KLB Construction Inc. 7/10/2018 - Laserfiche WebLink

CITY CITY OF EVERETT FINAL CONTRACT VOUCHER CERTIFICATION DATE: January 29, 2018 ADDRESS: PO Box 158 CONTRACTOR: KLB Construction, Inc. CITY/STATE: Mukilteo WA 98275 PROJECT TITLE: Sewer System Replacement & Capacity WORK ORDER NO. UP 3470-10 Improvement Sewer"M" Project, Phase 2 FINAL AMOUNT: $4,524,152.39 ATE WORK COMPLETE: December 21, 2017 Exclusive of State Sales Tax CONTRACTOR'S CERTIFICATION I, the undersigned, having first been duly sworn, certify that the attached bill is a proper charge for work performed and material furnished to the City of Everett, that the same or any part thereof has not been paid, and that I am authorized to sign for the claimant; that I have not rented or purchased any equipment or materials from any employee of the City; I further certify that the attached final estimate is a true and correct statement showing all the monies due me from the City of Everett under this contract; that I have carefully examined said final estimate and understand the same and that I hereby release the City of Everett from any and all claims of whatsoe nature whi I may have, arising out of the performance of said contract, which are not set forth in said I ate. CO TRAC OR TITLE KLB Construction, Inc. Subscribe4and sworn to before me this fl‘ii day of _ /,.,L,, 2Q+&2 vt S C� .r'' �F 0 _- ¢L !� 51oN `C( Notary Public '' oma•' 4:$• 1%' in and for the State of Washington, residing at �� d N O TA R y - , PUBLIC LoY . .# ()F WASH' PUBLIC WORKS DEPARTMENT CERTIFICATION I Certify the attached final estimate to be based upon actual measurements and to /a be true and correct. APP7,1 __VEDDa e: G/ !( X'��o�i✓ � X ctuD • Construction Manager Public orks Director Tom Fuchs Paul K anski INSTRUCTIONS The Affidavit of Wages Paid must be prepared by the prime contractor, all subcontractors, and all subcontractor's agents and forwarded with the Final Contract Voucher Certification. Contractor's Claims, if any, must be included and the Contractor's Certification must be labeled indicating a claim attached. Revised 6/2012