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11
INDIAN RIVER COUNTY, FLORIDA AUG j I ,-i99 L
APPLICATION FOR PAYMENT NO.35—
DEPT. ,
PROJECT NO:9623 ACCOUNT NO:315.-'10-572-068.09
PROJECT: WABASSO CAUSEWAY PARK BEAUTIFICATION PROJECT
CONTRACTOR NAME/ADDRESS: �iYL'\�i �Y��\� C� t7f �7Y�^� tom✓) _
APPLICATION DATE: I ►o I�� _ FOR PERIOD ENDING_(ollrt�(
STATEMENT OF WORK
Original Contrail Price $ c�lQ3. Materials StId $_ — 0 —
Net Change Orders $ �;2, 4QQ (Attach detailed schedule and paid invoices)
Current Contract Price $ • ` ZVotal Word/Materials to Date $oi(o5,_801,ga
Work to Date: Less 10% Retainage $
Under Original Contract $ Sub Total $'2iq �•9D
Under Change Order $�ICfE • (oa. Less Prior Payments $ --:):E!J9 , Q, +�
Percent of Work Completed to Date 4/0
BALANCE DUE THIS PAYMENT G
Contractors Certification
The undersigned CONTRACTOR hereby certifies that all items and amounts on the face of this application for
payment are correct; that all work has been performed and/or matenals supplied in full accordance with the terms
and conditions of the contract.
The undersigned CONTRACTOR hereby swears under penalty of perjury that (1) all previous progress payments
received from the OWNER on account of work performed under the contract referred to above have been applied
by the undersigned to discharge in full all obligations of the undersigned incurred in connection with work covered
by prior Applications for Payment under said contract, being Applications for Payment numbered 1 through -�
- inclusive; and (2) all materials and equipment incorporated in said project or otherwise listed in or covered by this
Application for Payment are free and clear of all liens, claims. security interests and encumbrances
Dated 2 �t� 1pfi R)<AV- '�C�Y�z' c-
ni01AN IVER COUNTY PUWI wOWO
BY:_��<;%J✓�! APPROVED GATE
(Nam le) OrRt; �� `' `'
DIV. HEAD j /
P.O. •
i G,.:_,� , 51
=S'E 19!1�1 personally appeared
vho being duly sworn, deposes and says that (so Is the
FACTOR above mentions, that (s&executed the above
nt on behalf of said CONTRACT bar o
tthal+ of-�►i®
corr t d complete aunty Commission
Apprtivery for Pavnrent
Notary Public --------_---- -- -----
My Commission Expires,2 �,�1 9 D_�te
A:'NI.Ii ATION F09 PAYMENT
Ar I
FINAL PAYMENT
CONTRACTOR
STATE OF FLORIDA
COUNTY OF
Personally before me the undersigned officer, authorized by the laws of said state to
administer oaths, comes A �rr-*r �rZ�- who on oath says:
That he is the Contractor with whom Indian River County, Florida, a political subdivision
of said state, did on the IG day of C-::) S? 1 9TJ enter into a contract for the
performance of certain work, more particularly described as follows:
WABASSO CAUSEWAY PARK
BEAUTIFICATION PROJECT
County Project No. 9623
Affiant further says that said construction has been completed and the contract therefore
fully performed and final payment is now due and that all liens contracting directly with or directly
employed by such contractor have been paid in full EXCEPT:
Name Description Amount
who have not been paid and who are due the amount set forth.
WITNESS: (Corporate Seal)
AWOZA/BROTHERS CORPORAIM .
K��bscri
astor)
By:Sb and sworn to before me this IC5" Day ofG �• 1
IAttest:
Notary Publi`3�,Ay��`s
G"G ..� fIGi iva at Large
My Commission expires:z �
Not
0HICIA KY. A
ROSEMARYFERRINO
ry yp p �v
Name of No t ed or anted
N(YrARYPUBIIC'sTATEGFF" "4
COMMISSION NO. CCWM6
Y E MM @ON EXP. MAY nM
I herewith acknowledge receipt of
Final Payment on above and do hereby certify that I
have no claims against the owner of said
property %%
Contractor
!NA1 PAYMVNI
FP I
X)s Artazoza Bros., Corp.
15901 S,W. 242 Street, Homestead, Florida 33031 - (305) 246-3223 - Fax (305) 246-0481
Mailing address - P.Q. Box 924890, Princeton, Florida 33092
....................
Atit� .91i.-1:�� 1t10t�;
`REQ':
Wabasso Causeway
Indian River County
1840 25th Street
Vero Beach, Florida 32960
Job Name: Wabasso Causeway
Indian River County Project No. 9623
Including c/o #1
Item Qtv. nwsrrintinn 'r- n�•e r i.,;• • r • , n- .
CU1
82
Coccoloba uvifera
Ea
0.00
82.00
$
150.00
$ 12,300.00
CU2
32
Coccoloba uvifera
Ea
0.00
32.00
$
50.00
$ 1,600.00
LL
8
Ligustrum Lucidum
Ea
0.00
8.00
$
350.00
$ 2,800.00
SP
346
Sabal Palmetto
Ea
0.00
346.00
$
160.00
$ 55,360.00
TSP
14
Sabal Palmetto
Ea
0.00
14.00
$
200.00
T-2. 800. 00
WR c/o#1
61
Washingtonia 8' & 10' CT
Ea
0.00
61.00
$
200.00
$ 12,200.00
WR c/o# i
72
Washingtonia 12' & 14' CT
Ea
0.00
72.00
$
250.00
$ 18,000.00
WR c/o#1
61
Washingtonia 16'& 20' CT
Ea
0.00
61.00
$
325.00
$ 19,825.00
WR
14
Washingtonia 22'& 24" CT
Ea
0.00
14.00
$
375.00
$ 5,250.00
IVN
196
Llex voimitoria
Ea
0.00
196.00
$
5.00
$ 980.00
SB
916
Spartina Bakerii
Ea
0.00
91600
$
6.00
$ 5,496.00
ST
164
Sophora Tomentosa
Ea
0.00
164.00
$
6.00
$ 984.00
HD
246
Helianthus did itis
Ea
0.00
246.00
$
2.25 1
$ 553.50
GP
223
Gallardia Pulchella
Ea
0.00
223.00
$
3.00
$ 669.00
MC
6601
Muhlenbergia
Ea
0.00
6,601.00
$
2.75
$ 18.152.75
SF
144055
Cynodon dactylon
SF
0.00
144,055.00
$
0.31
$ 44,657.05
CY c/0#1
599
Florimulch
CY
0.00
599.00
$
13.00
$ 7,787.00
96
Cao Rock Roulderc96-uu
$
1b 00
$ 7,200 00
16
Cap Rock Boulders
000
16.00
$
75 00
$ 1,200.00
c/o #1
1
Terrasorb
LS
0 00
1 00
$ -3,50000
$ 3,500.00
1
Mobilization
LS
0.00
1 00
$ 10,000.00
$ 10.000.00
c/o #1
1
Earthwork/Sae Preparation
LS
0.00
1 00
$
2,50000
$ 2.50000
1
Traffic Control / Safety
LS
0 00
1 00
$
3.00000
$ 3,000 00
c/o #1
1276
Instal! Shrub, 3 gallon
EA
0 00
1.276 00
$
4 00
$ 5,104.00
clo #1
7070
Install Ground Cover, 1 gallon
EA
0 00
7,070 00
S
2 00
$ 14.140 00
599
1 Install Mulch
CY
000
59900
$
12 27
$ 7,34_9:§2
cio #1
12
Relocate Palm
EA
000
1200
$
20000
$ 2.400 00
Total Cornpleted & Billed: $ 265,807.92
Payments Received To Date: S X39,227.12
M Retention ^ ».IS