2321 IFB 18/19-36 Park Ave Stormwater ImprovementsS ORD
FINANCE DEPARTMENT
'0A
L/
PURCHASING DEPARTMENT
TRANSMITTAL MEMORANDUM
TO: City Clerk/Mayor
RE: IFB 18/19-36 Park Ave Ston-nwater Improvements
The item(s) noted below is/are attached and forwarded to your office for the following action(s):
❑
Development Order
R
Mayor's signature
F-1
Final Plat (original mylars)
❑
Recording
❑
Letter of Credit
❑
Rendering
0
Maintenance Bond
Safe keeping (Vault)
F-1
Ordinance
F-1
Deputy City Manager
R
Performance Bond
❑
Payment Bond
❑
Resolution
F-1
City Manager Signature
City Clerk Attest/Signature
❑
City Attorney/Signature
Once completed, please:
❑ Return originals to Purchasing- Department
❑ Return copies
El
Special Instructions Please add with original documents
Li/ , r3oadzi4e,,,,-
From
SharePoint—Finance Purchasin-Forms - 2018.doc
3/1-1./2021-
Date
/11/202-1
Date
SUBCONTRACTOR'S / SUPPLIER'S WAIVER AND RELEASE OF LIEN UPON FINAL
PAYMENT
The undersigned Uenor.incmnmidarationofFincdPaymantindheanxouniof
. hereby weiwaa and releases its lien and right to claim a lien for
|obor, services ormaterials furnished to Soh ik Inc
(the Contractor) for the Project known as the 1" Street Lift Station
whose Owner ie Sanford The |abor, services or
materials furnished relate to improvements to the following property:
City owned alley that extends between I" St. and 2nd SL. between Sanford Ave. and
Palmetto Ave., and in 2 Id Street, west of Sanford Ave., in Sanford, Florida.
�}
DATED on.20_1`°l__'
Lienor BOB'S BAWCADES, INC.
921 SHOTGUN ROAD
Address: summSE FLORIDA 33326
4@Q QR 6994*196' 428 262;1
By: ~~
Printed Name and Title
97ATE OF FLORIDA -
Before me the undersi Notpi Public of the State of F1 rida, personally appeared
V)d 0-i*(06��J whose name(s) islare subscribed to the within instrument,
who pefs.onally--swQ�q, or affirmed that he/she is authorized to execute this docurnent and
thereby bind the Corporation.
^J � ��
Subscribed his day of .2O_l_�
6:ry Public Print, Type i-XI)IRB: Fcbfu,11)11, 2023
Commissioned State ofF|ori�o Name of Notary Pub|
I" Street Lift Station
AogLJvt1o.0018
���
SUBCONTRACTOR'S / SUPPLIER'S WAIVER AND
RELEASE mFLIEN UPON FINAL PAYMENT
Personally Known \/ Or, Produced Identification
Type of Identification Produced
END OF SECTION
15C Street Lift Station SUBCONTRACTOR'S 1 SUPPLIER'S WAIVER AND
August 10, 2018 RELEASE OF LIEN UPON FINAL PAYMENT
00646-2
The undersigned Lienor, inconsideration ofFinal Payment inthe amount of
hereby waives and releases its lien and right to claim a lien for
labor, services or materials furnished to Sanpik Inc
(the Contractor) for the Project known as the I"' Street Lift Station (IFB 17/18-61)
whose Owner is City of Sanford The labor, services or
materials furnished relate to improvements to the following property:
City owned alley that extends between 1st SL and 2nd 8t. between Sanford Ave. and
Palmetto Ave., and in 2nd Street, west of Sanford Ave., in Sanford, Florida.
DATED on 20
uemVc
COUNTY OF �/Q L
STATE OF FLORIDA
Before me, the under 'gned Notary Public of the St te of Flo A rsonally appeared
4E9��la2LQ ai lee of
�-� �; whose name(s) is/are subscribed to the within instrument,
who personally swore or affirmed that he/she is authorized to execute this document and
thereby bind the Corporation.
Commissioned State of Florida ---N� me of Notary Public
my COMMISSION # GG034410
Street Lift Station EXPIRES November 13,202§L BCONTRACTOR'S SUPPLIER'S WAIVER AND
August 10, 2018 RELEASE OF LIEN UPON FINAL PAYMENT
006464
Personally Known Or, Produced Identification
Type of Identification Produced
ENO OF SECTION
Int Street Lift Station SUBCONTRACTOR'S / SUPPLIER'S WAIVER AND
August 10, 2018 RELEASE OF LIEN UPON FINAL PAYMENT
00646-2
SECTION 00646
SUBCONTRACTOR'S I SUPPLIER'S IAWVER AND RELEASE OF LIEN UPON F11MAL
PAYMENT
The Undersigned Lienor, in consideration of Final Payment in the arnOUnt Of $_ -4— --
hereby waives and releases its lien and right to claim a lien for
Ialaor, services or materials furnished to Sanpik Inc
(the Contractor) for the Project known as the I"' Street Lift StatLion Ll FB
whose Owner is Crit of Sanford The labor, services or
materials furnished relate to improvernents to the following property:
City owned alley that extends between I" St. and 2"d St,, between Sanford Ave. and
Palmetto Ave., and in 2nd Street, west of Sanford Ave., in Sanford, Florida.
DATED on
Lienor:
Address:
By:
Printed Name and Title
COUNTY OF
STATE OF FL 4M79Z&—
the *81,e of Florida, personally 'appeared
as of
e,o
n n s isla e S rio
(s) is/are subscribed o the within instrument,
e—w� she is authorized to execute this document and
thereby bind the Corporation. 2
Subscribed and sworn to before me this, 4; day ofye-_ �_ 20_1,
of Iota Pubf`c
o ni Viln i �, sIr s
ioned State of Florida
1"'Streat Lift Station
August 10, 2018
Print, Type or Stamp -Vir
00 5
KARENANHW
Name of Notary Public f..* F�y commlsslo4q g C -,G 08C,05
ETBIES: Wmcdb, 26, 202,,
Bonded Tfru Wtwy RMc Wem*sm
— --- Z-__
r
SUBCONTRACTOR'S SUPPLIER'S A] , E -R R
RELEASE OF LEER UPON FINAL PAYMENT
mom=
Personally Known Or, Produced Identification
Type of Identification Produced
END OF SECTION
is' Street Lift Station SUBCONTRACTOR'S I SUPPLIER'S WAIVER AND
August 10, 2018 RELEASE OF LIEN UPON F114AL PAYMENT
ommm
SECTION 00646
SUBCONTRACTOR'S / SUPPLIER'S WAIVER AND RELEASE OFLIEN UPON FINAL
PAYMENT
The undersigned Lienor, inconsideration ofFinal Payment inthe arnountcf
hereby waives and ro|aesos its lien and right to claim a lien for
labor, services or materials furnished to San Inc
(the Contractor) for the Project known as the Is' Street Lift Station (IFB 17/18-61)
whose Owner is City of Sanford The Jabot-, services or
materials furnished relate to improvements to the following property:
City owned alley that extends between 1mSt. and 2 ndSV, between Sanford Ave. and
Palmetto Ave,and in2"uStreet, west ofSanford Ave,inSanford, Florida.
61
DATED on 20 19
Lienor
Address:
By:
Signature
PrinlCd Name and Title
COUNTY OF �'
Florida,STATE OF FLORIDA
Be
Pre me, the undersigned Notary Public of the State of U d
as pr of
Cc/L-rf*-ose narne(s) is/are Subscribed to the within instrument,
who personally swore or affirmed that he/she is authorized to execute this document and
thereby bind the Corporation.
Subscribed and sworn to before me this day of
tate i
2382
mission GG 2.1pj
Signature of Notary Public Prit
Commissioned State ofFlorida Nall
1uStreet Lift Station
Augumm.xnmRELEASE OF LIEN UPON F114AL PAYMENT
SUBCONTRACTOR'S / SUPPLIER'S WAIVER AND
Personally Known / Or, Produced Identification
Type of Identification Produced
ENI? OF SECTION
1't Street Lift Station SUBCONTRACTOR'S / SUPPLIER'S WAIVER AND
August 10, 2018 RELEASE OF LIEN UPON FINAL PAYMENT
00646-2
S#BCONTRACTOR'S / SUPPLIER'S WAIVER AND RELEASE OF LIEN UPON FINAL
PAYMENT
The undersignedUenor, in consideration of Final Payment in the amount of $
hereby waives and releases its lien and right to claim a lien for
labor, services or materiais furnished to Sanpik Inc
(the Contractor) for the Project known as the I" Street Lift Station (IFB 17/18-61)
whose Owner is City of Sanford The labor, services or
materials furnished relate to improvements to the following property:
City owned alley that extends between 1t St. and Znd GL. between Sanford Ave. and
Palmetto Ave., and in 2 d Street, west of Sanford Ave., in Sanford, Florida.
DATED on e- VIA, 20.6
By: A
Printed Name and Title
COUNTY OF,
STATE OFFLORIDA
Before me, the undersigned Notary Public of the State of Florida, personally appeared
as CALV"�'Vlokcc'
whose name(s) is/are subscribed to the within instrument,
who personally swore or a I qirmed that he/she is authorized to execute this document and
thereby bind the Corporation.
44
Subscribed and sworn to before methis day of
Signature of Notary Public Print, T)�peor,Stam
Commissioned State of Florida Nemo of Notary Public
1stStreetLift Station SUBCONTRACTOR'S / SUPPLIER'S WAIVER AND
August 10, 2018 RELEASE OF LIEN UPON FINAL PAYMENT
\ C r\
[�} ^ �z` �_
Personally Known Or, Produced Identification
Type of Identification Produced
END OF SECTION
1St Street Lift Station SUBCONTRACTOR'S / SUPPLIER'S WAIVER AND
August 10, 2018 RELEASE OF LIEN UPON FINAL PAYMENT
00646-2
� acjo'
SECTION 00640
CONTRACTOR'S WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT
The undersigned Lienor.inoonoido/oUonoftheoumoof $53,335.66
. hereby waives and releases its lien and right to claim o lien for |obor, services or
materials furnished through to the
for the Project knownaothels'Street Lift Station OFB 17/18-61) The
labor, services or materials furnished relate to improvements to the following property:
� �
{]b/ owned aUeythat extends between 1 8t and �� Gt. between Sanford Ave. and
Palmetto Ave., and in n4 Street, west of Sanford Ave., in Sanford, Florida.
This waiver and release does not cover any retention or labor, oan/iceo` ormaterials furnished
after the date specified.
DATED on October 22nd 20 18
L|nnuc Sonpik|no
Address: 3551VVLake Mary Blvd Suite 210
IS
Lake Mary, FL 32746
Matthew Sands, President
COUNTY OF Seminole
STATE OF FLORIDA
Before me the unders�igned.Notary Public of the StVe of Florida, personally appeared
4SCr%ft,�– :Pe'v-- --��h—ose name( -s) is/are subscribed to the within instrument,
who personally swore or affirmed that he/she is authorized to execute this document and
thereby bind the Corporation.
Subscribed and sworn to before me this A7 19.
"KI, state of Florida -N ta ry Pubtlic
i�,n G G72 1P2
lNtloh
-V, commismon t GG 212382
my Col it *010as
Signature -'of Notary Public 2�11 LCMTP -
Commissioned State of Florida Name of Notary Public
1stStreetLift Station
August 10, 2018
O0640-1
WAIVER AND RELEASE Of
LIEN UPON PROGRESS PAYMENT
Personally Known V Or, Produced Identification
Type of Identification Produced
15Y Street Lift Station
August 10, 2018
END OF SECTION
00640-2
CONTRACTOR'S WAIVER AND RELEASE OF
LIEN UPON PROGRESS PAYMENT