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2021-085A
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2021-085A
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Last modified
7/2/2021 5:03:42 PM
Creation date
7/2/2021 4:55:21 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
06/15/2021
Control Number
2021-085A
Agenda Item Number
8.D.
Entity Name
Florida Site Contracting
Subject
4th Street Culvert Replacement at 90th Avenue,
Project Number
IRC-2022
Bid Number
2021045
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Page 5 of 5 <br />ATTACHMENT A <br />1. List of all subcontractors, laborers, materialmen and suppliers who have not been <br />paid from the payment received from the last Pay Request and the reason why they <br />were not paid (attach additional pages as necessary): <br />2. List of all subcontractors, laborers, materialmen and suppliers for which a signed <br />release of lien form (partial or final as applicable) is not included with this Pay <br />Request, together with an explanation as to why the release of lien form is not <br />included (attach additional pages as necessary): <br />Contractor's Application for Partial Payment - 06-09 rev - 00622 - 5 <br />F:\Public Works\ENGINEERING DIVISION PROJECTS\2022 4th St Culvert Replacement at 90th Ave\1-Admin\Bids\Bid Documents\DIV 03—Contract Forms - 20201118.docx <br />
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