Okaloosa County BOCC — May 15, 2013 — CW Roberts Final Payment and Closeout Documents — reading text

has or will be made, and that the undersigned has the right to execute this FINAL Waiver and Release; and that all laborers, materialmen, and subcontractors employed by the undersigned in connection with the construction of improvements upon the aforesaid premises have been fully paid. L Witness Whercof, I/We have executed this instrument under seal this Z > day of if y Lf 2003 > ApliL 208. BY: Lp wn WVeez THLE: Eeteot State of, aaa lor ids. County of _ORafsodit The foregoing instrument was acknowledged to be true and correct before me by Dame Lhe , who certified under oath that he/she is the Pres tden& , of Peysonal Hoine Builders, Inc, and has full, complete and. unbridled authority to exectite the foregoing instrument on behalf of Personal Home Buildors, Inc, and has executed same on behalf of Porsonal Home Builders, Inc, this_ 2) day of B pe s), Qos. Sth A Aids Shella Lotus Fowlor ‘Notary Public Ic 1 ot OF FLORIDA ER lod bf 19 [B0ls © Commi RE104580 My Comtoission Expires: RR expires 6/10/2016 Ort SUBCONTRACTOR’S SWORN STATEMENT TO GENERAL CONTRACTOR ON REQUESTING FINAL PAYMENT STATE OF FLORIDA COUNTY OF ESCAMBIA _ Before me, the undersigned authority, personally appeared BILL SMITH who, being first duly sworn, on oath deposes and says: 4. That Bill Smith Electric, Inc. is/are a/an __ Corporation hereinafter called “Subcontractor”. (individual/Partnership/Corporation) 2. The affiantis the PRESIDENT _ of Subcontractor and is authorized to make this affidavit. (Owner/Officer) 3. That Subcontractor heretofare entered into a subcontract with C.W, Roberts Contracting, Inc., hereinafter called “General Contractor”, under Subcontract 1511041-3_, on the _21_day of February 2012_ for Rehabilitation of Public Parking Facilities, Okaloosa County In the arnount of _$647,225.93 __ to furnish material, labor or services for the construction of a certain building, or repairs, or alterations specifically described in said subcontract, as amended. 4, Subcontractor has fully completed alf work and furnished all materiais in accordance with the terms of sald subcontract and all amendments thereto; that all lenors, Including, but-not limited to all lakorers, materlalmen and taxes, have been pald in full, except: (List names of llenors and amounts owed) 5. Recelpt by the Subcontractor of Final payment, under the aforementioned subcontract, shall constitute a full release and discharge by the Subcontractor to the General Contractor of all claims of the Subcontractor against the General Contractor, arising out of, connected with, or resulting from performance of the obligations of the Subcontractor pursuant ta sale subcontract and all amendments thereto. BILL SMITH ELECTRIC (SEAL) ‘ a (Subeontr: of) ff ae pea BILL SMITH (SEAL) a (By) d SO OOS béfora me this 17TH day of APRIL , 2013. ma fg a ae hh. we Vz JP) | \ Notary Publ \_ heer _ ( _ oe, LBA M4 UETZ y Sof STs, Notary Publis » Wate of Florida cA “Sy Come, Euphws dan 22, 2077 _ SERIE — Commission # EE OBT444 “hati Bonded Through Malone Wetary Bet 201-0412 toe “~ **"* "55" ab0gNEbaZ0 20S 04-12 07:30 C, W, ROBERTS CONTRACTING, INC, P. O. BOX 16279, TALLAHASSEE, FL 32317 PINAL WAIVER AND RELEASE OF CLAIMS INCLUDING LIEN AND BOND CLAIMS Know all men by these presents, that Goodson Contractors, Inc, in consideration of payment in the sum of $127.50 receipt of which is hereby acknowledged, does hereby waive, release, and quit claim ell liens, Hen rights, claims or demands of every kind whatsoever which the undersigned now has, or may hereafter have against Okaloosa County Board of County Commissioners and C. W. Roberts Contracting, Inc. And its surety Liberty Matual Insurance Company, and /or Western Surety Company and that certain real estate and the improvements thereon, situated in Okaloosa County, Rlorida and legally described as Rehabiiltation of ar Facilities on account of work and labor performed, and/or material furnished in improving said property above described through “Final. It being the understanding of the undersigned that this is a Waiver and Release of all liens ' desoribed herein, and release of Okaloosa County Board of County Commissioners and C. W. Roberts Contracting, Inc. and its surety Liberty Mutual Insurance Company, end /or Western Sorety Company, for materials and services furnished, equipment supplied and/or work up until *Fipgl. The undersigned warrants thet no assignment of said liens for claims, nor of the right to perfect a lien against said real estate, has or will be made, and that the undersigned has the right to execute this FINAL Waiver and Release; and that all laborers, mnaterialmen, and guboontrastors employed by the undersigned in connection with the construction of improvements upon the aforesaid premises have beon fully paid. ”) Tn Witness Whereof, /We have exsouted this instrument under seal this_/o< day of Hori l 20138. BY: TITLE: State of J Lor sla County eae ~ ‘ regoing instrument was acknowledged to be true and correct before mo by | who certified under oath that he/she is the, of 0 Co 8, Tne. and hes full, complete and uabridled authority to execute the foregoing instrument on behalf of Goodson Contractors, [ne and bas executed same on bebalf of_ Go Contractors, Inc. this day of 620 f ¥ ~ - Can Cu “ 5 Notary Public ~ My Commission Expires un Wy Sen nly, § punts, % Fg OG Be $ wo H Zz Ee “Ubhic RES TAN S038: 8 E05 Poga 2/2 SUBCONTRACTOR’S SWORN STATEMENT TO GENERAL CONTRACTOR ON REQUESTING FINAL PAYMENT state or FL county or OkAlo0§ A Before me, the undersigned authority, personally appeared wa Micrel LiLddansono, baing first duly sworn, on oath deposes and says: 1. That _Insite Contractors, Inc, is/are a/an __ Corporation hereinafter called “Subcontractor”. (Individual/Partnership/Corporation) 2. The affiant is the / ‘ns jeleal t of Subcontractor and is authorized to make this affidavit, (Owner/Offiear) 3. That Subcontractor heretofore entered into a subcontract with C.W: Roberts Contracting, inc., hereinafter called “General Contractor”, under Subcontract _41511041-5 —, onthe 21 day of February, 2012 for Rehabilitation of Public Parking Facilities, Okaloosa County in the amount of $131,477.50 __ to furnish material, labor or sérvices for the construction of a certain building, or repairs, or alterations specifically described in said subcontract, as amended. 4. Subcontractor has fully completed all work and furnished'all materlals in accordance with the terms of said subcontract and all amendments thereto; that all lienors, including, but not limited to all laborers, materialmen and taxes, have been paid In full, except: {List names of lienors and amounts owed) Mow E_ 5. Receipt by the Subcontractor of Final payment, under the aforementioned subcontract, shall constitute a full release and discharge by the Subcontractor to the General Contractor of alf Calms of the Subcontractor against the General Contractor, arising out of, connected with, or resulting from performance of the Obligations of the Subcontractor pursuant to sald subcontract and all amendments thereto. nd » i: Gr, DORIS M. WESTERFIELD (sey Notary Public: - State of Florida My Gomm. Expires dan 25, 2015 Commission # EE-58612 {Subcontracto ) mt (SEAL) (By) President Swoxn to and subsgribed before me this /? day of Ape; / , 2013. in [Latin UY feat } Notary Public SUBCONTRACTOR’S SWORN STATEMENT TO GENERAL CONTRACTOR ON REQUESTING FINAL PAYMENT STATE OF FI Of) da COUNTY OF _F $ Before me, the undersigned authority, personally appeared _ | acc Tas fam Gay w who, being first duly sworn, on oath deposes and says: 1. That Ingram Signalization is/are a/an Cor pala Qa hereinafter called “Subcontractor”, (individual/Partnership/Corporation} 2. The affiant is the , p Vest d ent of Subcontractor and Is authorized to make this affidavit, (Owner/Qfficer) 3, That Subcontractor heretofore entered Into a subcontract with C.W, Roberts Contracting, Ine, hereinafter called “General Contractor”, under Subcontract (SJ) 04), on the day of v 20/2 for Rehabliltation of Public Parking Facilities, Okaloosa County In the amount of _$53,050.00 to furnish material, labor or services for the construction ofa certain bullding, or repairs, or alteratlons specifically deserlbed In sald subcontract, as amended. 4, Subcontractor has fully completed all work and furnished all materials !n accordance with the terms of sald subcontract and all amendments thereto; that all ienors, including, but not limited to all laborers, materialmen and taxes, have been paid in full, except: (List names of llenors and amounts owed) 5. Receipt by the Subcontractor of Final payment, under the aforementioned subcontract, shall constitute a full release and discharge by the Subcontractor to the General Contractor of all claims of the Subcontractor against the General Contractor, arising out of, connected with, or resulting from performance of the obligations of the Subcontractor pursuant to sald subcontract and all amendinents thereto, i 9 y (SEAL) woken ‘eto, ‘ fo ae Lucardint (SEAL) tay) (/ I [Zane ol. 9 RAM PAY Sworn to and subscribed before me this _/ a? * ay of A past , 2013, Notary Pub) ae, AUDREY KARAGHER dey NOTARY PHBLG EP PLORMIGA conned DOGO TS “areytoent SIMRO SUBCONTRACTOR’S SWORN STATEMENT TO GENERAL CONTRACTOR ON REQUESTING FINAL PAYMENT STATE OF Horida. COUNTY OF Washingioc Before me, the undersigned authority, personally appeared Ned p. Guether who; belng first duly sworn, on oath deposes and says: 4. That _Guettler & Guettler, Inc. is/are. a/an __ Corporation herelnafter called “Subcontractor”. (lndividual/Partnership/Corporation) 2. The afflant is the of Subcontractor and is authorized to make this affidavit. (Owner/Officer) 3, That Subcontractor heretofore entered Into a subcontract with C.W, Roberts Contracting, Inc, hereinafter called “General Contractor’, under Subcontract _1521041-7___, onthe 24 day of February, 2012. for Rehabilitation of Public Parking Facilities, Okaloosa County in the amount of $107,995.60 __ to furnlsh material, labor or services for the construction ofa certain bullding, or repairs, or alterations spectfically described In sald subcontract, as amended, 4, Subcontractor has fully completed all work and furnished all materials In accordance withthe terms of sald subcontract and all amendments thereto; that al] fienors, including, but not limited to all laborers, materlalmen and taxes, have been pald th full, except: (List names of llenors and amotints owed) 5, Recelpt by the Subcontractor of Final payment, under the aforementioned subcontract, shall constitute a-full release and discharge by the Subcontractor to the General Contractor of all claims of the Subcontractor against the General Contractor, arising out of, connected with, or resulting from performance of the obligations of the Subcontractor pursuant to sald subcontract and all amendments thereto, Cuetler * Cotter Lac. (SEAL) (Subcontractor) ° a be Gee... (SEAL) (By) fA . nto and subscribed 2 me this L & day ot byob , 2013, 9% My Notary Public State of Fiorida fy % Janice © George yal gw Commission DD989919 Fore Expires 06/09/2014 HORTHWEST Evora Dail News Published Daily Fort Walton Beach, Florida Distributed in Okaloosa, Santa Rosa & Walton Counties State of Florida, County of Okaloosa Before the undersigned authorized personally appeared ny GUtLAn Mm if, {tS who on oath says that (s)he is Lcfal Vee dv isin i Cu bf ke of the Northwest Florida Daily News, a daily newspaper published at Fort Walton Beach, in Okaloosa County, Florida; that the attached copy of advertisement, being a L £ pes 3 302 in the matter of Ad turtisum wk Vol Co mpl ition Aicpork Publ: iC. Purhins fae: iti £s in the Obake OSa. County Court, was published in said newspaper in the issues of N évtmber BiG te 83 ors ‘glonal“Altpoit Rehabil / lon of: Publlo /Patking ? AP | Affiant further says that the said Northwest Florida