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2018/10/17 Council Agenda Packet
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2018/10/17 Council Agenda Packet
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Council Agenda Packet
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10/17/2018
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, <br /> k. n <br /> JL 3 <br /> CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> DAl'E: March 29,2018 ADDRESS: P.O. Box 97 <br /> CONTRACTOR: Marshbank Construction Inc. CITY/STATE: Lake Stevens, WA 98258 <br /> PROJECT TITLE: 41st St to WMVD Freight Corridor Improv. WORK ORDER NO. PW-3472 <br /> DAl'E WORK COMPLETE: February 2,2018 FINAL AMOUNT: $3,083,395.47 <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 paid, and <br /> that I am authorized to sign for the claimant; that I have not rented or purchased any equipment or materials <br /> from any employee of the City; I further certify that the attached final estimate is a true and correct statement <br /> showing all the monies due me from the City of Everett under this contract; that I have carefully examined said <br /> final estimate and understand the same and that I hereby release the City of Everett from any and all claims of <br /> whatsoever nature which I may have, arising out of the perfolluance of said contract, which are not set forth in <br /> said estimate. <br /> x � x FRCS/0Eo� <br /> CONTRACTOR ����� II Y/Vi <br /> IZ'1'LE .`` \-�E C UN/11 fr, ,�, <br /> Marshbank Construction Inc. ,Z. .. -,;ss o,, -.. 2 <br /> Subscrio0n.; • . to .efore me this 1aO7 day of ,art,/ 201 c: --q y -cc-u„:1 <br /> v <br /> X R* - �� T' o US L I C <br /> otary a d �•�9�F` 4•�2.20 .••. .-'`-' <br /> I <br /> In an. for .e State of Washington,residing at I1 ��5/ kd /'�'�ii�„,„ASH, G��``\ - <br /> S! .)-2iv[ks , un q/1090 <br /> PUBLIC WORKS DEPARTMENT CERTIFICATION <br /> • <br /> I Certify the attached final estimate to be <br /> based upon actual measurements and to <br /> be true and correct. APPROTED Date: Vatrit t <br /> 7. <br /> X �. . X 61e44/ •'-r7 �w <br /> Construction Manager Public Works i erector <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 /> 46 <br />
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