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CITY <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 <br /> DATE WORK COMPLETE: October 25, 2017 FINAL AMOUNT: $891,426.98 <br /> (Includes WSST) <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 /> XX President ‘\r``\""%iii <br /> CO RACTOR TITLE ��� KEIMir, <br /> WIWAXavatiativoitX �� � <br /> ��_?ex 14-4,',/, 4_ <br /> Kassel &Associates, Inc. scid_yy kp.RY <br /> Subscribed and sworn to before Z .' = <br /> 5. <br /> me t is 29th day of March Pot"Nom �I <br /> X Notary Public �? �I °' - <br /> in and for e State of Washington,residing at Kirkland, WA 98052 �� s'' D5, <br /> 4/41,4• rE OF Nv. <br /> • <br /> PUBLIC WORKS DEPARTMENT CERTIFICATION <br /> I Certify the attached final APPROVED Date: 1114494 <br /> estimate to be based upon actual <br /> measurements and to be true and correct. <br /> ilii X Gf <br /> IARIAL: <br /> Construction Manager Utilities Director <br /> Tom Fuchs Paul Kaftanski <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 />