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2009-337
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Entry Properties
Last modified
3/18/2016 10:51:55 AM
Creation date
10/1/2015 12:58:57 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Change Order
Approved Date
12/15/2009
Control Number
2009-337
Agenda Item Number
12.J.5
Entity Name
Barth Construction
Subject
Change Order No.1 Indian River County Fire Station #12
Final Payment releaseof retainage
Area
3620 49th St.
Archived Roll/Disk#
4035
Supplemental fields
SmeadsoftID
7983
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x �I . <br /> � } AIA Document G706Ar" - 1994 <br /> Contractor's Affidavit of Release of Liens <br /> PROJECT: (Name and address) ARCHITECT'S PROJECT NUMBER: OWNER : El <br /> IRC Fire Station 412 ARCHITECT: ❑ <br /> 3620 49`" Street CONTRACT FOR: General <br /> Vero Beach, FL 32960 Construction CONTRACTOR: ❑ <br /> TO OWNER: (Name and address) CONTRACT DATED : 9/ 16/08 SURETY: ❑ <br /> Indian River County OTHER: ❑ <br /> 1840 25th Street <br /> Vero Beach, FL 32960 <br /> STATE OF: Florida <br /> COUNTY OF: Indian River <br /> The undersigned hereby certifies that to the best of the undersigned ' s knowledge, information and belief, except as <br /> listed below, the Releases or Waivers of Lien attached hereto include the Contractor, all Subcontractors, all suppliers <br /> of materials and equipment, and all performers of Work, labor or services who have or may have liens or <br /> encumbrances or the right to assert liens or encumbrances against any property of the Owner arising in any manner <br /> out of the performance of the Contract referenced above. <br /> EXCEPTIONS: <br /> SUPPORTING DOCUMENTS ATTACHED HERETO: CONTRACTOR: (Name and address) <br /> 1 . Contractor ' s Release or Waiver of Liens, Barth Construction , Inc. <br /> conditional upon receipt of final payment. 1717 Indian River Blvd., Suite 202A <br /> Vero Beach , FL 329 <br /> 2. Separate Releases or Waivers of Liens from BY : /i; ;, tIIIIIIIIIIIII, <br /> Subcontractors and material and equipment (Signature of authorized <br /> suppliers, to the extent required by the Owner, r sentati e) <br /> accompanied by a list thereof fL gmyV 0 i fM6 r <br /> (Printed name and title) <br /> Subscribed and sworn to before me on this date: <br /> Notary Public: ✓ k�A� 1 <br /> My Commission Expires: .7 / Z Z, <br /> , " • MARION H. <br /> *' M' COMMISSI III DD 7 <br /> EXPIRES: J� 2 , 2 798038 <br /> 8011101rnm IY Public <br /> 2012 <br /> � Notary Public UrxlBnters <br /> AIA Document G70BAT° — 1994. Copyright ® 1982 and 1994 by The American Institute of Architects. All rights reserved. WARNING : This AIA ' Document <br /> m <br /> prot((cted kly U ,S, Copyright Lav° and International Treaties . Unauthorized reproduction or distribution of this AIA Document, nr any portion <br /> of it, 1 <br /> r:ijy result in sevore civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law, This doeumentwas produced <br /> by <br /> AIA software at 16: 12: 19 on 12/02/2009 under Order No. 1000396135_1 which expires on 04/22/2010, and is not for resale. <br /> ( 1213547073) <br /> User Notes: <br />
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