /> /' - - x 1 '`iCV int F �O...11.E <br /> CONT'I' CT t ' lcY �i►ilYt �� TITLE <br /> IMCO genera Construction,Inc. _,40T44) y <br /> Subscribed and sworn to before me this t day of JitieutanAzLail. cp. 408ic, ; <br /> X th// -?6,--/ N+s... <br /> PO*c <br /> Notary P U =OpWAS.�� o <br /> ii»If!!LI <br /> in and for the State of Washington,residing at — <br /> PUBLIC WORKS DEPARTMENT CERTIFICATION <br /> I Certify the attached final estimate to be <br /> based upon actual measurements and to t <br /> be true and correct. APPROVED Date: <br /> X - X <br /> 7/ FUi <br /> ojkt Manager Public Wor1 `Iirector ' <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 Iabeled indicating a <br /> claim attached. <br /> 63 <br /> Revised 6/2012 <br />