Texas Waiver and Release of Lien by Contractor by mlp18219

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									Laredo ISD -Finance Department

Communications & Cabling
Section 1         -Project Description
Project:         Nixon (002)

Purchase order #:              2010702

Vendor:    Advanced Communications       Vendor ID #           2010702
           & Cabling
Section 2 - Checklist of final payment requirements:
                                                                                Attached
                  (Items a to d may be detailed in Attachment K)         Yes   No or N/A
   a       Affidavit from Contractor that payrolls and bills for
           for materials and equipment and other indebtedness
           connected with the work

   b       Certificate evidencing that insurance will be
           in effect until final payment

   c       A written statement that the contractor knows no reason
           that the insurance will not be renewable to cover the
           period required by the contract documents

   d       Consent of surety to final payment

   1       Attachment K   Certification of Project Compliance
   2       Exhibit A      Waiver of Mechanic's Claims
   3       Exhibit B      Final Release of Mechanic Lien Claims
   4       Final Payment Request

   5       Proof that plans were reviewed and filed with the
           Texas ADA Regulatory Agency
Section        3 Recap of Project Payments
           Total Contract Cost:          $ 49,628.63

                 List of Payments
                         D
                 Payment # ate        Amount
                       1    9/16/2002 $ 28,934.75
                       2 11/25/2002          9106.23
                       3    5/29/2003        4325.45
                       5     6/5/2003        4780.77
                       6    7/31/2003        2481.43
                       7
                       8
                       9
                 Final
                                       $ 49,628.63
Comments:

Special Conditions to Follow Up:
Laredo ISD -Finance Department

Architect/General Contractor Close-out Form
Section 1         -Project Description
Project:

Purchase order #:

Vendor:                              Vendor ID #

Section 2 - Checklist of final payment requirements:
                                                                                  Attached
                  (Items a to d may be detailed in Attachment K)           Yes   No or N/A
   a       Affidavit from Contractor that payrolls and bills for
           for materials and equipment and other indebtedness
           connected with the work

   b       Certificate evidencing that insurance will be
           in effect until final payment

   c       A written statement that the contractor knows no reason
           that the insurance will not be renewable to cover the
           period required by the contract documents

   d       Consent of surety to final payment

   1       Attachment K   Certification of Project Compliance
   2       Exhibit A      Waiver of Mechanic's Claims
   3       Exhibit B      Final Release of Mechanic Lien Claims
   4       Final Payment Request

   5       Proof that plans were reviewed and filed with the
           Texas ADA Regulatory Agency
   6       Certification of Project Completion by Campus Staff
            To be Signed by the CEIC. (Note Use format for Attachment K)
Section        3 Recap of Project Payments
           Total Contract Cost:

                 List of Payments
                         #
                 Payment Date        Amount




                                      $         -
Comments:

Special Conditions to Follow Up:

								
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