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3 <br /> 12 <br /> CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> CONTRACTOR:Kassel&Associates,Inc. ADDRESS: 7126 180th Ave NE#C103 <br /> CITY:Redmond STATE: WA 98052 DATE: March 23.,2018 <br /> PROJECT TITLE:WFP Operations Bldg. Seismic Retrofit–Rebid WORK ORDER NO. UT3600 5 <br /> DATE.WORK COMPLETE: October 25,2017 FINAL AMOUNT:$891,426.98. . <br /> (Includes.WSST) <br /> t <br /> CONTRACTOR'S CERTIFICATION i <br /> i <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 /> r <br /> X �-7, X President <br /> CONTRACTOR TITLE \\\\‘‘‘‘trtt� 1 <br /> 1 i <br /> Kassel &Associates, Inc. _o _itY E ��1'�i��o� • <br /> i, <br /> Subscribed and sworn to before r Z; , u c <br /> rn t 29thday of March w .5N o l <br /> .� cv' <br /> X ss Notary Public 0j%0_ 'p%moo;=n - <br /> in fon State of Washington,residing at Kirkland, WA 98052 �i, 6- '',,,� Oh,`�-T`= <br /> /,/rill TA1� -,z" <br /> I <br /> x <br /> 1 <br /> PUBLIC WORKS DEPARTMENT CERTIFICATION <br /> 11 1 <br /> I Certify the attached final APPROVED Date: ieh b h 4' 4 <br /> estimate to be based upon actual i <br /> measurements and to be true and correct. CGti 1 IiI <br /> Xoie x t <br /> uction <br /> Manager Utilities Director <br /> Tom Fuchs Paul Kaftanski <br /> I <br /> N <br /> INSTRUCTIONS 'i <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 /> i <br /> Revised 9/94 l <br /> ti <br /> I <br /> i <br /> 50 s <br />