2018/09/26 Council Agenda Packet

5 CITY OF EVERETT FINAL CONTRACT VOUCHER CERTIFICATION CONTRACTOR:R.L.Alia Company ADDRESS: 107 Williams Avenue S. CITY: Seattle STATE: WA 98057 DATE: April 12, 2018 PROJECT TITLE: Hayes Street Regulator&CSO Controls (SR01, SR02 &SR03) WORK ORDER NO. UT3398-31 DATE WORK COMPLETE: April 11, 2018 FINAL AMOUNT: $3,104,509.11 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 whatsoever nature which I may have,arising out of1performance of said contract,which are not set forth in said estimate. _� ii, PA NK/6, X-::"(1/1t5/7.r / X f w ?f 51)e `.lQ �510NF1p•�,� .0 CONTRACTOR TITLE =o_ NpTARY R.L.Alia Company + -' PUBLIC Z. Subscribed and sworn to before � �T •..?!;2w�?�a•'��.` X e this/i ay of/PPJ L, z Public •�',i yup wp x-• `� in and foif the State of Washington, residing at Ic ralg • PUBLIC WORKS DEPARTMENT CERTIFICATION I Certify the attached final APPROVED Date: estimate to be based upon actual measurements and to be true an. c%rrect X gn/ zAti_ X / Construction Manager Ut'l ies Director Tom Fuchs Paul Kaftanski 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 9/94 22