Bid PW 02-00-12-20 Billing Docso�� �K���tio PURCHASE ORDER
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V: „—� r" 55 S.E. THIRD AVENU�
- z �` OKE�CHOBEE, FLORIDA 349i4-2903
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THIS ORDER SUBJECT 70 CONDITIONS ON FACE. NO
CHANGE5 MAY BE MAp� WITMOUT WRITTEN P�RMISSION
OF PROCUREMENT MANAQEMENT.
DATE I VENDOR N0. I D�LIVERY DATE
INO. I ACC7. NUM�ER I QUANTITY I UNIi
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INVOICE IN DUPLICATE;
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F.O.B. DESTINATION
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CITY OF OKEECHOBEE IS EX�MpT FROM FEpERAL EXCI&E ANO TRANSPOR7ATION
TAXE8 AND STATE SALES TAX. DO NOT INCLUDE TH�SE YAXE9 IN YOUR lNVOIC�.
EXEMPTION CERTIFICATE WILL BE SIGNEp UPON REQUEST
STATE SAl.ES TAX @XEMPTION 8b•8012621666C-8.
FEpERAL I.D. 59-6000393.
AUTHORIZED SIGNATURE
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TERMS
AMOUNT
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RECEIVING RECORD
UNIT
PARTIAL [] FINAL ❑
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PURCHASE REQUISITION
CITY OF OKEECHOBEE
55 S.E. Third Avenue
Okeechobee, FL 34974-2903
Tel: 863-763-3372
Fax: 863-763-1686
B& B Site Development, Inc.
1505 C South Parrott Ave
Okeechobee, FL 34974
THIS ORDER SUBJECT TO CONDITIONS ON FACE.
NO CHANGES MAY BE MADE WITHOUT WRITTEN
PERMISSION OF PROCUREMENT MANAGEMENT.
f'i�,����
�?-18�1`I
Req. No. 16469
Important: This number must
be shown on ail invoices,
packages, cases, tickets and
correspondence.
SHIP TO:
City of Okeechobee
55 SE Third Avenue
Okeechobee, FL 34974
INVOICE IN DUPLICATE:
�F�.
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DATE VENDOR NO. DELIVERY DATE SHIP BEST F.O.B. DEST. TERMS
02/12/21 N/A N/A N/A N/A NET 30
ITEM NO ACCT. NUMBER QTY UNIT DESCRIPTION AMOUNT
1��"� ��C�,./Q�j � PW 02-00-12-20 City of Okeechobee $184,813.65
Taylor Creek SE 8th Avenue
Stormwater Conveyance
Bid awarded 2/2/21 by City Council
Drawdowns
TOTAL $184,813.65
cllY UF OKEECNOBEE 15 EXEMPT FROM FEDERAL EXCISE AND TRANSPORTATION
TAXES AND STATE SALES TAX. DO NOT INCLUDE THESE TAXES IN YOUR INVOICE.
EXEMPTION CERTIFICATE WILL BE SIGNED UPON REQUIEST.
STATE SALES TAX EXEMPTION NO. 85-8012621656C-6
FEDERAL I.D. NO 59-6000-393 � �
RECEIVING RECORD
❑ PARTIAL
,TURE
X FINAL
..;r.�.
'Y� -�`� City of Okeechobee
,;'-`�,> Checklist for Purchase Requisitions/Purchase Orders
Today's Date:
U'1�-��
Vendor � � � � Originating
�d�b �,�� .1��.,�.1,�,.i(��►�Y1�.�1�'� �✓1C
IrJU�a ('_, 5.. ( C�ry'L� ✓L'ni.C�,
1� i IC.Cr.('_CVIi)1'� �,i' : �L .3�I�r 7�j
Sec6on I.
Please mark each item YES or IVO to determine if the checklist of minimum requlrements for an item and
service is needed for your department prior to ordering/purchasing the item/service. If the answer is YES
any of the below, please include the items listed in Section II.
B. Is the vendor coming on city property other than deliverina an
a contract for
limits
Section II.
a�w• ��,a �o ,�
Form ���
(Rev. October 201 S)
Department of the Treasury
Internal Revenue Service
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the
following seven boxes.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line
B&B Site Development, Inc,
2 Business name/disregarded entity name, if different from above
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❑ Individual/sole proprietor or
single-member LLC
Request for Taxpayer
Identification Number and Certification
► Go to www.irs.gov/FormW9 for instructions and the latest information.
❑ C Corporation ❑✓ S Corporation ❑ Partnership
(Applies to accounts maintained outside the U.S.)
Give Form to the
requester. Do not
send to the IRS.
4 Exemptions (codes apply only to
certain entities, not individuals; see
instructions on page 3):
Exempt payee code (if any)
❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ►
Note: Check the appropriate box in the line above for the tax classification ot the single-member owner. Do not check Exemption from FATCA reporting
LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is code (if any)
another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that
is disregarded from the owner should check the appropriate box for the tax classification of its owner.
U Other (see instructions) ►
5 Address (number, street, and apt. or suite no.) See instructions.
1505 C South Parrott Avenue
6 City, state, and ZIP code
7 List account number(s) here
❑ TrusUestate
Requester's name and address (optional)
� Taxpayer ldentification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see Now to get a
TIN, later.
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and
Number To Give the Requester for guidelines on whose number to enter.
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or
Employer identification number
v0000���r��
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withhoiding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign Signature of
Here U.S. person ►
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www.irs.gov/FormW9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS must obtain your correct taxpayer
identification number (TIN) which may be your social security number
(SSN), individual taxpayer identification number (ITIN), adoption
taxpayer identification number (ATIN), or employer identification number
(EIN), to report on an information return the amount paid to you, or other
amount reportable on an information return. Examples of information
returns include, but are not limited to, the following.
• Form 1099-INT (interest earned or paid)
Date ►
Form 1099-DIV (dividends, including those from stocks or mutual
• Form 1099-MISC (various types of income, prizes, awards, or gross
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest),
1098-T (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident
alien), to provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might
be subject to backup withholdrng. See What is backup withholding,
later.
Cat. No. 10231X Form W-9 (Rev. 10-2018)
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�lication and Certificate for Payrnent �
TO Contractor: Cify of Okeechobee PROJECT: Taylor Creek SE Sth Ave APPLICATION N0: 1 Distribution to:
55 SE 3rd Avenue Stormwater Conveyance PERIOD T0: 3/19/2021 OWNER: x
Okeechobee, FI34974 , � } , ARCHITECT:
FROM 8&B Site Development Inc VIA i' ��}y�, � t�N� y CONTRACT DATE: 2/12/2021 CONTRACTOR:
CONTRACTOR: 1505 S ParrotfAve ARCHITECT: �'����=i',:., PROJECT NOS: PW 02-00-12-20 FIELD:
Okeechobee, FL 34974 �' 'i� { . ''� f -'• �i,�ry�s ' OTHER:
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the ConVactor's knowledge, information and belief the Work
Application is made for payment, as shown below, Ifl COf1f12CfI0fl Wlth fh8 C011t1'BCt. covered by this Application for Payment has been completed in accordance with the Contract Documents, that all
amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and
Continuation Sheet, AIA DoCument G703, IS BttaChEd. payments received from the Owner, and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM ................................................ $ 184,813.65 �.
2. NET change by Change Orders .......................................... $ _
3. CONTRACT SUM TO DATE (Line 1+2) .................................. $ 184,813.65
4, TOTAL COMPLETED & STORED TO DATE (Column G on G703) ... $ 72,037.03
5. RETAINAGE:
a. 10% % Of Completetl Work $ 7,203.70 �,
(Column D+E on G703)
b. 10% % of Stored Material
(Column F on G703)
Total Retainage (Lines 5a+5b or Total in Column I of G703)
6. TOTAL EARNED LESS RETAINAGE ....................................
(Line 4 less Line 5 Total)
7. LESS PREVIOUS CERTIFICATES FOR PAYMENT .................
(Line 6 from prior Certificate)
8. CURRENT PAYMENT DUE .................................................
9. BALANCE TO FINISH, INCLUDING RETAINAGE
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CONTRACTOR• t
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BY� Date: *
State of: kCoun y of: ` �
Subscribed and sworn to before me thist: :l' day of CL(?-�1 20�
� � ,is'r Notary Public Stai2 oi Flarida
Notary Public: � � j,�, (��L�, (1 �� � ��,
Paity NA Bume4te
My Commission expires: �::_ e My Commission I-II-I oGA73�
�6rn.� Ex�u�s t�/02/202a
� 7,203.7o ARCHITECT'S CERTIFICATE FOR PAYMENT
$ 64,833.33
In accordance with the Contract Documents, based on on-site observations and the data comprising this
application, the Architect certifies to the Owner that to the best of the ArchitecYs knowledge, informa6on and belief
the Work has progessed as indicated, the quality of the Work is in accordance with the Contract Documents, and
the Contractor is entitled to payment of the AMOUNT CERTIFIED.
$ 64,833.33 �,_
; 1��.
AMOUNT CERTIFIED .......................... .l: .............. (�,�>� ��,1 3.�
(Attached explanationif amount cert�ed diHers from the amoun ...�plied. Initial all figures on this Application and on the �
Continuation Sheet that are changed to conform with the amount cerfified.J
ARCHITECT: --"`" � -
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gy: _ ,._ ;,�-' DATE: ��t�Li
This certificate is not negotia6le. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment
and acceptance of payment are withdut prejudice to any rights of the Owner or Contractor under this Contract.
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ana mcemauonai i reanes. unaumonzea reproaucuon or a�scnouuon or [ms r�ir� Locumen[, or any pomon oi ic, may resun m severe crvu ana cnmmai penames, ana wm oe prosecucea co me max�mum
excenc possioie unaer cne iaw. i nis aocumenc was proaucea oy ruH soituvare ac iµ:4a:s+ un variai�uui unaer �raer ivo.'iuuu�aav�o_ i wnicn expires on ainr�uvo, ana is noc ror resaie.
User Notes: ,
(Line 3 less Line 6) $ 119,980.32 ;�`
���� Do��t,�rt��r"!t '+�?i)��'" -- '1:'�'9��
Continuation Sheet
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT,
containing Contractor s signed certification is attached.
In tabulations below, amounts aze stated ro the nearest dollar.
Use Column I on CoNracts where vaziable retainage for line i[ems may apply.
From: I3KB Site De�rlopment, (nc.
Jab: Ta� lrr C'reck Sl� f;th A� enue
Loc: Okccchobee. FL 3-497-F
APPLICATION NO:
APPLICATION DATE:
PERIOD TO:
ARCHITECT'S PROJECT NO:
3/19/2021
3/19/2021
PW 02-00•12•20
A B C D I? F G H I
WORK COMPLETED MATERIALS TOTAI
FROM THIS FERIOD PRESENTLY
ITEM DESCRIPTION OF WORK PREVIOUS STORED (NOT COMPLETED ,�a BALANCE TO RETAINAGE (IF
N0. AND STORED FINISH VARIABLE
UNIT APPLICATION IN D OR E) TO DATE (G / C) (C - G) RATE)
MEAS QUANTITY UNITCOST SCHEDULEDVALUE (D+E) �D+E+F)
� Mob and Demob LS t $ 9,400.65 S �1,700.33 $ 4,700.33 50°/a $ 4,700.32 $ 470.03
z Turbidity controls LS i $ 1,055.00 5 $ o°io $ �,055.00 g -
3 Piping materials and inlets (Excluding 5 sr,836.70
Seporator) �S � $ 64,263.00 $ 57,836.70 90% $ 6,426.30 $ 5,783.67
4 Drainage Seporator LS � $ 32,550.00 $ $ - o°io g s2,550.00 $ -
5 Maintanenance of Traffic �s � g s,0o0.0o S :�,aoo.00 g s,000.00 ao�ia $ s,000.00 $ soo.00
6 Concrete Sidewalks curbing and Driveways �S + $ 30,845.00 $ - o°ia $ so,845.OD $ -
� SubbaselBase Material Placement including � g g,000.00 5 a,5oo.00
com action LS $ 4,500.00 50% $ 4,500.00 $ 450.00
e Roadway Paving LS � $ 21,700.00 $ - o°io $ 2�,�00.00 $ -
9 Roadway Markings, Striping & Signage LS � $ 3,000.00 S o°ia $ s,000.00 $ -
�o Project Stabilzation and cleanup LS � g 3,000.00 $ - o% $ s,000.00 $ -
�+ Construction LayoutlRecord Drawings LS � $ 4,000.00 S :�,000.00 g 2,000.0o so°io $ 2,000.00 $ 200.00
S
S -
S -
$ -
�
$ 184,813.65 $0.00 $0.00 $72,037.03 $0.00 $72,037.03 39% $112,776.62 $7,203.70
OKEECHBEE COUNTY CEMETERY ROAD IMPROVEMENTS SOV PAGE 1 OF 1
�c��°tial Waive� anc� Release o,,f'Lien
(C'ontinent upon receipt of payment)
The undersigned lienor, in consicleration of the sum of $ 64,833.33 hereby releases Its lien
and rights to claim a lien for labor, services or materials furnished Thru 3-19-2021 to CITY
of Okeechobee the property described below for the City of Okeechobee
The following described property: C�� oP Okeechobee Taylor Creek
SE St°' Avenue Conveyance
@ SE �th avenue and SE 6th Court
�F: I�rainage work per contract
This waiver and release does not cover any retention or labor, services or materials furnished after
the date specified above.
�
I)ated: � ,� �?�'
I,ienor's Name:
B&B Site Development, Inc.
1505 C South Parrott Avenue
State of Florida
County of � (��Qe.C,{� bQ.2�
The foregoing was subscribed before me this ��,�f�� day of �!jC���`C�-� , 2021
By rn r��n � �: �� i-,�, _,`,fi;�}�,,,,!'o f ��- �- ��� �)��� �� L`k=;;� �c;�� f,f�? {�-�-, i l'�.��.. Who is personally known
And who acknowi'edged before me that the same was executed freely and voluntarily for
the purposes therein expressed (under authority duly vested by said corporation)
My commission expires:
r�
�' ; Patty M BurnetQe
�� � My Commission I-II-I UOt3'%3�M
q�� Expves 10/02/202A
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� i�l.�� �J�1t ° ���'f. � Y(', ( ;.,�.
Notary P blic, State of Florida
Okeechobee, Florida 34974
3 l�"� k�+ � "TAr'+,�Jo►cs�'c= :�u� :� ; �
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Uni�fed °
_ Renta/�
Construction Notice Dept.
PO Box 1389, Simi Valley, CA 93062 93 l4 8898 8030 0015 9641 23
Addi�ess Service Regzresled
3/15/2021
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE, FL 34974
UNR704 6007556
,,<C��,:��
Enclosed you will find a notice that is being sent to you on behalf of United Rentals (North America), Inc. in
regards to the const►•uction project known as SE 8TH AVE 1MPROVEMCNTS 24 and located at SE 8TI-[
AVE AND SR 70 , OKEECHOBEE, FL 34974. The name and address of the person who contracted for the
furnisl�ing of equip�nent is B& B SITE DEVELOPMENT INC 1505 S PARROTT AVE UNIT C,
OKEECi-IOBEE, FL 34974-6i29. Thank you ior iaki��g the time to read this lett�r.
This is NOT a Lien or Bond Claim and does not necessarily indicate any
amounts are currently overdue
This notice is being sent to make you aware we have provided services to someone contributing to this
construction project. This is a common procedure required by statute in many states. This notice is not
recorded and is not public information.
This notice should not reflect in any way on the integrity or credit standing of any parties associated
with this job.
Answers to a few common questions regarding the enclosed notice:
What do I do if this notice contains inaccurate information?
We attempted to verify all information before sending this notice. If any of the construction parties listed on
the document are incorrectly referenced or you discover any other inaccuracy in the info�•mation, please contact
our third party provider at 800-522-3858 ar email united@crfsolutions.com.
Our records indicate the following parties are associated with this job:
Owner: CITY OF OKEECHOBEE, OKECCHOBEE, FL
General/Direct/Original Contractor: B& B SITE DEV�LOPMENT INC, OICEECFI013E�., F"L
Lender/Surety:Please advise if Lender/Surety applicable
How do I obtain invoice copies, make payments, or request a lien release/wliver?
Customers may access all of the above via UR Control at www.unitedrentals.com (clicic on Online Services,
then UR Control), or by calling 888-481-2660. Lien releases requested via UR Control will be provided within
24 hours. Those requested via email (lienreleases@ur.com) or by phone will be provided within 72 hours.
NOTICE TO OWNER/NOTICE TO CONTRACTOR
(Preliminary Notice, Notice Of Intent To Claim Against Bond)
WARNING! FLORIDA'S CONSTRUCTION LIEN LAW ALLOWS SOME UNPAID CONTRAC'TORS,
SUBCONTRACI'ORS, AND MATERIAL SUPPLII:RS TO FII,E LIENS AGAINS'I' YOUR PROPTRTY f VL'N IP YOU
HAVC MADC PAYM�NT IN FULL.
UNDER FLORIDA LAW, YOUR PAILURE TO MAI<E SURG THAT WE ARE PAID MAY RESULT IN A LIEN AGAINST
YOUR PROPERTY AND YOU PAYING TW[CE.
IO.�VOII) -\ I.IF.N:\�I) I';\1'INCi I WICI{. YOli \il`�"I�OI;'I;�1N �1 �1'IZl l I�I:\ Itl;Lii.\til: I RUtii t'ti I\'I:RI' "I'I��11:
YOU PAY YOUR CONTRAC"I�OR.
TO THE OWNGR:
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE, FL 34974
CUSTOM�R:
B& B Si'I'E DEV�LOPMENT INC
1505 S PARROT"I' AVE UNIT C,
OKEECIiOBEE, FL 34974-6129
The undersigned hereby informs you that he has furnished or is tLrnishing services or materials as foflows: Various Construction
Equipment Rentals, for the improvement of real property identified as: SE 8TH AVG IMPROVEMENTS 24. The property is located
at: SE 8TH AVE AND SR 70, , OKEECHOBEC, FL 34974, APN#: . Under an order given by: B& B SIT� DEVELOPMCNT [NC,
1505 S PARROTT AV� UNIT C, , OKECCHOBEG, FL 34974-6129
A demand is made for a copy of the Notice of Commencement to be faxed to 805-�22-7171, or email to
myjobinfo a crfsolutions.com. Any demand made pursuanC to Sec[ion 713.16(2) or Section 713. I G(4) or Section 255.05, Fiorida
Statutes, must be served as follows:
Name ot Lienor:United K�n�ais (�iorth An�cricu), iuc.
10330 llavid Taylor Drive
Cliarlotte, NC 28262 800-522-3858
PLORIDA LAW PRESCRIBCS TI-I� SERVING OF THIS NOTICE AND RESTRICTS YOUR RIGI-IT TO MAI<E PAYMGNTS UNDL'R
YOUR CONTRACT IN ACCORDANCE WITH SECTION 713.06, FLORIDA STATUTCS. IF J06 IS BONUCD UNDER SECTiON
713.23 I'LORIDA STATUTES, SECTION 255.05 FLORIDA STATUTGS OR 270 U.S.C. THE F1RM SGNDING TI-IIS NOTICG WILL
LOOK TO THE BOND (SURETY CO.) POR PROTECTION IF NOT PAID. IF PAYMGN7' BOND GXISTS, PURNISH A COPY 1'O
THE UNDCRSIGNED. PROVIDE NAME AND ADDRESS OP [30NDING COMPANY. FAILURL-' TO PROVIDE Tl-llS
INFORMATION MAY RENDER YOU LIABLE I�OR DAMAGES. 1'LGASE R�FER "f0 T}-1� C[Z}' NUMBGR LIS'I�ED F3L'LOW WtITN
RESYONDING. IT' TI-iERC 15 MORE THAN ONE CONTRACTOR ON THE EN'('IRC PRO.iLC`C, PLEASE FURNISFI TI-1L'
UNDERSfGNGD WITH A COPY OF rACH CONTRAC"C.
IMPORTANT INFORMATION I=OR YOUR I'ROTECTION
Under C'lorida's Laws, those who work on your property or provide materials who are not paid have a right to enlorce their claim f'or
payment against yow� property. This claim is Icnown as a Construction Lien. lfyour contractor fails lo pay subconfractors or inaterials
suppliers or neglects to make other legally required payments, the people wllo are owed money may lool< to your property for payment,
EVEN IF YOU HAVE PAID YOUR CONTRACTOR IN PULL.
PROTECT YOURSELF - RECOGNIZE diat this Notice to Owner may result in a lien against yow• property unless all those supplying a
Notice to Owner have been paid.
LEARN more about the Construction Lien I,aw, Chapter 713, Part I, and Chapter 255, Florida Seatutes and the meaning of this Notice by
contacting an attorney or che Florida Dept. of Business and Professional Regulation.
I declare that I am authorized to tile chis claim on bchalf of the claimant. 1 have read the foregoing document and I:now the conients thereof;
the same is true of my own I<nowledge. I declare under penalty oPperjwy thac the foregoing is h•ue and correct. Executed at Simi Valley, CA
on 3/15/2021 for United Rentals (North America), Inc. .
6y: Laura Pavey / Authorized Agent for United Rentals (North America), Inc.
CC: TO ORIGINAL CONTRACTOR
B& B S[TE DCVELOPMENT INC
1505 S PARROTT AVE UNIT C
OKEECHOBCE PL 34974-6129
Cert #: 9314 8898 8030 0015 9641 23
CRP#: 6007556
CC: TO LENDI;R, SURCTY OR BONDING COMPANY
Bond/Loan #
C.onstruction Notice Department
P.O. Box 1389 • Simi Valley, CA 93062
�9ddre,rs Scrvice RequestcA
Y BOWES
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: �;(y,`� ���
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, ' �*� � 0000352408 MAR 15 2021
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+I�IF;i,j,jfiiliil��!'I�'lill�ll#,j�ii�jij�i�,i,j.jiiFai=ilttr�t'
I get you the release once Ive been paid but before my
next draw is released.
at least that's how I have done it for years with the
county.
I do not have the funds to pay before I get paid. That is
why the retainage is held as well.
Michelle Baughman,
President
On Tue, Mar 23, 2021 at 11:29 AM Patty Burnette <pburnetteC�citvofokeechobee.com> wrote:
' Hi Michelle.
I forgot to mention to you this morning that I received this Notice to Owner in the mail yesterday. I believe
we will need a release from them before we can pay.
� Patt� 2V1. Burnette
'; �jenera�Services Coorc�inator
� Cit� of O�eec(�o6ee
' SS S.� 3Y`� �venue
O(eec�o6ee, �FL 34974
! P�one: (8 63� 763 -3372 ext. g 82 0
Direct: (863� 763-9820
rFax: (863� 763-1686
Qi ve�a�c� ��� ��- �f
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Patty Burnette
From: Patty Burnette
Sent: Tuesday, March 23, 2021 11:57 AM
To: Michelle Baughman
Subject: RE: Notice to Owner
Ok I will let you know if something is different.
Patt� M. Burnette
C�enera�Services Coord�inator
Cit� of O�eec(�o6ee
55 S� 3"� �Lvenue
O�eec�io6ee, rFL 34974
P�one: (863� 763-3372 ext. g8�o
Direct: (863� 763-g82o
�Fax: (863� 763-1686
e-maiC �6urnette@cit�ofo�eec(�o6ee.co�ri
�
we6site: www.cit�uofo(�eec�io6ee.cor►i
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Under Florida law, email addresses are public records. If you do not want your email address released in
response to a public records request, do not send electronic mail to this entity. Instead, contact this office by
phone or in writing, Florida Statute 668.6076.
CITY OF OKEECHOBEE ELECTRONIC DEVICE DISCLAIMER: Florida has a very broad public records law.
Most written communications to or from local officials regarding city business are public records available to
the public and media upon request. Your correspondence via e-mail, text message, voice mail, etc., may
therefore be subject to public disclosure.
From: Michelle Baughman <bbsitedevelopmentinc@gmail.com>
Sent: Tuesday, March 23, 2021 11:44 AM
To: Patty Burnette <pburnette@cityofokeechobee.com>
Subject: Re: Notice to Owner
No ma'am
�. �#'R � � �p�, ; r�,� ��a�
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�.�_ c.� ��c ,� f.�-rti..� �.^� t �`�c� �'�- ..�. '1 '�9 ;� � ,,� �i � �t � lQ � 1..� 7 �. f �?
�lication and Certificate for Payment ;`a ��c,�,�.:�-:, b
_� -; �-�,
TO Contractor: City of Okeechobee PROJECT: Taylor Creek SE 8th Ave APPLICATIOIV N0: 2 Distribution to:
55 SE 3rd Avenue Sformwater Conveyance PERIOD T0: 4/20/2021 OWNER: x
Okeechobee, F134974 ARCHITECT:
FROM 8&8 Site Development Inc VIA CONTRACT DATE: 2/12/2021 CONTRACTOR:
CONTRACTOR: 1505 S Parrott Ave ARCHITECT: PROJECT NOS: PW 02-00-12-20 FIELD:
Okeechobee, FL 34974 OTHER:
Co� f , j PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work
�� �/) �/1 � j � � J, � covered by this Application for Payment has been completed in accordance with the Contract Documents, that all
App �,�.,t t, r� ��� � belOW, IIl COf1118CtI0f1 Wlth th2 COf1f�8Ct� amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and
, � 8ff8Ch8d. payments received from the Owner, and that current payment shown herein is now due.
COn , ,
2. � ��Q►UJ�,�� �'��L' ................................. $ 184,813.65 "� � �
� �� �� 6 � ��� �� �� .
......................... $ - CONTRACTOR: �
�.. _.
3. C $ 184,813.65 By: �, Date: � � t%
4. T ATE (Column G on G703) ... $ 142,563.33 e` � State of: Co nty of:
5. R�. �,,.,,.,�. � Subscribed and sworn to before me this o�o ay of 14 p�-i � 2021.
a. 10% % Of Completed Work $ 14,256.33 �� � �
(Column D+E on G703) Notary Public: �"� U��v �us� s�c� �r F►o��.� p �
Traci �ut3htan
b. 10% % of Stored Material M Commission ex � r_ M C�is� F!N 013�57
(Column F on G703) Y �q�d� _ t a�� 9cu_�rzoaa
Total Retainage (Lines 5a+5b or Total in Column I of G703)
6. TOTAL EARNED LESS RETAINAGE ....................................
14,256.33 ARCHITECT'S CERTIFICATE FOR PAYMENT
$ 128,307.00 ��
(Line 4 less Line 5 Total) In accordance with the Contract Documents, based on on-site observations and the data comprising this
7. LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 64,833.33 ��� application, the Architect ce�ifies to the Owner that to the best of the ArchitecYs knowledge, information and belief
""""""""' the Work has progessed as indicated, the quality of the Work is in accordance with the Contract Documents, and
(Line 6 from prior Certificate) the Contractor is entitled to payment of the AMOUNT CERTIFIED.
8. CURRENT PAYMENT DUE '
................................................. $ 63,473.67 �`
9. BALANCE TO FINISH, INCLUDING RETAINAGE
(Line 3 less Line 6) $ 56,506.65 ��� AMOUNT CERTIFIED .................................................... � .` � I`
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS
Total changes approved in previous months by Owner
Total approved this Month
TOTALS � _ � _
NET CHANGES by Change Order � _
(Alfached explanationif amount cedified dillers fiom the amount applied.Jnitial all (gures on this Application and on the
Continuafion Sheet that are changed to con(orm with the amountcerfified.J
ARCtlITfGT� - , , , _ _ ----- = , ------ . , `
BY� DATE:
This certiflcate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment
and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.
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ocu e - . opyri , , , an e merican ns i e o rc i ec s, rig s reserve . . is • ocumen is ro ec e y.. opy aw
ai ia inzerna[�onai i reanes. unaumonzea reproaucnon or mscriounon oi mis rur� Locumenc, or any porr�an oi n, may resuic ro severe civii ana cnmmai penames, ana wiii oe prosecucea co cne maximum
extenz possioie unaer cne iaw. i nis aocumenz was proaucea oy Hw soirvuare at iv:va:s4 un uariyi�uw unaer vraer rvo. iuw�as4�o_ i wnicn expires on sicu�uua, ana is noz ror resaie.
User Notes:
���� t3ca�c�ur��e�'t# �G�'E�3�.' — 'L 9�''.3�
Continuation Sheet
AIA Document G702, APPLICATION AND CERT[FICA'ITON FOR PAYMENT
containing Contractor s signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where vaziable re[ainage for line items may apply.
From: lic�.f3 Sitc De�'NIU}Jlll�fit. Illl'.
Juh: Ta� lur ('reek SI: �{th �lvrnuc
Loc: Okr�chub��, [�I. 3�1�)7�
APPLICATIOIV NO:
APPLICATION DATE:
PERIOD TO:
ARCHITECT'S PROJECT NO:
M20/2021
4/20/2021
PW 02-00-12-20
A B C D E F � H I
WORK COMPLETED MATERIALS
PRESENYLY TOTAL
ITEM FROM THIS PERIOD COMPLETED BALANCE TO RETAINAGE (IF
N0. DESCRIPTION OF WORK PREVIOUS STORED (NOT AND STORED ��0 FINISH VARIABLE
UNIT APPLICATIOfV IN D OR E) 7o DATE (G 1 C) (C - G) RATE)
MEAS QUANTITY UNITCOST SCHEDULEDVALUE (D+E) (D+E+F)
� Mob and Demob LS � $ 9,400.65 $ 4,700.33 S 2,850.00 $ 7,550.33 80% $ 1,850.32 $ 755.03
z Turbidity controls LS � $ 1,055.00 $ S - o% $ �,055.00 $
3 Piping materials and inlets (Excluding S s�,ass.�o 5 s,a2s.so
Seporator) �S � $ 64,263.00 $ sa,263.00 �oo°io g - g 6,426.30
4 Drainage Seporator LS 1 $ 32,550.00 S 32,550.00 $ 32,550.00 100% $ -$ 3,255.00
5 Maintanenance of Traffic LS � $ 6,000.00 S s,000.o0 8 t,soo.00 g a,5oo.00 �s°io $ t,5oo.00 $ 450.00
$ 23,000.00
s Concrete Sidewalks curbing and Driveways LS 1 $ 30,8A5.00 $ 23,000.00 75% $ 7,845.00 $ 2,300.00
7 Subbase/Base Material Placement including � $ 9,000.00 $ 4,500.00 S 2.700.00 0
com action LS $ 7,200.00 80% $ 1,800.00 $ 720.00
a Roadway Paving LS i $ 21,700.0o g - o% $ 21,700.00 $ -
� Roadway Markings, Striping & Signage LS � $ 3,000.00 $ o°io g s,000.00 $
�o Project Stabilzation and cleanup LS � $ 3,000.00 S �.soo.00 g t,5oo.00 5o°io $ t,5oo.0o g �so.00
11 Construction LayouURecord Drawings LS i � 4,Ooo.00 S 2,000.00 � 2,000.0o eo�io $ z,000.00 $ 2oo.00
$ -
$ -
$
$
$ -
$ 184,813.65 $0.00 �72,037.03 $70,526.30 $0.00 $142,563.33 77°/a $42,250.32 $14,256.33
OKEECHBEE COUNTY CEMETERY ROAD IMPROVEMENTS SOV PAGE 1 OF 1
Pa�tial Waive� and Release of Lien
(Continent upon r�eceipt of payrnent)
The undersigned lienor, in consideration of the sum of $ 63,473.67 hereby releases Its lien
and rights to claim a lien for labor, services or materials furnished Thru 4-20-2021 to CITY
of Okeechobee the property described below for the City of Okeechobee
The following described property: City of Okeechobee Taylor Creek
SE 8t" Avenue Conveyance
@ SE 8tla avenue and SE 6t" Court
REF: Mics work per contract
This waiver and release does not cover any retention or labor, services or materials furnished after
the date specified above.
Dated: �--� � ��� ('jd �
Lienor's Name:
State
Cour
By �
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B&B Site Development, Inc.
1505 C South Parrott Avenue
�i�raar�lrl}1PP Flnriria �4974
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PaYtial Wr�ive�° �nd Release of L�en
The undersi�ned lienor, in consideraii�n �aft�e sum of �10 00 hereb� �~�]ea�es Tts lien and
rights to claim a I�en for labor, servic�s ar �3terials furnished Thru 3-�0-2021 to B&B Siie
Development, Inc. a�d The Citv of O�eechobee on the property desc�bed below for the
City of Okeech�b�e:
The following descr��aed property: City Q� O�e�chobee Taylor Creek S� ��' Avenue
S�o�r�av�=a��r C�nveyance.
CUkeecho��e, Fiorida 34974
Project #PW 02-00-12-20
FDEP Agreement No. I.P47020
This waiver and release does not cover �ny rete�tic�� or labor, services or materi�ls %nished after
the date specified abovE.
Dated: �pri18, 2�21
Lienar's Naia�e:
State of Geor�ia
County of �uJinnett
Contech Engineered Soiuiions, LLC.
P.O. Box 936362
�Atlanta, Ga. 31193-�362
;� � ;"
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i
Print: Lauriz As�-ilev
Title: CCS
The foregaing was subscribed befo�z me this 8 day of A r�l , 2021
By Laurie Ashlev of Contech En�ineered Solutions_ Who is personally known
And who acknoti�ledged before me that t�� sa�e was executed freeiy and v�luntarily for
the purposes therein expressed (under au�hQrity duly vesied by said ca�oraiion}
My commission exp�rzs:
���`5 2�?�
`,�,�����aK+�Ip��'�.
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e �7. �Jss�oNF�ti� :
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DocuSign Envelope ID: 65F9DD51-CDE6-4E71-ADE7-7C372ECOBC79
Partial Waiver and Release of Lien
The undersigned lienor, in consideration of the sum of $10.00 hereby releases Its lien and
rights to claim a lien for labor, services or materials furnished Thru 3-20-2021 to B&B Site
Development, Inc. and The Citv of Okeechobee on the property described below for the
City of Okeechobee:
The following described property
Project #PW 02-00-12-20
FDEP Agreement No. LP47020
City of Okeechobee Taylor Creek SE 8th Avenue
Stormwater Conveyance.
Okeechobee, Florida 34974
This waiver and release does not cover any retention or labor, services or materials furnished after
the date specified above.
Dated: 04/09/2021
State of �'c�k�� ►vc
COU11� Of MECKLENBURG
Lienor's Name:
United Rentals
7400 Commercial Circle
Fort Pierce, Fl. 34951
DocuSigned by:
����:i 1 �'U�l.1A�lN
i4^oSu3CE2o39v i2...
DORIAN MITCHELL
Print:
Title: CREDIT ASSOCIATE
The foregoing was subscribed before me this 9 day of APRIL , 2021
B�l DORIAN MITCHELL p f UNITED RENTALS NORTH AMERICA INC Who is personally known
And who acknowledged before me that the same was executed freely and voluntarily for
the purposes therein expressed (under authority duly vested by said corporation)
My commission expires:
N KUDA
Electronic Notary Public
Mecklenburg County
North Carolina
Commission Expires 10/23/2021
DocuSigned by:
l:/�/LOL �
BA013FF333E44CF...
Notary Public, State of P�� Nc
Pa�tial Waive�° and Release of Lien
The undersigned li.enor, in consideration of the sum of $10.00 hereby releases Its lien and
rights to claim a lien for labor, services or materials furnished Thru 3-20-2021 to B&B Site
Development, Inc. and The City of Okeechobee on the property described below for the
City of Okeechobee:
The following described property: City of Okeechobee Taylor Creek SE 8th Avenue
Stormwater Conveyance.
Okeechobee, Florida 34974
Project #PW 02-00-12-20
FDEP Agreement No. LP47020
This waiver and release does not cover any retention or labor, services or materials furnished after
the date specified above.
Dated: _ :�� / 'j�. ,;��~��
Lienor's Name
American Concrete Industries, Inc.
350 N. Rock Road
Fort Pierce, Fl. 34945
_ `__..� � �°��___._ J
�/ ,
Print: �jr�'�r �' �� �� ���.G % � ;
Title: �, ;�-�1 _ �;�
State of Florida :,
Count of � � '
Y �_�_�_ � �: r['���
r_ The foregoing was su�scribed b�fore me this �% ���day of �v `,�✓ , 2021
� . � � �- , _ .__.
BY �a •�`r � ;�` .t� . ��'r� ;;c:' of , �rir''c � "i i�c�3 � j��T�t°�i ' .
�-�' -7�� .L��r Who is _grsonally known
And who acknowledged before me that the same was executed freely and voluntarily for
the purposes therein expressed (under authority duly vested by said corporation)
My commission expires:
� �Y '�. 141f`r�i�lahi �U I i�5s�'',
Coinrniss;on f � �� �.,` .
a ,,:Y L•xpira� oep�ern� �i . . ,.
\
�'.�, f,n� Pr.p '6'i�t�u�.vc ti ae ., -.
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Lc'f " '� �/ _ ,;•�
, .,.
No blic, State of Florida
PaYtial Waive�° an� Release of �ien
The undersigned lienor, in consideration of the sum of $ 64,833.33 hereby releases Its lien
and rights to claim a lien for labor, services or materials furnished T'hru 3-19-2021 to CITY
of Okeechobee the property described below for the City of Okeechobee
The following described properiy: City of Okeechobee Taylor Creek
SE St'' Avenue Conveyance
@ SE 8th avenue ancl SE 6t°' Co�art
REF: Drainage work per contract
This waiver and release does not cover any retention or labor, services or materials furnished after
the date specif ed above.
Dated: ;� i��, I � �t.0�.1
Lienor's Name:
B&B Site Development, Inc.
1505 C South Parrott Avenue
Okeechobee, Florida 34974
� ^ � u ��
r
Print: Michelle H. Baughman
Title: President
State of Florida
County of �� � �,�
The foregoing was subscribed before me this 3t�' day of t`t��ce.1� , 2021
BY en.�.��<<,a.P.x�.A+,.►�.. of ��� �;�.c�t�,�P�,� Who is personally known
And who acknowledged before me that the same was executed freely and voluntarily for
the purposes therein expressed (under authority duly vested by said corporation)
My commissi
�� 'a«'�y �� se�� �r �a�
, �raci SuHivan
8�j Cornmisssion H!-! 0934fr3
� � • ' 24
� � n�
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Notary Public, State of Florida
� '�I� `[.� �w� ��..� ;rx-�t ��'t �`'..�: �'"� �".:" .�. �1 3'�'�'
tion and Certificate for Pa
Subscribetl and sworn to before me this
TO Contractor: City of Okeechobee PROJECT: Taylor Creek SE 8th Ave APPLICATION N0: 3 F(NAL Distribution to:
55 SE 3rd Avenue Stormwater Conveyance PERIOD T0: 5/5/2021 OWNER: x
Okeechobee, FI34974 ARCHITECT:
FROM 8&B Site Development Inc VIA . a'�� . CONTRACT DATE: 2/12/2021
CONTRACTOR:
CONTRACTOR: 1505 S Parrott Ave ARCHITECT: °�"��'� �'��� � PROJECT NOS: PW 02-00-12-20 FIELD:
Okeechobee, FL 34974 ��i �?��'�. `' �
OTHER:
CONTRACTOR'S APPLICATION FOR PAYMENT , �`, r�,; + y'�,,;j �, The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work
Application is made for payment, as shown below, in connection with the Contract. :� �'-t •� �; covered by this Application for Payment has been completed in accordance with the Contract Documents, that all
amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and
Continuation Sheet, AIA Document G703, IS 8tt8Ched. payments received from the Owner, and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM ................................................ $ 184,813.65 ��-t��.7��XL'���l��/1�,�� ::..�%"�- ,
2. NET change by Change Orders .......................................... $ - CONTRACTOR: _
3. CONTRACT SUM TO DATE (Line 1+2) ..................................
4. TOTAL COMPLETED & STORED TO DATE (Column G on G703)
5. RETAINAGE:
a. 10% % Of Completed Work
(Column D+E on G703)
b. 10% % of Stored Material
(Column F on G703)
Total Retainage (Lines 5a+5b or Total in Column I of G703)
6. TOTAL EARNED LESS RETAINAGE ....................................
(Line 4 less Line 5 Total)
7. LESS PREVIOUS CERTIFICATES FOR PAYMENT .................
(Line 6 from prior Certificate)
8. CURRENT PAYMENT DUE .................................................
9. BALANCE TO FINISH, INCLUDING RETAINAGE
$ 184,813.65 By:
$ 184,813.65 State of:
$ -
$ 184,813.65
$ �128,306.93
$ 56,506.72 '�.
j� - : =_. � .. ;.
.� . ,�--,� _ _
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Date: .--- —" � �'r.��,�. d�
�' '�° Traci Suitiven
Notary Public: ���� � e�+� ar �oza o9s�s
My Commission expires:
ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Documants, based on on-site observations and the data comprising this
application, the Architect certifies to the Owner that to the best of the ArchitecPs knowledge, information and belief
the Work has progessed as indicated, the quality of the Work is in accordance with the Contract Documents, antl
the Contractor is entitled to payment of the AMOUNT CERTIFIED.
��-
AMOUNT CERTIFIED � � ' ' �
............................. ..,.z, ............. _. _- _ ..
(Attached explanationif amount cerfified differ lrom the amount applied: Inifial all figures on fhis Application and on the ..
Continuation Sheet that are changed to confam w'dh the amount ce�ti(ed.)
ARCHITECT• - - � �'
By: - �i � s ��—_---_, DATE: .
This certificate is ot negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment
and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.
ocume - . py ig , , , an y e men n n i u e o rc i ec s, i s . : is • ocume is p o ec e .. opy g
ana mcemanona� i reanes. unaumonzea reprooucnon or mscnoui�on oi m�s r�iH uocumenc, or any poaion or �c, may reswc ro severe crvu ana cnmmai penames, ana ww oe prosecucea co me mawmum
ex[enc possio�e unaer me iaw. i rns aocumen� was proaucea oy rvH sacware ac iw:wa:ag un uariaituui unaer �raer �vo. wuu�aa4m_ i wnicn expires on .sicu�uues, ana is not ror resaie.
User Notes: .
(Line 3 less Line 6) $ _
���� [3+c��+cw rrti+�rrt G'�"'�Ci3:'" ,—, 1 !�9��
Continuation Sheet
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT,
containing Contractor s signed certification is anached.
In tabulations below, amounts are stated to Ihe neares[ dollar.
Use Column I on ConVacts where varia6le retainage for line icems may app(y.
1=rom: [3<e�i s��� ���� �i�,r�„��,�. i�,�.
.lub: Ta� lur Creck Sl: 8lh /���enuc
Luc: Okcechub�c. I� I. 3-197-4
APPLICATION NO: 3 F1NAL
APPLICATION DATE: 4/20/2021
PERIOD TO: 4/20/2021
ARCHITECT'S PRO.I�CT NO: PW 02-0�-12-20
A B � D E F G H I
WORK COMPLETED MATERIALS TOTAL
REM FROM THIS PERIOD PRESENTLY COMPLErED BALANCE TO RETAINAGE (IF
N0. DESCRIPTION OF WORK PREVIOUS STORED (NOT pND STORED ��0 FINISH VARIABLE
UNIT APPLICATION IN D OR E) TO DATE (G 1 C) (C • G) RATE)
MEAS QUANTITY UNITCOST SCHEDULEDVALUE (D+E) (D+E+F)
7 Mob and Demob LS t $ 9,400.G5 $ 7,550.33 5 1,850.32 $ 9,400.65 100°/a $ -$ 940.07
2 Turbidity controls LS 1 $ 1,055.00 $ 1,055.00 g 1,055.00 100% $ -$ 105.50
3 Piping materials and inlets (Excluding S sa,263.00 8
Seporator) �S � $ 64,263.00 $ 64,263.00 10o°io $ - g 6,426.30
4 Drainage Seporator LS 1 $ 32,550.00 $ 32,550.00 S $ 32,550.00 100% $ -$ 3,255.00
5 Maintanenance of Traffic LS � $ 6,000.00 S a,soo.00 s �,soo.00 g s,000.00 �oo°io $ - g soo.00
$ 23,000.00 5 7,845.00
e Concrete Sidewalks curbing and Driveways �S � $ 30,845.00 $ 3o,eas.00 �oo�io g - g s,084.50
� SubbaselBase Material Placement including $ 7,200.0o S �,soo.00 g g,poo.00 100%
com action LS � $ 9,000.00 ° $ -$ 900.00
$ Roadway Paving LS 1 g 21,700.00 3 2�,�00.0o g 2�,�00.0o ioo°io $ - g 2,no.00
9 Roadway Markings, Striping & Signage LS � $ 3,000.00 S 3,000.0o g s,000.00 �oo°io g - g 300.00
�o Project Stabilzation and cleanup LS � $ 3,000.0o S �,5oo.00 S �,soo.oa g a,000.00 �oo°io g -$ 3o0.00
+� Construction LayoutlRecord Drawings LS i g 4,000.00 S z,000.00 s z,000.00 g 4,000.00 �oo°io $ - g aoo.00
$ -
$ -
8 -
S
$ -
$ 184,813.65 $0.00 $142,563.33 $42,250.32 $0.00 $184,813.65 100% $0.00 $18,481.37
OKEECHBEE COUNTY CEMETERY ROAD IMPROVEMENTS SOV PAGE 10F 1
Conditional FINAL Waive� and Release of Lien
The undersigned lienor, in consideration of the sum of $ 56,506.72 hereby releases Its lien
and rights to claim a lien for labor, services or materials furnished to CITY of Olceechobee
the property described below for the City of Olceechobee
The following described property: City of Okeechobee Taylor Creek
SE 8th Avenue Conveyance
@ SE 8th avenue and SE 6t" Court
REF: Drainage worlc per contract
This waiver and release does not cover any retention or labor, services or materials furnished after
the date specified above.
f�L� . - a � i � ,� ' . l
Lienor's Name: B&B Site Development, Inc.
1505 C South Parrott Avenue
State of Florida
County of ���� ,
Olceechobee, Florida 34974
.,�, f � ��.�
r �
Print: Michelle H. Bau hg man
Title: President
The foregoing was subscribed before me this d o'�" day of � , 2021
By ��, �����,� of �a������,,�.}� , Who is personally lcnown
And who acicnowledged before me that the same was executed freely and voluntarily for
the purposes therein expressed (under auihority duly vested by said corporation)
My commission �,x�,,�;.�,�, �.a�.�,
.,.,"' ,°�ns Fae� stmrc or,• FkMi�a
:,b'�,, .�� �Y' ....:.SP.961A8G7
�'�;r. _ .:,;;�. _.�� ��a ���e�
.. ;..,ro�.
a a��
�'.d`v:;�vv � :;�..:: =•,,.^e
�1 �
, .
Notary Public, State of Florida
DocuSign Envelope ID:696821D5-51CC-4F46-A746-1A4DBCEDF760
FINAL Waiver and Release of Lien
The undersigned lienor, in consideration of the sum of $10.00 hereby releases Its lien and
rights to claim a lien for labor, services or materials furnished to B&B Site Development,
Inc. and The City of Okeechobee on the property described below for the City of
Okeechobee:
The following described property:
Project #PW 02-00-12-20
FDEP Agreement No. LP47020
City of Okeechobee Taylor Creek SE 8th Avenue
Stormwater Conveyance.
Okeechobee, Florida 34974
This waiver and release does not cover any retention or labor, services or materials furnished after
the date specified above.
Dated: 05/10/2021
State of R��i�� Nc
County of MECKLENBURG
DocuSigned by:
Ca�.�.acC- �t.o�l,u�
CANDACE MOBLEY
Print:
Title: CREDIT ASSOCIATE
The foregoing was subscribed before me this �� day of MAY , 2021
By CANDACE MOBLEY 0 f UNITED RENTALS (NORTH AMERICA) INC �o is personally known
And who acknowledged before me that the same was executed freely and voluntarily for
the purposes therein expressed (under authority duly vested by said corporation)
My commission expires:
11/16/2024
CINDY L MCINTYRE
Electronic Notary Public
Mecklenburg County
North Carolina
Commission Expires 11/16/2024
(NORTH AMERICA) INC
Lienor's Name: United Rentals, �X�
DoeuSigned by:
C M�I
3P�b�; State of�df3��X NC
FINAL Waive� and Release of Lien
The undersigned lienor, in consideration of the sum of $10.00 hereby releases Its lien and
rights to claim a lien for labor, services or materials fumished to B&B Site Development,
Inc. and The City of Okeechobee on the property described below for the City of
Olceechobee:
The following described property:
Project #PW 02-00-12-20
FDEP Agreement No. LP47020
City of Okeechobee Taylor Creelc SE 8th Avenue
Stormwater Conveyance.
Olceechobee, Florida 34974
This waiver and release does not cover any retention or labor, services or materials furnished after
the date specified above.
Dated: ���-�Da �
Lienor's Name: Q Dixon Construction, LLC
4689 SW Dactyl Street
Port St. Lucie, F134953
�'�1 ���.r�.-- � l�C_6�L.1
1'rint: �t ,1.� h-�'► r� � i1C�+�
Title: � �U �'t.P�
State of Florida
County of ���e�t _
The foregoing was subscribed before me this�day of ���, 2021
By �,���� 0; �� of ��, �,�� b��$�,���L� Who is personally known
And who acicnowledged before me that the same was executed freely and voluntarily for
the purposes therein expressed (under authority duly vested by said corporation)
My commission expires:
�;,s,. f.._ .�.�.
= .,� E�afsry Put51tC State af Flcricl�
`'�� � Philip J �au�hman
< ._ � ,
�(�,� � . . �x,��r�5 oai�aizozz
�va w."aa''.•r ,,:'we�,�v
��� �
� �
Notary Public, State of Florcida
�'INAL Waive� and Release of Lien
The undersigned lienor, in consideration of the sum of $10.00 hereby releases Its lien and
rights to claim a lien for labor, services or materials furnished to B&B Site Development,
Inc. and The Citv of Okeechobee on the property described below for the City of
Okeechobee:
The following described property:
City of Okeechobee Taylor Creek SE 8t1' Avenue
Stormwater Conveyance.
Okeechobee, Florida 34974
Project #PW 02-00-12-20
FDEP Agreement No. LP47020
This waiver and reiease does not cover any retention or labor, services or materials furnished after
the date specified above.
Dated: `�,L� /G�, �� C�'�-�%
Lienor's Name:
State of Florida
County of ,,�� (��tC � �'
American Concrete Industries, Inc.
350 N. Rock Road
Fort Pierce, F1. 34945
`-�� � '`-��
Print: � ��'��'�'f �...- i i%t,�.,�
Title: � �!�
.✓'�ti% CC�%y� � �
�
The foregoing was subscribed before me this�day of �c�.-��1 , 2021
BY '��'_'�'�--< < c� of �•7t�:iir��¢•? �i�r�.���f T,,�J :...,cr�C Who is per nallv known
And who acknowledged before me that the same was executed freely and voluntarily�o`r
the purposes therein expressed (under authority duly vested by said corporation)
My commission expires:
_�,��Y���,,_ A':A.�GIEAJONNSCN
��,� .� ' Commis�icn = GG 106505
���'�";��' ��.t Expires 5eptemDer2A, 2021
��F oF FL��J Baadad TNu 6uS�at Notefy Scivicea
�
�/ '
,��...� C..-r . �-.•_...�
... •
Nota Pu lic, State if Florida
FINAL T�'aive� and Release of'Lien
The undersigned lienor, in coz�zsideration of the sum of $10A0 hereby releases Its lien and
rights to claim a lien for labor, services or materials furnished to B&B Site Development,
Inc. and The City of Olceechobee on the property described beiow for the City of
Olceechobee:
The following described property
Project #PW 02-00-12-20
FD�P Agreement No, LF47020
City of Okeechobee Taylor Creelc SE 8th Avenue
Siormwater Conveyance.
Olceechobee, Florida 34974
This waiver and release does not cover auy ret;ention or labor, services or materials fui•nished after
the date specifi�ed above.
Dated: � � - ( �.> � �}� �
State of Flot ida
Lienor's Name: C.W. Roberts Constructing, Inc.
County of �,� ,�,�-��,o�
The foregoing was subscribed before me this p D`�lay of �q� , 2021
�
By ��re R��rt,�.�� of �.,u� Who is personally known
And who acicnowledged before ine that the same was executed freely and voluntarily for
the putposes therein expressed (under authority duly vested by said corporation)
M� �,� "yp� Notary P�State csE Florid�
m . Philip ,9 Baughsnan
� � My Commission GG ?.a2607
�'k � Expires 06110/2022
or a
��%�C$h�
� � �� �
/ � _
/" —
Notary Public, State of Florida
y�'oi�3
FINAL Warve�° and Release of �+�,ie,n
Tt�.e undersigt�ed lie�zo�•, in coz�szderatiai� of the sum of $lO.OQ l�cz•eby releases Its lien and
rib��ts t� clair� a lien f.o�• lavor, s�rvi�ces or mai:ezials fux-��ished to B&B Site Develo�znent,
Inc. �nd Tl.x� Cii,y of �lceecllobee o�l the pt•operty �desc�•iUed belo�uv fox• the City of
Okeechol�ec:
The fcsllo�i�ab des�;t•i�ed ���ope�•iy:
Pi•oj eci #P''�JV �2-�JO- R 2-20
FDEP �gY•�ea���t 7�1�. LP47020
City of Olceechovee Taylar Creelc S� S`i' Avenu�
Sioxmwatez C�nveyan�e.
Olc�ecllobee, Florida 34974
This vv;��veP• ��ad �elease d�es not cove�� any re�ention or labo�•, se�vices or materia�s furnisk�ed after
ille date speci�ea ai�t�ve.
;
I)a,�ed: '� �%��,. ` ��0� %
Sta.�� +lJ� �'-�����. �.1�.:�.� t; .; ,.,..
�tJUg1$wJ �J� ��. +�,.
:�7 6? t'
Atla�lta, t�a. 31193-�636'�
+ �l V'1�..4. "
Y f (
r�- � �
�Ifl13�:: �;r�,c.r.; ,,_ �.�.: yi g €�,�
�'J.t�e: ��,'�' ' .
'T���e fc��•egoing was subscl•f u�d l�efox•e me this :' � day of ,�'�';�',..,; , 2021
By.'-.���:r. .��t`,��,; of �� �,K�, u>,;,,N�c�� _a:;i���. ::,.,:� Vtjho is persarially lcnow��
�.x�ad �a��c� ac�r�nowledged Uefore ��le tliat the same was cxccut�d fi•eely and voluz�tazily fox
tdle pu�-y��ses therein e�cpressed (under authority du�� vested by said corpox•ation)
��' `
,
l��I� ca��r�a��s�i�t� exp��•es: 'F.`� •y,�N • ,�; -:��.
, .T. .���s �,rA. i
? . v� pci' Q,T Ql� y�9� �� Q. �.
� " • � . C: �
� '� pua,�,c, : c :
: .. �. � : ��
o :�
:`�'L� '' � :"�; :?' y , �,�'
��'�,,� •COU���.���
���ii������`
Lie��oz•'s N�.me: Contecl� �rlgineea•�d Solux�o��s, LL�.
P.O. I3oa �36362
�� `-
�' ,
I'�ota�y Pul� ic, State of I'�t��i�da
,
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