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Bid PW 02-00-12-20 PaymentPatty Burnette From: Sent: To: Cc: Subject: Attachments: Connie Vanassche <ccvgovser@gmail.com> Thursday, June 3, 2021 9:06 AM Acevedo, Arlene Marcos Montes De Oca; Robin Brock; India Riedel; David Allen; Patty Burnette; Kay Matchett LP47020 - payment request - City of Okeechobee LP47020_RFF1-final_file copy_000122.pdf Good Morning Arlene -- Hope this finds you and your family well! On behalf of the City of Okeechobee, please find attached the payment request for the SE 8th Avenue Stormwater project in the amount of $184,813.65. The expenditures for this project came in under budget. Task 1- Construction is 100% completed. The Final Progress report, which includes construction progress photos, will follow in a separate email. Please let me know if you have trouble with the attachment and/or require additional information. Thank you for your consideration. Kindest Regards, Connie Connie Vanassche (561-512-0089) James R. Spratt (850-228-1296) Dale Milita (561-718-2100) CAS Governmental Services, LLC "Communication Advocacy Specialists" P.O. Box 35 Canal Point, FL 33438 Ph: 561.924.7702 Fax: 866.929.8006 Email: ccv�ovser@�mail.com 1 RIi�7SI�.D PAl'�IEN'1' RIiQCES'I' Sl;Mil1:�12ti' PqR�I UE;1' :��;rcement \u. _J71RII Yaymcnf Rc<piest No. _I_ Rryurst Date:_�la�� 25. 2112I nf Okccchobcc Grantcc: (Nax�r i ,i��,;�r,��:�dd«•.��.,� Sj tiF;'PhirJ Avcnuc Crantee's f.r:mf �lana;icr bkcechobcc. M7nrida 3a97J �larcos �lontes Dr Or.� Task \n(s). 1 fask:�mount(s) ReyucsteJ: S_18a,813.G5, (�iRAN'f f?\PGNDI"I�I IRI�S SUViN1ARl' SGC�PION I'RICVIOUS 1IA'PCHI;VC FIiVUti 'fU'1�.\I. :11`fl10121%ISDT:\tiKti :1VOUN'fOP�I'111S P:U'�IM:\'1' �PO'1':V.('ligll!I.:\'1'IVF: M'OK'I'lllti CI'HC��1.:\'I'1\'6: eH:qi'r:sr et:Qrtsrs r:�i��e�re�•:Qurs'rs Hr:Urerr a�.crcw�cF�ino� 't'ask L• Cunatructian (5211).113O 5 IR1,R13.65 S - S IR�,AI3.G5 S - 5 - 7'ask 2: 5 • 5 - $ - S - g - "Pask 3: S - S - 5 - S 5 - 't'ask a: y - g - $ _ $ _ ti _ �f:��k 5: S - ti - S - S - S _ 'I'ask(: S - S - ti $ - � _ �Pnsk 7: g _ g _ g _ g _ � _ '1'ask N: ,y' _ g _ ti _ g g _ '1'usk ): $ - S - S - S - S - ror:��..\�fOl;\7 S I%J.M13.4i S 5 ISa.813.(,5 S R ro r:�i, ni; ucr: r (:V,I.'I':\tiliti) 52119,11!( S l,k:ti5 �f0'1':\ L Cl'� �I i:l.:\77 V F: 1'AY>I F: V.1. � RF:QI�ES'1'tiUi+: 5 .J.222.35 S . �fU'f:\I. NI�JLV\1\G (:�I.L'f.�Sl:ti� S 2d,??2.35 S GIL�N'1'1'sF. CF:Ii"PIFICA'I70\ FLORIDA DGPARTMENT OF GNVIRONMENTAL PROT�CTION k��:c�t �s r H�ok r.�varn.�•r - r:�H•r u ii►:��inu�isr.�n�:��r or: r:�n. Grantee Name: City of Okeechobee Payment Request No.: 1 DEP Agreement No.: 47020 Amount to Cretlit Invoice toward Match or Local Vendor Name Invoice Date Invoice Amount (1) Share or Other Funding Requested Amoun[ (3) Check Number TasklOe�ive(�'ble Numbe Budget Category Number or Amount Not Re uested 2 $ - � - B&B Site Development, Inc. 1 3/19l2021 $ 64,833.33 S - $ 64,833.33 1376 1 Contractuai (Subcontractors) B&B Site Development, Inc. 2 4l2/2021 $ 63,473.67 $ - $ 63,473.67 1377 1 Contractual (Subcontractors) B&B Site Development, Inc. 3 4/20/2021 $ 56,506.65 S - $ 56,506.65 1378 1 Contractual (Subcontractors) S - $ - S - $ - S - $ - S - � - S - $ - S - $ - 5 - $ - S - $ - S - $ - Totals: $ 184,813.65 $ - $ 184,613.65 Grantee's Ccrtification of Payment Request I. Marcos Montes De Uca (Prin[ name of Grantee's Grant Manager designated in the Agreement) on bclialf of City of Okecchobee , do hereby certify for (Print name of Grantee) DEP Agreement No. _4702U aud Payment Request No. that: I. The disbursement amount requested is for allowable costs for the project described in Attachment 3 of the Agrcement. 2. All costs included in Ute amount requested have been satisfactorily purchased, performed, received, and applied to�vard completing the project; such costs are documented by invoices or other appropriate documentation as required in the Agreement. 3. The Grantee has paid such costs under the terms and provisions of contracts relating directly to the project aud the Grentea is not in default of any terms or provisions of the contracts. i___. rantee's Grant Manager's Signamre Marcos Montes De Oca Prin[ Name � _... .... , �- / , � .... _, / L:r,' i.�`/��'` � � Grantee's Fiscal Agent Signattird India Ricdcl Print Name 8G3-7G3-3372 863-7G3-3372 Telephone Number Telephorte Number F.ngiucer's Certification � af Payment Rcqucs[ � ORLI' SUQ�tIT fF COtiSI'RUCTION Iti PART O� TIIE PRO1G(.T �. M,^.rcos Y. �loutcs Dc Oca, P.C. , Lciug Ilrc Ywfcssionul Engiuccr rtt:uncil by (uime ofPrMessiunnl Lnginecr) Cily of Okcceholrec .�� 'csponsi6lc Ibr oversccing tonslructian of thc projcn (nainc nf Cirantcc) dcsaibcd in Ihc Agrccmcm and do hmc6y ttnify that fur DEP Agrecman No. A7020_ anJ Pa�nuut Rcqucsi No. _I_ I. All pcnuits mid approvals rcquircJ far tlic emisUi¢tiou. �rl�ich is undenvay, Lavc I:wcn obioincd. 2. Pa}ntcill is in accordancC will� col�slNciion con�ract prot95ions. J. l;onslnlL'lit)n IIN lo IIIC (loitll 0( II115 �)�ylllclli rCqueSt is in canlpliBllcU ��•i111 I�ie lp�U'avC11 �Jl;ins Jnd �lennilc. :1. �q��iymeni, matcri:ds.labor, aud sen�ices represenled bythe eonsvuclion imoiees ha�•c 6cen salistaclorily purehased orreeeiwd aud applicJ to Ihc prqccl iu ncrordancc wiih coustrn<linn couvacl documems IileJ wilh and prcviously appro�•cd by ILc �cpa�iwcul af 6uaiwnmaual Pwtcction. ��"°�'cSMARCOS �y'fr. �:p�a`�` ��'��Q��`: ".' O : //� ° 2'. �` '� i°• E. .� � tA'��ua� y�`I'ruRssionat Enginccr c� fft, .,, �'.��, TG�1,� ,'� J� U� Rc l:^,"i N.. ., v,.r �3�' O o r�� ,�r,nn,�,no�� '�99`'�.=,,1_�� .�• ��,x�„ '% ' y v' �v ��Q�. (P.L•. Nwnhcr) ��liJllii3E•S��2t.� 31 � ,yr2021 , oe a`�4 a.\ CITY OF OKEECHODEE ORAHTFUNOS ��,^.� :`vSC.JPOA �_hU`c •�✓Ee�H'Jl.'� f! ::n+.f �_i � �r�� SimTrust Business Online Sw+74usr (�AHn � o o � � � � !� - 7.iGt0i . . •a t. .[. �Ct'�. ��_e.�t v� � 3'r� v�r pDttMf�Mo CeA�tf !c ��..._� "' S�zry Three Thousand Four Hundred Sevenry 7hiee antl 67/tG0 Cellars "' a,'2J21 SG9 473.U7 „� r�� _o��, r CITV OF O EECM09EE i B 8 8 Sile Developmant 1�1 /; � • � 7505-C South Parron Avenue �- - � � - - Ckeechobee.FL 3a97a � - � ---¢�^ - �i'OOi377��' �:063102152�:10000�04i3820��' -.N�- srl' t(� #4,;""sli i'�r �A�`€;''i � ' ��i�. -i.�: fii�� (�i�; �iiY2J�� ..1250006 �:25C00257.7486'=06371:C3U!C58 I' +`��i .. . . . ;�•� � ii- -- -- -- -- -- -- -- - _ __ ... ._ __ � :ITY �F OKEECHOBEE 3 S.E. 3R� AVFNU`c • OKFECHOBEF. FL 3a9i a /OF�oMEfCy � CITY OF OKEECHOBEE �� ,., , � �v\ GRANT FUNDS � u � m�I 55 S.E. 3RD AVENUE • OKEECHOBEE, FL 34974 ' �__ . �'-;(OR�O��.i �rtnNr furvu� TOTAL 0.00 SUNTRUSTBANK OKEECH08[E OFFICE B15 S. PPHHOTT AVENUE, ONEECHOBEE. FL 34914 PAY �OLLMS AND CENTS DATE "` Sixry Three Thousand Four Hundred Seventy Three and 67/100 Dollars "' w-z, - 001377 '�"� 1377 M1WNT 4/23/21 $63,473.67 TO THf: ORDFR CITY OF O EECHOBEE or r) B & B Site Development �' 1505-C South Parrott Avenue - �-' "—' ----- Okeechobee, FL 34974 �.-._ — .'C?�--- �i'00 i 3 7?��' �:06 3 10 2 1 5 2�: 10000U04 3 38 20i�• ---._.._-- — — — — --- -_ ------- Date: nJ23127 Check: 1377 Amount: 63,473.67 Discount: 0.00 Vendor:8 & B Site Development Invoice Amount Reference Amount Deseription Distribution Amount .._. .- ------ � -----� -- .._ _ - — ----- - - -- --- ---... _. _ _� 5530A 63473 87 PO 507.5 Draw 2 SE 8t� Ave Stortnw8ler conveyanG(.307�0559-001.BJOU 83,479 67 _... .. _____ __ _'____.._ _..._. . ,__._.... . '_'___. . � . __- _..______ . ____.___ ``�y.OF'�kFFCY 0 �?� - � �m 0 � _:� � � ,z� �:' a6 975* TO: g& 8 Site Development 1505-C S Parrott Ave�ue Okeechobee, Fi. 34974 ITEM I ACCT. NUMBER NO j ___._ —.___-____— 1 307-559-&300 VOUCHER CITY OF OKEECHOBEE 55 SF. THIRD AVENUI: OKEE;CHOBEE, FL 34974-2903 863-763-3372 QUANTITY UNIT DESCRIPTION PW 02-00-12-20 Taylor Creek 10% retention fee retainage to date E14256.33) PO Amount 184,813.65 Reas. 128,307.00 �' Balance 56,506.65 � TOTAL PO 5025 Draw 2 ar2sr2os� UNIT 'I AMOUNT —__I�___ __ EI 70,526.30 -7,032.63 S 63,473.67 _ --- _--- --- -- ---- ----_ _ ------- _ -- --------- ---- _ Date: 4/23/21 Check: 1377 Amount: 63,473.67 Discount: 0.00 Vendor:8 8 B Site Development Invoice Amaunt Reference Amount Descriptian Oistribution Amount — � -- -------�-- -- ____ _ � 55309 63,473.67 PO 5025 �raw 2 SE Bth Ave Stormwate� wnveyan� 307-0559�001.6300 63A73 (i7 _ _ �—'—______ ,_ _._��_ _.._._— .___....___..__ C.��,�•OF'OkFFC'y w ,z`` 'E�-- c'+':.; m 6�� a° ;�-� ' yo` �797 • TO: g� g Site Development 1505-C S Parrott Avenue OEceechobee, FI. 34974 ITEM I ACCT. NUMBER I QUANTITY I UNIT NO 1 07-559-6300 � VOUCHER CITY OF OKE�CHOBEE 55 SE THIRD AVENUE OKEECHOBEE, FL 34974-2903 863-763-3372 DESCRIPTION PW 02-00-12-20 Taylor Creek 10°!o retention fee retainage to date $14256.33� PO Amounc 18d,813.65 Reqs. 128.307.00 Bala�ce 56,506.65 ITV Of OKEECHOBEE IS E%EMPT FROM FEDERAL E%CISE AND TRANSPORTATIO� AXES AND STATE SALES TAX, DO NOT INGLUOE THESE TAXES IN YOUR INVOICE. XEMPTION CERTIFICATE W ILL BE SIGNED UPON REQUEST. 4LE5 TN( E%EMPTION NO. 85-8012621656C•6 EDERAL I.D. NO. 59-6000393 � PO 5025 Draw 2 4/22f2021 UNIT AMOUNT S 70,526.30 -7,052.63 TOTAL S 63,473.67 / % _�� __ _ / �/ , AUTHORI2ED SIGNATURE PARTWL( ) FINAL ( ) T� }'_• '�`�-L� Docurr� � rat�+G702"' — 'f 992 , i,L ` . , , . . Application and Certificate for Paymenf . _._ TO Contractor: Clty Of OkeeChobBB PROJECT: Taylor Creek SE &h Ave APPLICATION N0: 2 Distribution to: 55SE3rdAvanue SlormwaterConveyance PERIODTO: 4/20l2021 OWNER: x Okeechobee, F134974 ARCHITECT: FROM 88B Site Development Inc VIA CONTRACT DATE: 2/12/2021 CONTRACTOR: CONTRACTOR: 1505 S Parmtt Ave ARCHITECT: PROJECT NOS: PW 02-DO-12-2U FIELD: Okeechobee, FL 34974 OTHER: CONTRACTOR'S APPLICATION FOR PAYMENT Tha uMersigned ContraGor r.eriifies thal to 1ne 6es10l Ihe ConVaclols krwwledge, information and belief the Wwk wvered by Ihis Applica6on fw Payment has been comple(ed in accorda�e vnih the Contracl pocuments, that all Application is made for payment, as shown below, in connection with the Contrect. amo��s nave bee� �d ny me ca,o-�aor r« work ror wnkn prevaus cenfica�as ror Pa ymeM were i5sue0 and C01 3ti0t1 Sh2et, AIA DOCUtnBnt G703, iS 2n2ChCd. paymenLS received (rom the Oxner, and tha� current paymem shami herein is now due. 1. ORIGINAL CONTRACT SUM ........... . � 184,813.65 '� '"�,�+ rZ C - - 2. NET change by Change Orders ........... ......................... .... $ - CONTRACTOR: ULt L".J c� �'�- �v��Q r'�1 �/ `j� . 3. CONTRACT SUM TO DATE (Line 1+y) ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, g 184,813.65 By: l, �'� ( �;'�� ,� �` Date: � � 4. TOTAL COMPLETED & STORED TO DATE (Column G on G703) ,.. $ 142,563.33 �� State of: Co nty oC / � � 5. RETAINAGE: Subscribed and sworn'to before me Ihis ao'�- ay of .�(f__ 2p21. a. 10% °/o Of Completed Work $ 14,256.33 ✓ (Column D+E on G7031 Notary Public: �"� �'/ P�� Smm d FIrnCa p O b. 10% % of Stored Materiai My Commission ex e3fi}� � My� SCOnvruseiai HH D73f%'i9 �� (Column F on G703) '�a,�a� Ew�. �a�sna2� Total Retainage (Lines 5a+5t or Total in Column I of G703) S 14,256.33 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. 70TAL EARNED LESS RETAINAGE .................................... $ 128,307.00 � (Line 41ess Line 5 Totaq in accordance wiN Ihe Contract Doaments, baseA on or-site cbservatrons and the da�a compnsing Nis � i appication, the fuchitect ceArGes W tlie Owr�er that to the best of the ArchilecCs knowletlge, in(orma6on and beNef 7, l SS PREVIOUS CERTIFICATES FOR PAYMENT ................. $ 64,833.33 � �� yyork has progessed as indicaled; the qua§ty W Ihe YJork is m accordance w�Ih the Contract Dceuments, and (Line 6 from pnor CerGiisdlB) Iha Contractor is en6tled lo paymeniof Ihe AMOUNT CERTIFIED 8. CURRENT PAYMENT DUE ................................................. $ 63,473.67 ✓ 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 31ess Line 6) $ 56,506.65 �'� AMOUNT CERTIFIED .................................................... . � �-' •. . . . (W!achad expanatanJav�px,( cmGt�eO tlMers frmr (ho artpurd a;pueo. InRia y; figures ai fhis App'�rcation arxl m tlre CHANGEORDERSUMMARY ADD�TIONS DEDUCTIONS �""`�10f�'�maiarecn�rocon/amwrtnti�eamQuncc�i�eo.J '-.: , ' �, . .. . . : _ _ _ . . . Tolal changes approved in previous rtrnths by Ovmer ARCHITECT: � �� '' • Total approved th�s Month By: DATE: TOTALS S _ � _ TharsNfica�eusnolnegWyGe. TheA1rI0UNTCERTIFIED:>pay;bleonlftotheConVaqwr,amedheren. Iswance,pa�rrani NET CHANGES 6y Cha�e Order S and accxptm�ce dpapi�eni are w�matgepufKe to ar�y r5hr> c' C�re O,merv Cmvatr. uMzr tnn Gmtra:!. ° i . , eiwinir�nwi.�w�ircaiir�.i:iwuu�n��<.��;.epruuuciwn��uisinrxiuono��ni.:u,.��ucumcn�.��runrp�niir�.��i�.�iiayrc.unin.c�i��c:i�ii::nu�nn��ni�;ciu.i.•a.anau�ii�k�y�.�.. .. , . euene poss�we unaer �ne ww. i n�:s oocurnem wus proouceo oy NiH smiware a� iv:Ha�.w uu ua n��uui unoer vmer rvo. iuwcy.Wco � wnicn expues on �r� utwo`ano is rw� �or resaie. Uber Not05: ;�-_A11-1_ �ocument G703" — 1992 Continuafion Sheet �vnu,.�m.,vu�uzsrN�.ic,cnu�nHua:fl�ur�cnnonFoevnvauni. From:6$BSitelhvelopment,lne APPI.ICnTIONNO: 2 ..nu�nin�ConuxuMa�ign�Jce�iili.:ni�misnlleah<J. Jpb:TaybrCreekSGRthAvenuc AI'PLIC:ITIONI��'PF.: M20r1021 �,,,:,�w��:.,,,M�,,,..:�:,W„�,��.�.�W�„��,.„�,,,,.��„��a,. t.�,�:o�;,:«nan«.t�i.;a»a 1'F.RIODTO: N20/1011 u��c,�iu��oi��c�Hw�a.,�i�.,.��,��,m.��n��wc�•i��ri��kn<��.��ws�i,pi,� :�RCill'fECT�SPROJF.CI'�O: PW01•Oafb70 A B c D E F G H I WORKCOMPLETED MATERIALS FROM iH15 PERIOD VRESENTLY 707u REM DESGRIPTION OF WORK PREVIOUS STORED (NOT �OMPLETED ,� BAtANCE TO RETAINAGE (IF N0. nHOSTOiiEn (��) FINISH VqRIABLE UNIT APPLICATION IN D OR E) To aA7E (C • G� RATE) MEAS �UANTITY UNITCOST SCHEOUIE�VALUE (DtE) �U�E�F� � Moband�emob LS t S 9,C00.65 5 4.70033 f �,850.OU S 7.550.33 80% 5 1.850.32 S �55o3 � iurbiditycontrols LS + S 1,055.00 S 5 D°5 S �.o550a 5 a Piping materials and inlets (Excluding � 5 s�.e3c�o s s,azs.3a Seporator) �S S 64,Y63.00 5 6i,26300 100.. 5 � S sA2u.30 � DrainageSeporator LS t S Ji,550.00 S 31,550.00 S 32,55000 100k S S 3255fq� s MaintanenanceofTraNic L5 , 5 6,000.00 5 3.oG0.Uo S �,soo.00 s 4.5ao.00 7s% 5 iSooGO 5 aso.q; S 23,000.00 s Concrete Sidewalks curbing and Dri�eways L5 + S 30,845.00 S i3.00000 �sw 5 �.eas.a� s 2,so0.00 1 SubbasalBaee Materiai Placemenl including � S 9,000.00 5 4,SOO.CU S 2,700.00 com aeRon LS 5 7,2W.00 80% S t,8C9.00 S 7Yu.00 e RoadwayPaving LS i E 21,700.00 S o�, 5 2t700.00 S - 9 Roadway Markings, Striping 8 Signage LS i E 3,o0a.00 s c�, � 3.00o ao 5 - +o Project Stabilzation and cleanup LS • 5 3,000.00 S �� S 1,50000 5056 S LSro.00 S �5o.o0 ++ ConstructionLayout/RecordDrawings LS i S 4,OU0.00 5 Z�W S 2.000.00 so°m 5 2.a000 s 2Gu.co s s s s s S 184,813.65 SU,00 572,03T.03 570,526.30 50.00 5142,563.33 77Yo 542,250.32 514,256.33 OKEECHBE'c COUNTY CEMET[RY ROAD IMPROVEMENTS SOV PAGE 1 OF 1 P�rrtial Wa[ver und Release of Lien (Contifzent upon �•eceipt of p�cyfnent) Tlie imdersigned (ienor, in consideration of the sum of � 63,473.67 hereby releases Its lien and ri�hts to claiui 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 fi>llowing described property REF: Mics work per contract City of Okeechobee Taylor Creek S� 8"' Avenue Conveyance @. SG 8th avenue and SF. 6"' Court This waiver and relcase docs not cover any retention or labor, services or materials furnished atter the date specitied abovc. Dated: y�� I� �� Lienor's Name: B&B Site Development, Inc. I 505 C South Parrott Avenue Okeechobee, Plorida 34974 � �,��_`�. z co�� f Print: Michelle H. Baughman Title: President State of Florida County of Okeechobee The foregoing �vas subscribed before me this Zo� day of A�� I , 2021 By t��,� � �,,, of �j �. ; � �� .,�„�,�� , Who is persanally known And who acknow edged before me that the same was executed freely and voluntarily for the purposes therein expressed (under authority duly vested by said corporation) My coin ' . �� oleiy PuO4c Smm d Florida. . --'_ Traci SWliven `Z.� � .J�l�.�-� �rp„� E��a o�a oiaeao �1J U�l Notary Public, State of Florida ,; �.?9s<r Partinl Waiver and Release of Lien _______ The undersigned lienor, in consideration of the sum of Sl0 QQ hereb�� releas�slislien�nd__ ___ 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 8�' Avenue Stormwater Conveyance. Okeechobee, Florida 34974 Project #PW 02-00-12-20 FDLP Agreement No. LP47020 This waiver and release does not cover any retention or labor, scrvices or materials fumished after die date specified above. Dated: April 8, 2021 Lienor's Name: Contech Engineered Solutions, LL,C. P.O. Box 936362 Atlanta, Ga. 31193-6362 �� F ` ,. ,-�%?--�'�_�-��=� Print: Laurie Ashlev Title: CCS State of Georgia County of Ciwinnett The foregoing was subscribed before me this 8 day of April ,�021 By I�aurie Ashlev of Contech Engineered Solutions_ 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 cornmission expires: --.+�'tS "Z�23 \ � � ' � � \,: . .. .� . � �'i`: l�� J ` '' � � /�� / . . o . �.l�y � '',, � G7:i �1�' ��, ': � .� Notary Public, State of�ia '��i�'�°•`: �..:�"'�V.�``�,� , ' '�.�� COUN�� *`"'" � �'6�laaaae+y°'' Oo�uSign Envelope ID: 65F9�D51-CDE6�E71-ADE7-7C372ECOBC79 Pa�tial Waiver a�zd Release of'Lie�z The undersigned lienor, in c�nsideration of the sum oF$10.U0 hereby releases Its lien and ri�hts to claim a lien tor labor, services or materials fiirnished Thru 3-20-2021 to B&13 Site Develooment. Inc. and The City of Okeechobee on the property described belaw for the City of Okeechobee: Tl�e fotlowing dzscribed propercy: City of Okeechobee Taylor Creek SE 8`'' Avenue Stormwater Conveyance. Okeechobee, Florida 34974 Project �PW 02-00-12-20 FDEPAgreemcnt Na LP47020 This waiver and rolease does not cover any retention or labor, services or matcrials fiimished after the date specified above. Dated: oaiosnoz, Lienor's Name: United Rzntals 7400 Commercial Circle Fc�rt Pierce, Fl. 34951 �Oocu3iqned by: bV'ta�n, 1�1.t('l�,t,(�, 19�5010Ei9]94�^.. �I117t: DORIAN MITCHELL T1tIC: CREDIT ASSOCIATE State of �C��zd�a Nc County of MECKLENBURG The foregoing was subscribed before me this 9 day of APRIL 20� � [3Y DORIAN MITCHELL 0 f UNITED RENTA�S NORTH AMERICA INC Who is personally know�i And who acknowledged before me that the same was execi�ted freely and voluntarily tor the putposes therein expressed (under authority duly vested by sai�l corporation) My commission expires: — N KUDA Electronic Notary Public Mecklenburg County North Carolina Commission Expires 10l23l2021 ooa�spnaa ey: Ca'�no�i � w�cF Notary Public, State of PF I�t�F� Nc Parti�cl Waiver and Releccse of Lien �Che undersigned lie►ior, 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 Develovment, Inc. and The City of Okeechobee on the property described below for the City of Okeechobee: The t<�lto��ing described property: City of Okeechobee Taylor Creek SE 8`'' Avenue Stormwater Conveyance. Okeechobee, Florida 34974 Project #P W 02-00- l 2-20 PDEP Agreement No. LP47020 17iis �vaiver and release docs not cover any rocention or labor, services or materials furnished aRer thc date specitied above. `,; �% Dated: `';'i-. ,"1 '� � ✓�G;�'f Lienor's Name: American Concrete Industries, Inc. 350 N. Rock Road Fort Pierce, Fl. 34945 `�..;�" _ ----t;.__.___ �;� , Print: � �o�Y''r'�1`� ''� � � � ;�- Title: ;'��:>�C_.-„,:': State of Florid� County of ` - r" �,r�,� � `';•';;_ � The foregoing was su�scribed b,gfare me this `% ' day of �':< :' , 2021 By �y�; �.�: ��-- `, �.��g d before�me th �� •"� �r`,�� ,� _%;�� Who is pg�Lnally known And who acknowled at the same was executed freely and voluntarily for the purposes therein expressed (under authority duly vested by said corporation) My commission expires: � � �) - "� % ti ..:i E n7r:50:' % r _ ; r loe4)5 %/� � .;� : � ', " yTFd�. '�-..' ,..=..r-',��- Notary Public, State of Florida Partial Wa�ver attd Release of Liei� "I�he undersigned lienor, in consideration of the sum of $ 64,833.33 hereby re(eases Its lien and rights to claim a lien for labor, services or materials furnished Thru 3-19-2021 to Ci"I�Y of Ol:eechobee the praperty described below for the City of Okeechobee "Che tblloivin�, describcd propeny: City of Okeechobee Taylor Creek SC 8"' Avenue Conveyance @ SC 8th avenue and SC 6"' Court RF.F: Drainage work per contract This ��aiver and release docs not cover any re[etttion or labor, services or matcrials furnished after the date specitied abovc. Dated: ��7�� Lienor's Narne: B&B Site Development, [nc. l �OS C South Pan•ott Avenue Okeechobee, Florida 34974 i�Q_k_ � - � ,.�y��, Print: Michelle H. Bauehman Title: President State of Florida Gounty of ��.,�� The foregoing was subscribed before nte this �1y day of ►`t�a,c�h , 2p21 B� ��— �� t �e6 S��c.pr�/e1�oQrricn4 T,,. Who is personally known And who acknowledged before me that the same was executed freely and voluntarily Far the purposes therein expressed (under authority duly vested by said corporation) My commissi � ' �� TfBdSUMIV811WiBalFlaiOu . � ((}� G � MyConYnhaon HH Ut368D J�LL-�.� %�-�'----""- � ` _ Zd -�C Notary Public, State of Florida 5 t9�2o2 t o � ye CITYOFOKEECHOBEE GRANT FUNDS �,. 55Sf.JRf�AVL\l�F •CN(Li:G'NUfiEe.FLJ:VlJ � � �� S�.inTrust Ousincss Online :;F��;Bn„K 001376 �.,— �1 F C � �'1FFpf F. ,....� n i ._, ;��=c.w�.:.r��..r. �376 ��r ooiuus•rw ecvs ..,e a_... "' Sixty Four Tbow^and Eiyht Nunamtl Thirry Thrao and 33/100 Oollars "' 3i3V2t �4 g33.33 . o n;e cr+c��. CITY OF OKEECH(3�E'E `. f3 & � Si;o Do�c;opment �� /( �/� � �,�r.QA 7505�C South Parro¢ Avenue � � -- 0 Okaechobee, fL 3�i97a �— � ''+./ . _._______ _._-__.._ . _______— �i'00�376��' �:063i02152�C�0000qA433020��' ,�.-._'._;-_"'i .� '_�: � �1I !; ' � Ili�� S��dl' � ;j�� I�,�f`s � ��tl � � .. �JJ.I'J c i . �OOU: �. >. , .� v.. � � . �. J .,.>i. i'; ;;��, i;�`". 3F t ; . ! � I _�J I Ix � `o 0 im m � �< �m;:��; � �,� i c ��s � ,R i I � :ITY OF OKEECHOBEE : 3.E.3f�D,-:/ENt/[ • �7K: EC'.HGH'cE FL'3:.si: _ 3.�19i21 PW 02-00-12-20 �OF OKEFQS;.\ CITY OF OKEECHOBEE � oe,� GRANT FUNOS ��T .,.� S.E. 3RD AVENUF • ��NFri:HCi9EE. F1'34974 Z ��,p� 0=,�' . � 64,833.33 � '` . _�::�, TOTA SUMi�HU_TEiANK. OKEFCf10BEE OFPI(,E 315 ,^. N%v RO'I T AVFNI IE. �KrFCM � flF .. '�I :fc�� : 64,833.33 L 64,833.33 c�-aic 001376 "" ppY WLLARSAND CENiS i�l:i'F i�".:l)'Jh: "` Sixry Four Thousand Eight Hundred Thirty Three and 33!100 Dollars "' g 3/31/21 CITY OF OKEECH�B�E33.33 I(.-:�I11� �",RUF.F �� i �� B& B Site Deveio ment t �' ' P , — C�,�-s�.... _ c��u.e... __ 1505 C South Parrott Avenue �'� �-"" Okeechobee. FL 34974 __ ::�' _____ _ . __ _ _ .._ _ _ n•00 l 3 76i�' �:06 3 �0 2 i 5 2�: �OOOOO,E}1. i 38 20��' _ _ ___ — — ____._ _.. _ - ---- __-- --__ __ __ — Date: 3131/21 Check: 1376 Amount: 64,833.33 Discount: 0.00 Vendor:6 & B Site De�elopment Invoice Amount Reterence Amoun[ Description Distribution Amount -� -- ...__... __--- — -----�------. .. _.. _ - -- . __ . ... F Vv �):i-i ,. i0 6C.8,]J J3 '. 5571�? �:.833.33 PO SJ25 C?raw t Taylor Cmek Stortnw.V.r.,on�ey:m 3n, 0554-OU7.6300 f�l...l .+? `\�y.oF •OKFFCy �, . o ti. � ��`' .,,,� �'" y.�'/ : .�'. T ��f-�:� � � � i._� J --' ;a . %'9} * TO: B& B Site Devetopment 1505-C S Parrott Avenue Okeechobee, FI. 34974 ITEM NO 1 VOUCHER CIT'Y OI� OKLEC�-IOBEE 55 SE THIRD AVENUE OKEECHUBEE, FI. 34974-2903 863-7G3-3372 ACCT. NUMBER QUANTITY UNIT DESCRIPTIOiV �59-6300 PW 02-00-12-20 Taylor Creek 10% �etention fee PO Amount 184,813.65 Reps. 64.833.33`� Balance 119,980.32'� :Itt Or OKEECHOBEE IS FXEMPT FROM FEOERAI EXCISE ANO TRANSPORTAiION 'AX:S qND STATE SALES 7AX. DO NOT INCLU�E THESE TAXES IN YOUR INVOICE. XEMPTION CEBTIFICATE WILL BE SIGNEO UPON REQUESi. ALES TAJ( EXEMPTION NO. 85-8012G21656C-6 - EDERA� I.D. NO. 59�6000393 � PO 5025 Draw 1 3/29/2021 UNIT AMOUNT 72,037.03 -7,203.70 TOTAL 64,833.33 / _.. , � AUiHOBREDSIGNATURE ' RECEIVED idAR 3 Q 202? n =� �I_� Documertt G7�02" — '1992 Application and Certi�cate for Payment ��( ��'� _ TO Contractor: Cify Of OkBeChobee PROJECT: 7aylor Creek SE 8th Ave APPLICATION N0: 1 Distribution to: 55SE3NAv�nue Sto�mwaterConveyance PERIODTO: 3/19/202f OkeecFro6ee, FI34974 OWNER: x " ARCHITECT: FROM 8&B SRe Development Inc VIA .� •. • CONTRACT DATE: 2'12/2021 CONTRACTOR: CONTRACTOR: f 505 S Parrott Ave ARCHITECT: ' � �''� :.: PROJECT NOS: PW 02-00-12-20 Okeechobee,FL34974 . - -_�", .�_;;�.,�, � FIELD: OTHER: CONTRACTOft'S APPLICA710N FOR PAYMENT Tne undersgned Contraclorcert�fies Ihat to the best of the Convactors krr�vriedge, mformation arui 6ehef �he'Nork Application is made for payment, 8S ShOWfI belOW, ifi COf1f12C110f1 Wilh ihB COf1�f2Ci. covered by this Applicatbn for Payment has been canpated in actordynce w,th the ConVxl Documents, lhat al! artrounts have 6een paid by the ConUaclor iw Work tor w�ith previous Certficales for Payment were issued and Continuation Sheet, AIA Document G7D3, IS 2f�dCI72d. paymenls received 6om the Ovmer, anA thatwrtent payment shavm herein is now tlue. 1. ORIGINAL CONTRACT SUM ................................................ $ 184,813.65 � 2. NET change by Change Orders .......................................... $ - CONTRACTOR: ,%� � /' 3. CONTRACT SUM TO DATE (Line 1+2) ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, g tg4,813.65 B: � j/� /�'/� '' r r� �' ' f Y �� i ., x�, _ •9 ��' l.�: � I _ Date: • : " � �t� f 4. TOTAL COMPLETED 6 STORED TO DATE (Column G on G703) ... $ 72,U37.03 State oC yr"Couniy of � + 5. RETAINAGE: Subscribed and swom to before me this•-� J"�✓day oi 1 Qfi I1 20�� a. 10 /o �o Of Completed Work $ 7,203.70 �. (Column D+E on G703) Nota Public: 7�(� � ��! �' �, y* ry��a� fy 1(,{; �" �, �.�.. �ri j� aQ � Y Puonc State c' F<ar.ea b. 10% °lo oi Stored h4aterial � Palty M Burnette My Commission expires: � My Comm�ss�on r.n ,pt�: 3: (Calumn F on G703) 'i,,,,d� Ezpvas t�i0Yrz02n Totai Ratainage (lines 5a+5b or Total in Column I of G703) S 7,2U3.?0 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE .................................... $ 64,833.33 (LinB 4 IeSS Lin2 5 TOt81; In accortlance wiih the ConUxt Documents, based on omsite observations 2nd Ne data compnsing this 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT ................. app�icatbn, the Architect certifies ro Ne Ovmer that to the besi ef the Ard�itecCs knovAedge, intormation anU be�iet the Work has progessed as indicaled, the qualiry of the Work is in accoNante wilh Ihe Contract DccumeNs, and (Line 6 irom prior Certificate) the Contractor is enG!IM to payment of !he AMOUN? CERTIFIED. B. CURRENT PAYMENT DUE ................................................. S 64,833.33 _. _- 9. BALANCE TO FINISH, INCLUDING RETAINAGE ...__. -. i{ '' ,! (Line 31ess Line 6) $ 119,980.32 ;' AMOUNT CERTIFIED �" "� ............................../....: ............... �i,zf �j� 3�' �Atlx+�ed Bxplana;,0�ilamounf rertAaU aMe�s Irom the emourq,epj4ep, Irt1ie1 a� Fgipes ar fhrs Appleafia� antl a� Ihe CHANGEORDERSUMMARY ADDITIONS DEDUCTIONS �0°r'w"108�°"�'��'etneoyedrocadnmwrtntneamamtcert�,ee.� , ,;,, Tofal changes approved in previous monihs by Owner ' � �- � � ARCHiTECT: ` - "'} 7Tota1 approve0 thrs Monih l .� -' �� ' : By: - ,. DATE: �=flt.� TOTALS S _ S _ insc?ruf:ea!enirolnegcna�e. TGeAA10UVTCER.TIfIEDhpaya�ko�i��yto!heCwitraqauemclixrnu. Iswnnre,�iyn�evi NET CHANGES by Change Order � eed ar.xp�y�ce ol0ayment are vntlioul prejuiice loany nphls of iheO.�rrr w CmYa-tor un,^.c� I�is Carract , '),1 � ... ..� U � 1 `A . �I:�.:w i . .J • . a �� oia �.. io -�lr��q,�.nw:inno uum�.�nuno � . . u .u. .ur�m� ui� > ii�.0 .u�� n ini �� u •. , , -" orY �y� ... � ua i i mwu � r �� . . �. ,i � V . �� . �, i . uaj tcw � � cy c, u.r � - �xi � � �ti. pru. _ °.. � r c� vc � e�nem possioie unani me iaw i nis oocurnem was proouceo uy nih sortwaee u� 1iw �.n.,w ui i u.�i i �r�uur ��aer vraer rvo iv�uea.w�o � nicn`expire:: on �� ii�wo. � n,o is noe ror ieyei� U58r Nofes� `�'�lA �ocumen�t G703'" — 1992 Continuation Sheet niniw,��,�.��c;u..nvm.icnnrienHuaseuricnuoNt�oKr.�vn�i�ni. Fram:NXl3SiteDevebpment,ine. APPLICA'PION1u: �wu,��N, c.�m�,:u,r, ;v,�..�, ��r.a�M � ll��..n� 1 ob: 'I'aplor Creek SF. Sth Avenuc � :�rr�.tc.aTion n:rrr: 3nsrzoz� i� Wn�mr,w,, n.i,,....��:,�,�.,�, ,�.� y�,� nw �.�«,� �oi�� Luc: Okeechobee, PI. 34974 u,:i..m��i�„c�,:��.�..,,��...��r.��r.,, _.�.r,�,-r„�n.,.�„ ..�oi�U PERIOIITO: ?1f9/20tf ARCNITFC.I.'S 1'ROJI�:(? NO: PW02-0042-PO A d c D E F G H � WORKCOMPLETED MATERIALS PRESENTLY i07�L REM FRON THIS PeRIOD COMP�ETEO BALANCE TO RETAINAGE IF OESCRIPTION OF WORK aND S70NED FINISH VARIABLE N0, PREVIOUS ��RED�NOT h t UNR APPLICAiroN M D OR E� io oa7E «� �� (C � G) RqTE) MEAS q1ANTRY UNITCOST SCHEWLEDVALUE �O�E) ��E�F) + Mo0 and Demob �S � 5 9,400.65 S 4,700.73 $ ; 70033 spi; S 4.700.32 : � Turbfdi controls �g � a�oo3 Ty S 1,055.00 S • � ox S t055.W 5 � Piping materials and inlets (6ccluding f i7,836.T0 $epOratorj �S S 64,263.00 S 5i,&36.7D �D?�; S 6A26.:;D 5 5,783.87 a Drainage Seporator LS i 5 32,550.00 S o�.k 5 32.550.00 5 s MalntanenanceofTraffic LS t S 6,00a.00 5 a,ouo.00 5 ;?nxa� ,pa,�; 5 3,000co z 3P7 6 Concrete Side+valks curbing and Driveways �S � 5 30,845.00 o°s S �o,eas.oa � � SubbeselBaschlaterialPlacementincluding S a,500.00 ccm action LS ' S 9,000.00 ;.c?9.00 Y1=�. 5 1,5Cc.p0 < qSC�ryJ � � Roadway Paving LS S 27,700.00 � oyo s s�,�c�.a s s Roadway �darkings, SUiping & Signage lS � S 3,o00.Uo c�t 5 3.anoc 5 +� ProJect Sta6ilzation and eleanup LS + 5 3,oao.0o s ox s a.000 0o s +� ConsiructionLayout/RecordDrawings L5 � s q,00o.a0 f 2,aoo.00 ?�;ppp �po5 y,qp,pp s 2JQ.00 S S S 5 S $ 184,813.65 50.00 SD.00 572,037.03 50.00 $72,037.03 39% 5112,776.fi2 5T,203.70 OKEECHBEECOUNTYCEMETERVROAD�MPROVEM19ENTSSOV PAGE I Of 1 P�rrticz! Waiver aszd Release of'Lien (Coyttinent icJ�on t•eceipt of p�ry�nent) "I'he �mdcrsigneci lienor, in consideration of the sum of $ 64.833.33 hereby releases Its lien and rights to claim a lien far labor, services or materials furnisheci Thru 3-19-2021 to CITY of Okeechobee the propertr� described below for the City of Okeechobee 1'he t�,llo�ving described property: City of Okeecl�obee Taylor Creek SF. 8`�' Avenue Conveyance @ SE: 8th avenuc and SI; 6"' Court RFiF: Drainage work per contract This �vaiver and release does not cover any retcntion or labor, scrvices or materials furnishtd after the date specifiea �bove. �7 � � D�ted: ;��.;�,��;�(��.1 9 �— Lienor's Name: State of Florida cot��lty ot ��,G��ecl�; ��e �. B&B Site Development, Inc. 1505 C South Parrott Avenue Okecchobee, Florida 34974 ��1��'� ��.� �'-� � � i � =i � �:1� ; r �i;� a� �: ��- Print: 'i i v C`�� i'C��.�t'�<<f}L. Title::%� �� ., �" ° - —� The foregoing was subscribed before me this �� il`�� day of I�t.��'�i-�'-� , 2021 E3y��'��i'.i^�i�� f,;,.:!c:l�;��z!bf _,��-r,, '�t,t�. ��=;:, ,�n�;?r,f I;�� - ��, , ��_ Who is personally known And ��ho acknawledged before me that the same was executed ti•eely and voluntarily for the purposes therein expressed (under authority duly vested by said corporation) My commission expires: .. Pa�ly M Burne�le ,p My Commisswn MH O�B734 �aFy� ExO�res 10l02/302A ! �� ,� i �_,;��.t,��i ��-I � ��uz t�_.r� ;� Notary Pi�blic, State of Florida �BId$��I � Ren�a/s Cunstructiun Noticc Dept. I'O Roz 1359. Simi Vallev. CA 930(2 :Iddre.e.a Scr��icc H�rqur.��ed „�i �r._ozi crrv or- ohcr_c►ioE3ee �� SE �RD AVF OhF:L:CIiOI3GG. I'l. 34974 9 i I-i 7iS93 tiUi(i UII I? 9Ci•11 _'? u�r�%o-} 600%s>% I:nclosed you will tind a notice [hat is bcing senl to yuu on bch�ilFof Unitcd Rentals (North Americti). Inc. in rcgards to thc cc�nslructiun prujcct know-n as SI: $Tli AVIi 1�4PROVEMIiNI'ti _�i and loc:itod a� SI; S'I I I �V1=. ,�NI) SR 711 . OKF.f:CI IO[3Gf:. PI. 34974. "1'hc name and adJress ol�thc p�rson who cunU:ictcd tiir thc liunishin_ ufequipment is B& B SI'I'li Df:VI?L(7PML;N'I WC I�O� S I':VtRO"CT �1V1� UNI"I C, OKt{k=.Cl IOtilil•:. PL 3�974-(i129. "Thani: you ior taking thc timc lu rcud tiii5 Ic[tcr. This is NOT a Licn or liond Claim �ind docs not neccssarily indicatc any amounts arc cw•renth� ovcrduc l'his notice is being sent to makc y�u awarc we have provided scrviccs lo somrone contributing to this consn uction projecL This is a common pracedure rcquired by stature in many statcs. 'ihis notice i; not rccordcd and i; nut public information. '1'I�is nntice should nnt reticct in any ��ay on [hc intep;rity or credit standinti of smy p:�rtics associated �vitU this job. An,wers to a fc�v comnion quos[ions regarding thc enclusrcl noticc: Wlml do 1 du i1'tltis nolicc cuntains inacau•atc infnrma[ion? We �ttempied tn ��rity ,ill inlorivation bcl�ore sending this notice. I f airy of'thc construcCion partics listed on the docununt :irc incorr�ctly retorenced cx you discowr any othcr inaccurac�� in the information, plcase cont;�ct our Ihird pcu•q' providar at 800-�2?-3SiY or cmail unitcdiq!crlsc�lutions.com. Our rccurds indicatc [h� fullowing partics arc associated �� ith thi; job: Owncr: CI'fl! OF OKEECIIOISI:G.OICEECIIOREIi. Fl. Ceneral/DirecdOrigin:J ContrActnr:l3.l'• l3 SI'1'E UI:YEI.OPME\l� INC. OKEt:Cf101i6:E, FI, LenJer/Suret}•:Plense xdvise if Lender/Surety i�pplicabic How do I oblxin invoice copics. mal:c payments, or rcqucs� a licn rele:ischrai��cr? Cu,tomers mav xcess all of the above via UR Conu�ol at www.unitech�entuls.coni (click on Online Serviccs, then UR Control), or by calling R88-4RI-2660. Lien relcase, requcstcd via UR Contrul will he provided within 2d hour,. I'hose requested via cmail Qicnrcicases,� ur.comj ur by phone will hc provideci wiihin 7? hour;. �o-rice ro owNctz�uc��ric[�: �r�� co��r�tnc�roiz I I'rrlitnin:u'� Nolicc. Noticc Of Intrnt To Claim :\g:iinxl Rond) ll':�RNIN(i! PLORID;\'S Cc)NS'fRUC11ON LII'.N 1.:1\1' AI.LOl1 S SO\q!i U\'I!�11D C'(1N 1'It:\(' PORS. tii ilil'ONfR:1C„fOltti.:�Nl) !v1A'I'I;RI;1L SUPPLIIiItti 1'U PILG I il:Ni :\(iAl!�ti'I' Yt)l II2 PROPIiR l'ti' I:VfiV' IP YOI' 11:\\'G hl:\I)I: I':\1'\il:\'l I\ I l l.i.. t�VUF.I< PI.OKII)�\ LA\V. 1'(NJI: P;\ILUKII �I'O M:\I:I: SUlill 1'I I:\T 1VIi ,1kli P:�II) \1:\Y It1iSUL1' IN ;\ 1,11[N AU:\I\S i� YOUR PKl)I'IiR'('1' :\VD YOl' P:11'1\(i I'11'I('li. �f(>:AA'UIII ,A 1.11?N ,AA'I) P�AYI\G �I�11'ICI:. ti'Ol � �IUti'f OIll;�lA' �� 11'Itfl"fl;:A IZI�:I.I�:r\SI? I'itt7�t t �� I�b"I.R1' �fltili: YOU P:11' YOl iR COA�fRAC"fOR. I�O'11�11[ O\I'vl?R: crrv or o�:ra�.ci iorsei�; ;s sr: �itu nvi�. UKGECI IUlilili. PL 3�147d (.'t.tti fU\IIiR: R X IS SI'fl{ I)IiVIiLOI'hll{NT IVl' I505 S I': Vtlt�)1' I' :A Vf: UNI�I C. Uhl[IiCIIOBIiI',. PI. :.�q7.{-GI?9 "I'hr ur.�lrni_nrd hcrcb�� in(urms �uu lhat he lias Iiu�nishrJ ur is furni;hing s�•rcicc> ��r m,rtcrial, :u li�ll�i�cs: \':iri��us ('ansuvclinn I:qui� mtn� Rcntals. tiir ihr impru��cmcnt ol'rcal propcm� idcntitirJ as: Sb: 8"I'I I:1VI�: Ik1PltOVL�iliVfti'_-1. -I�ht prop¢nc is Ioc:�t�:f t�C Sli til�l I;\Vli:\til) tiR ?u.. Ul:b:l'.CIIUlilil?. I��I. 3-t')Tl. rV'\::: .(.indcr.m ordn� ptiocu b��: H K IS il-I�h. I.)1'�'I?L(�I':\�Ili\�f I\C. IiU� ti P:1KRO'I'1',\VL I'\I'f ('.. UI:P.I{('1111IiI:G. PI. ;.J97-l-h129 � :1 d�•m:m�l i:: madr lin� u cnpy� af lhc Nulice ul C'uimncnccmciu tu br I;�xcd tu Slli-i??_7171 . or :niail to m}jahintiryi'crl;�rlwii.ns.cum. Anv dtmunJ maJ�• pur,uunt �� Scciiim 71 ;.IGf2) or Secliou �1 ±J6i'!) ar ticctiun 2».Oi. Plurida Slntut�•s. musl hc s�n�cd as follo�cs: \:uno u� l.icnucl.ini[cd I<tnt:ds �\ortii :\mrricu). ine. IO.i30 D��iJ "I'a�iur Dri�c Ch;u�luLL�•. V('?R?(i2K1111-i22-3RSR PLOI2IU:\ f.:\U' PRIitiCKlldh:ti TI Ili SI�:ILVIN(i UI� �I'I I(ti 1�<TIICI`.:�\D KIiSPRIC'I'S 1"UUIZ KIGI fl -fU \I:\klf P:\1'�IIf\Tti t. �'\UI-:K 1'OUK CO\��ILAC'1' IN ACCUItI)AN('I: W'I�I'l l tiliC'I'IUN 71.i.0ii. I�LOKIIh� SP:�"I�l'l'P.ti. IP lUH li ItUVI)I�:I7 UNI)lilt til{Cl�lO\ 713.?: PI..OItll)A 5'fA'I'l ��Ili.l'. tiI:C'llON 2ij.p5 I�LORII);\ S'I':\l�l!"I�liti UR ?7U I I.ti.C. �Ilil�. I'IK��I tiI:NDING "I'I Ilti NU"Il('l; �L�II.I I.00f< l'O l'I Ili I30ND (tiURI:'1'1' CO.) POI2 I'RO"fI'.C'I'IUN II' NO'1' P:11D. If PAV'\41�:N1' RUND L-:XI�TS. PUKNISI I A t'OPl' �I�U l'UI: U\I)IiRti1CiN�iD. I'ROVIDIi N:\VIfi;WD ;\Dnitti5ti OI' ISU\UIN(i ('OMP�\VY'. PAILUItIi fU PltO\'IUI{ ll Ilti NF(HL\L� fIUV A1A1' I2P.tiD1'.I2 YOl I.I:\Itl.ii POIt DA�9AGI;S. I'I.I;��Si•. RIiFL:it "fcl'I'I Ili Cifl \l \IItF.K I.I� I'I'.0 Ii1:L(i1ti \1"I il `: Ith:SPONI)W(L IP -I'111�:RP, 15 \tUlth: l-I IA1 UVIi CUN'flt.1(' fOK O\ 111L: P.N"IlKli PKU.Ih:C'I�. PI.P:A�h: PI'IL'�'Itii I I�I Ih: I'\DI`.Ittil( LVlil) N'I"fll A<'UI'Y' I1P P.A('ll C(>\'fRAC'I�. Iti1P(1R f:\Vf I\fOR�I;\Il0\ POIt 1'Ulil: I'Rt)I'f(`IlU1 l!ndar IloriJ:i s I.a«�s. th��.;�: �� hn �e�urk un � our properq- ur proeidr m:ncrials �eho arc noi paid hace a rieht ti� rnli�rcc. lhi�ir ��laim li�� p:i� iurnt :i;_ainst ��uur prnp�•rn�. -I'hi, cl:�im is knnwn us �.� Cunstruc�ion I.i�•n. If vw�r contructur I.iils to p:p� sub�•unUaclnts or materi;ils supplicrs ur naglects tu wukr olhcr IaEall�- rcyuired p�ry�tnunls, the pcuple �vhu ;u'�• uwed monoy nt:io laok ta puur properly� liw p�ivm�nt. IiVL:N IP YpU I1:AVli P,�IU 1'OUR CON"fKr1C'fOR IN I�UI.I.. PIt11'll;(.'f 1"l)URtiI?I.P - RIiCOCiNI"/.G th�l this Nuticc tu O�cncr m;q� resull in a licn ai�ainsl your proptrt�� tmirsa all lhusc supph�in_ a �:otlec [o O�� ner Ictvc h�•en paid. I.fiAR� tno�r abuvl d�t ('un�trurliun I.icn L�w. Chaplcr 71i. I';vt I. ;md Chaptcr'_». 1'Inridn tiut�uir, �and the nrcaning ul this \u�i..�i' hy ��nntasting :m :utarne�� or Ihr Plorida DcpL u(13usincss and I'rolcssi�mal Rcgulatiuu. I deelar�• lh:rt I:mi authoriicJ tu lilc Ihis �•laim ou behalfoYlhc daimani. I hac�c rcml thc li�rc�ning documcm and knm�� thc cowants iL.•r�•nl: th� samc i� truc oi my u�Yn kuu��lcdgc. I Jccl,uc undar pan;dty oi pci,iury thai thc liircgoing is u�uc and an rcci. I>sccuted at tiimi V;Jic�. l'A un i'I ii20� I lin� I;nitcd Kcrual, (tiorth ;lmeric:U. Inc. . B�: _ __--__ _— - . _ � _ I.auru Puvc� : :\uthmlrc�i :\��•ni li�r Unilcd Rcnlals 1\'urth:\meric;�l. Inc. CC:'f0 C)RI(il\AL. CON flt,�Cl'OR li K 8 tiffll UIiYI>LOPMI'N'I' INC I�US S P�AKRUI'"I' .4VI: UNI�f C l)l:P.t?CFIUIiI;I' RI..3dn7:1-61'9 Ccn r;: �� i 14 ABNR R0: 0 IIU 1 i 9(i-0 I 23 CRPt7: GIIU75>6 C(.': TO I.I'.NUI:R. SUltl�:l'Y OR RONDING COh1P:1NY' � 5/25i2021 SunTrust Business Online 001378 "'�_ oi �•'�cy CITY OF OKEECHOBEE �r' 4+ �j GMNiFUND3 JUNTRUSTBrWK 55 S.E.9ROAV[NUE � ONEECHpOEE, FL J<D7a � ON[ECMD�Cc OfFlCE � 1 lIS�.PMnJTfA�i.l:UE CNC[L�I�_G!C.ILN9i� u\�[0`��0�: / �''1�1Y"' 'v �' 1378 Y�Y oMiwns�NO cErils W;F iwWrvt ••' FiRy Six Thousantl Flve Huntlretl Siz antl 65/'00 Oollars'^ 5/21121 SSG.506.65 ro rHe oaoen CITY OF OKEECHOBEE OF � 8& B Site Developmenl C- _� �505•C Soutb Parrott Avenue Okeechobee, FL 34974 ��'00 13 78�i' �:06 3 LO 2 L S 2�: 10000�04 3 38 20��' i i� �� t�i �I• E• ��;i ��! �31�� j� '��ri � � i! I:'� � �� i Ii�E?.�'l;jki 2i25o�F�3 2��,Pnn259a209 Ot3t Ispip• r,56 ''ip:i��#�1f . ��:'��i � �� -- • - - - - - xm S � � � ^� m s9 � 9 cm m� T�n L^�n ,� Y� �c'�� aS gmi3 _o•am� �R� ;�� r m ^`'�R u4 _ � �� ,� � r ur �ncc�nuoct 5 S.E. 3RD AVENUE • OKEECHOBFE, FL 3A974 5/20/21 PW 02-00-12-20 Finat pf �KEEqj, CITY OF OKEECHOBEE A+, �� p GRANT FUN�S �! m 55 S.E. 3RD AVENUE • OKEECH08EE, FL 34974 :F( o�� 56,506.65 PA� DOLLARS AND CENTS "'* Fifty Six Thousand Five Hundred Six and 65/100 Doliars "` 56, 506.65 TOTAL 56,506.65 SUNTRUST BANK OKEECHOBEE OFPICE 815S.PAqROTTAVENUE, OKEECHOBEE,FL34B74 DATE 63-215 001378 °" 1378 AMOUNT 5/21J21 $56,506.65 TO THE ORDER CITY OF OKEECHOBEE �F B & B Site Development � ' 1505-C South Parrott Avenue �� .�-' - � �- Okeechobee, FL 34974 E - i�'0013 7B�i' �:06 3 l0 2 L 5 2�: 100000D4 3 38 20��' Date: 5/21/21 Check: 1378 Amount: 56,506.65 Discount: O.QO Vendor:B & B Site Development Invoice Amount Reference Amount Description Distribution Amount PW 02-ODd2-20 Final 56,506.65 55474 � 56.SOB.fiS PO 5025 Draw 3 Taylor Creek Stormwater Conveya 307•0559�007.6300 56.506.65 �-�r-I� a�c��,�..��t ��cs2-- — -� s92 � L��(��r1 � i�i�'..�Y--_ '; Application and Certificate for Payment -- To contractor: Cify of Okeechobee 55 SE 3rd Avenue Okeechobee, F134974 FROM B&B Site Development Inc CONTRACTOR: 1505 S PaaottAve Okeecho6ee, FL 34974 PROJECT: Taylor Creek SE 8th Ave Siormwater Conveyance 3�I; a� �t;;;1, c�', VIA ._ ` . ARCHITECT: ' � �' ``L` '` ` ��"�` f Cu.i � 5t�5�� Application is made for payment, as shown 6elow, in connection with the Contract. 5'�S-c� 1 Continuation Sheet, AIA Document G703, is attached. 1. ORIGINAL CONTRACT SUM ................................................ $ 184,813.65 2. NET change by Change Orders .......................................... _ $ 3. CONTRACT SUM TO DATE (Line 1+p) ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, $ 184,813.65 4. TOTAL COMPLETED & STORED TO DATE (Column G on G703) ... $ 184,813.65 5. RETAINAGE: a. 10% % Of Completed Work $ . (Column D+E on G703) b. 10% % of 5tored Material (Cotumn F on G703) Total Relainage (Lines 5a+5b or Total in Column I of G703) 6. TOTAL EARNED LESS RETAINAGE ................................... (Line 4 less Line 5 Totai) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT ................. (Line 6 from prior Certificate) B. CURRENT PAYMENT �UE ................................................. 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 fess Line 6) $ APPLICATION N0: 3 FINAL PERIOD T0: 5/�2021 CONTRACT DATE: 2/12/2021 PROJECTNOS: PW02-00-12-20 Distribution to: OWNER: x ARCHITECT: CONTRACTOR: FIELD: OTHER: i ne unaersgneo wnvactor cerohes that to the best of fhe ConUactor's knowledge, information and beiief the Work avered by tl�is ApplicaGon for Payment has been comple�ed (n accordance with the ConUact Documents, that all amounis have been paid by tha Contracrorfor Work forwhfch previous CeNficates for Payment were issued and payments received from tha Ovmer, and that wrtent payment shovm herein is nowdue. CONTRACTOR: ��v �� "�� BY� � � Date: �.5 =10 -0�002, � State of: ounty of: Subscribed and swom to before me this , Traei Suqivan Notary Public: �j�V E ��O�M4 013938 My Commission expires: S - ARCHITECT'S CERTIFICATE FOR PAYMENT $ 184,813.65 � J�� ;. : In xwrdance with ihe ConVact Dacuments, basetl on on-site observations and the data comprising this application, the Architect cer6fies to the Owner thatto fhe best of the A�chitecPs knowledge, inlorma6on and belief �$ a28,3�6:93— �e Work has pmgessed as indicaled, the quality ot the Wo�k is in acwrdanrs with the ConVact Documents, arid � Ihe Cnntractor is enWed to payment of the AMOUN7 CERTIFIED. $ _._56�50fi.--I� �'' -- CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Tolal changas approved in previous mon�hs by Ovmer Tolai approved this Monih TOTALS $ - 5 - NET CHANGES hy Change Order $ .� �, , �_�---- � � AMOUNT CERTIFIED ...............................�,1.}:............. �' :i c.. , ,; �� s . -- .. r: �; (AttacA� explanaliond amounf ceqi(rod diNers lran Ihe amount 9ppb�ed. Irctiel eH 6gwes m Ih's Appl�icatian qid pi (/�e Cmti�ualron Sheef tAaf ere changed �o conlortn wAh Ihe a� nf EeRdred.) i ARCHITE� ' ,. B1', � � �� .:-_�,.-_ DATE: �;��,,; 7Ns cerlificale �s Aof riegdiaWe. Tlre pMOUNT CERTIFIED is payabie ml� lo Ne Contrapor named herein. Issuance, payrtwnt�� and acceptanca d payrt�ent ara withou! aejudice lo any rights of Ihe Ovme� a CanVactw undEr lnis ConlracL . - � P� � , a. r iueo ,i m i anu �memauunu� � reaues. uwmna�au rcprwuc�mn ar a�sv�ommn u� �ms nu� ua;umem, or uny;wmm� oi u, mey reswi m xvere civu unu crun�nm pcnmucs, miu wm oc pm5ecuteo �u me muxunum enen[ possioie urwer me iaw. i nis documenc was proaucea oy hw soitware a[ �iv:vy:.w uu oyr roi�uui unaer �roer rvo. iuu�m,rieo i wnicn ezpves on aic ucwo, ana is noe wr resaia. Usar notes: ' �AIA �ocument G703'" — 1992 Confinuation Sheet nin i�x�m�m cvnz, nrri.�cmocu nNuc�H'nricnrioN ron rnvmexr, From: B&B Site Development, Ine. APPWCATION NO: ��,�a��- ca��«ors.� 3 HNAL s �,ea «n�r u�� s wm�i,m. Job: Taylor Creek SE 8th Avenue APPLtCAT10N DATE: 0/2N202f �„�anw,��n��„.am„w,��"�a�za�om��e.,.4�ami�. Loc:Okeechobee, F1.34974 r�a�on •ro: e�aso2t Ux Calumn I un Convaxs �rhac c�iabic mminage fur linr i�ems rtuy apply. ARCHITECT'S PROJECT NO: PW02A0.12•20 A B � D E F G H I WORKCOMPLETED MATERULLS PflESENTLY TOTAL ITEM FROM THISPERIOD COIAPLETEO BAIANCETO RETAINAGE�1F �ESCRIPTIONOFWORK � ANDSTORED FINISH VARIABLE N0. PREVIOUS StORED NOT % UNR APPLICA710N M � OR E) TOOAIE �� ) (C • G) RqTE� MEAS QUANTITY UNRCOST SCHEq1LE0VqWE (D�E) (D�E�F) � MobandDemob LS t S 9,400.65 S 7,556.33 S 1,BSa,32 S 9,�o0.65 t00% S 2 - f 940.07 iurbiditycontrois LS � S 7,055.00 S 7,oss.0o S �,p�5.pp �00% E - 5 t05.50 � Piping materials and inlets (Excluding 5 sa,2s3.00 S Seporator) L5 � s 64,2fi3.00 S 64,263.00 70096 E - 5 6,426.30 � DrainageSeporator LS � S 32,550.00 5 32,550.0o S • g 32,55o.ao tW% S 5 Main[anenanceofTraffic LS i - 5 3,2ss.00 S 6,000.00 S 4,500.00 S 1,500.00 S 6,000.00 700% y . 5 �� e ConcreteSidewalkscurbin andDrivewa s i S �� S �,sts.00 9 Y �S S ao,e�s.00 s 3o,eas.w �wx s - s 3,oea.so � eombactlon ge Material Placement including �S � S 9,000.00 S �,ZOD.00 S 1,800.00 5 9,OOD.OD 100% S - 5 gpp.pp 6 Roadway Pavfng LS 1 S 21,700.00 S 27,7oD,00 5 p�,�pp.pp t00% S 9 Roadwa Markin s, Stri in 8 SI na e LS i - 5 2,��0.00 Y 9 P 9 9 9 S 3,OOO.QO S 3,040.00 S 3,�� s - 5 �� +o Project Stabilzation and cleanup LS i S 3,000,00 5 t,sc-0.00 f t,soo.00 5 3.coo.pp ipp% S ++ Construction La outlRecord Orewin s LS � - S �� % 9 S 4,OOD.00 S z,000.0o S Zo�.aa 5 4,aoo.00 t00% S - 5 auo.00 S f S 5 S 184,813.65 50.00 5142,563.33 542,250.32 50.00 5184,813.65 100% SO.OD E18,481.37 OKEECHBEE COUNTV CEMETERV ROAD IMPROVEMENTS SOV PAGE l OF 1 Conrlitional FINAL Waiver �in�l 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 Okeechobee the property described below for the City of Okeechobee The following described property: City of Okeechobee Taylor Creek SE 8"' Avenue Conveyance @. SE 8th avenue and SE 6th Court REF: Drainage work per contract This waiver and release does not cover any retention or labor, services or materials furnished aRer the date specified above. Dated: �� —�L 2� Lienor's Name: B&B Site Development, Inc. 1505 C South Parrott Avenue Okeechobee, Florida 3497� �/ �i U�� Print: Michelle H. Bau hman Title: Pcesident State of Florida County of n�,,,.�� The foregoing was subscribed before me this !a'�"day of /1�1.A� , 2021 By ��r�vllrll-8� of � , Who is personally known And who ackno�vl�edged before me that t e same was executed freely and voluntarily for the purposes therein expressed (under authority duly vested by said corporation) My commission � ,j�,�,s; >;ry PWic Smm d Flalde Fa,,.,A `i. `.: S:tM{y8f1 _.. 1nA w 1 1)V�'^-tiK�v,^`� i � '�' � ,.;:hx� HM Ot3660 pH' -..,.^4 �.f��Ul�l �� - Notary Public, State of Florida DocuSign Envelope ID: 896621D5-51CC-4F46-A748-1A4DBCEDF760 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 Okeechobee: The fouow;ng described property: City of Okeechobee Taylor Creek SE 8`�' Avenue Stormwater Conveyance. Okeechobec, 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: osiyoi2o21 (NORTH AMERICA) INC Lienor's Name: Uriited Rentals, kfX� (�DacuSlpn�tl by: �.�. �u� ssoa�aea�araarF CANDACE MOBLEY Print: T1t12: CREDIT ASSOCIATE State of R�C�t�Pi�xxx tvc COUrity Of MECKLENBURG The foregoing was subscribed before me this �o day of MAY , 2021 $y 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 r........�.-��..., c....�....- � i i�ciome �D eu5lpn�d by: C:�..l� !. M�f� 'Pi��; State ofl�'Ydfk#iX NC 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: T'he following described property: City of Okeechobee Taylor Creek SE 8�h 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: c5—�-�j-o?OoZ 1 Lienor's Name: Q Dixon Construction, LLC 4689 S W Dactyl Street Port St. Lucie, Fl 34953 �1�-f�%ta.-- l�aC 6LL. Print: /�1.1p h-r►rJ �i ��,6� Title: U1N h.2,V� State of Florida County of ��Pt _ The foregoing was subscribed before me this�day of , 2021 By ��I-�Qxd? °f ��1�.�C' 9�e }filc,�%m J Who is personally known And who acknowledged before me that the same was executed freely and voluntarily for the purposes therein expressed (undcr authority duly vested by said corporation) My commission expires: �, , � / � .;k Notary Pub�lc Slate of Flaida �,// �—_^ , Philip J Baughman / ��-"-� y% /--- _ � . �P'Raa6"°rz°� Notary Public, State ofFlorida ar.0 v v �� .. 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: City of Okeechobee Taylor Creek SE 8`h Avenue Stormwater Conveyance. Okeechobee, Florida 34974 Project #PW 02-00-12-20 FDEP Agreement No. LP47020 This waiver and retease does not cover any retention or labor, services or materials fi�rnished after the date specified above. Dated: /�'� � C��% Lienor's Name: American Concrete Industries, Inc. 350 N. Rock Road Fort Pierce, Fl. 34945 �� LC Print: f 0�'�':'� , l; t;c ;� : Z'ltle:��i/C .'rr7.-1' State of Florida County of ,�j� (�,rC� � � The foregoing was subscribed before me this�day of ./`'�C��- 2021 By �c'l�: i' �-. .5t��v� of ��.i;,,�,., �>nc �� ,.� ..�nC . Who is per nallv known And who acknowledged before me that the same was executed freely and voluntarily �`or the purposes therein expressed (under authority duly vested by said corporation) My commission expires: ; .fi'jYO.°F-,_ A'7q.4CIEAJOHN50N � /� � ,`J � ��`'��r��f � Commission=GG1U8505 y��•}y�, Ezpire> Septem�er2d, 2021 Nota PU I1C, State f Florida fOFFl.�'` BatldOdllW&.�ST'�NOWySG(Y[CC FINAL Waive� �ncl. 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 Olceechobee: The following described property: City of Okeechobee Taylor Creek SE 8`�' Avenue Stormwater Conveyance. Olceechobee, 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 fuinished after the date specified above. Dated: � L�_ . j �� - ,.�.1 Lienor's Name: C. W. Roberts Constructing, Inc. C ii.�C' 4t-*-�` ;._,�. �L11�' .L.�' � `�rint:: 1i�['� � ' F . �.��ua a ;' Title: �' �� ' ,� State of Floc•ida County of nKPech�f�e The foregoing was subscribed before me this_ L`�iay of _�_ , 2021 BY S�JQ Roi„�,,,,� of C"�,utZ Who is persona(ly known And who acknowledged before me that the same was executed freely and voluntarily for the pucposes therein expressed (under authority duly vested by said corporation) M� �� Notary Public Slate of Florida Philip J Baughman +d�a^� My Commiuion GG 242807 3 ExpiresOBItW2022 / '" " � , ��Z O "—' Notary Public, State of Florida �'�'�>��= FINAL Wcsive� an�l Release of Lien The undersigned lienor, in consideration of the sum of $10.00 hereby releases Its lien and riglits to claim a lien for labor, services or materials furnished to B&B Site Develo ment Inc. and The City of Ulceechobee on the p��operty described below foz- the City of Olceechobee: The following deseribed property: City of OlceeChObee Taylo2' Cl'eelc SE 8��' Avenue Stoimwater Conveyanee. Olceechobee, Florida 34974 Project #PW 02-00-12-20 FDF,P Agreement No. LP47020 This waiver and release does not cover any retention or labor, services or materials furnished after the date spccified above. Dated: /��a,, �/ o2po2 / r Lienor's Name: Contech Engineered Solutions, LLC. P.O. Box 936362 Atlanta, Ga. 3 1 1 93-6362 �� , / ,��'.i�.uG.c_r •A��C i��G-, G •� l Print: i„�,. �: a,C� �l r��, Title: �C, State of �s�a �-�°�� County of � 7�-% W `n�P The foregoing was subscribed before ine this // day of _/i% 2021 By � of ��w�� ece� ;o � Who is peiso ally known And who acicnow edged beforc me tl t the same was exccuted fi-eely and voluntarily for the purposes therein expressed (under authority duly vested by said corporation) .�`�`� � J � ab+�`''�, My commission expires: �.�`�,v�'•S;G,t'�, ry s'. ; ; �::,;' ,;;., „ �1�"f� v.^. " a• `c`' ` �� =�'� �o�'�^ r mr ��= otary Pu ic, State of F�le�i�a ; 2�T : � ✓ :°`� `�; ` �,O J,'a.. � .,�� ; %,1 f�,i;;'`\``�.