Okaloosa County BOCC — August 5, 2014 — Cell Phone Lot Project Closeout Checklist and Docs — reading text

knowledge, information and belief the Work has prog) 1 as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is State of: Florida County of: Bay ' entitled to payment of the AMOUNT CERTIFIED. Subscribed and sworn to before me this 4 day of Notary Public: zt > f cue C0} A ARCHITECT: f .- mee ; UNT CERTIFIED $ £ ef O92. [ae . i } CLA we o fi GELIA A NDER: 1% ch explanation if amount certifies : = MY COMMISSION # EC1 3 Date: 6-2-4 & expIRES November 08, 20s bern ; not negotiable, The AMOUNT CERTIFIED is payable only to the Contractor named herein. liffers from the amount applied for.) oF 1407) ? 4, ae on 53 FloridaNotaryService.com Issuahce, payment, and acceptance of payment are without prejudice ta any rights of the Owner or Contractor under this Contract. SCHEDULE OF VALUES por (bug 6-12-14 APPLICATION NO: Final CELL PHONE WAITING AREA APPLICATION DATE: 6-Jun-14 PERIOD TO: 6-Jun-14 A B c DIRECT PURCHASE ORDERS D E FE G H i TTEM DESCRIPTION OF WORK SCHEDULED DEO DPO SALES TAX WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE NO. VALUE # VENDOR AMOUNT | SAVINGS | FROMPREV. | THISPERIOD | PRESENTLY | COMPLETED (G+C) ‘TO FINISH . APPLICATION STORED AND STORED (C-G) @+E) (NOT IN TO DATE DORE) (D+E+F) General Conditions 3,500.00 " $0.00 $3,500.00 $0.00 $3,500,00 100.00% $0.00 $0.00 Bonds & I 2,167.00 [. $0.00 $2,167.00 $0,00 $2,167.00 100,00% $0.00 $0.00 Mobilization 6,500,00 $0.00 $6,500.00 $0.00 $6,500.00 100.00% $0.00 $0.00 MOT & Testing 3,300,00 $0,00 $3,300.00 $0.00 $3,300.00 100,00% $0.00 $0.00 Site Demoliti 13,950.00 $0.00 $13,950.00 $0.00 $13,950.00 100.00% $0.00 $0.00 Canopy Demoliti 2,800.00 $0.00 $2,800.00 $0.00 $2,800.00 100,00%, $0.00 $0.00 Cc d Sut 1,650.00 $0.00 $1,650.00 $0.00 $1,650.00 100.00% $0.00 $0.00 Limerock Base & Grading 3,160.00 $0.00 $3,160.00 $0.00 $3,160.00 100,00% $0.00 $0.00 Striping, Wheelstops, Detec. Warnings & Signs 6,500.00 |, $0.00 $6,500.00 $0.00 $6,500,00 100.00% $0.00 $0.00 Curbs, Ramps, & Concrete Islands 26,350.00 $0.00 $26,350.00 $0.00 $26,350.00 100.00% $0.00 $0.00 Concrete Driveways 9,776.00 $0.00 $9,776.00 $0.00 $9,776.00 100.00%. $0.00 $0.00 Misc. Metals 840.00 $0.00 $840.00 $0.00 $840.00 10.00%. $0.00 $0.00 Electrical 4,500.00 [?* $0.00 $4,500.00 $0.00 $4,500.00 100.00% $0.00 $0.00 0.00 [* $0.00 $0.00 $0.00 $0.06 0.00% $0.00 $0.00 0.00 |. $0.00 $0.00 $0.00 $0.00 0.00%. $0.00 $0.00 0,00 $0.00 $0.00 $0.00 $0.00 0.00% $0.00 $0.00 0.00 $0.00 $0.00 $0.00 $0.00 0.00%| $0.00 $0.00 0.00 st $0.00 $0.00 $0.00 $0.00 0.00% $0.00 $0.00 0.00 |. $0.00 $0.00 $0.00 $0.00 9.00% $6.00 $0.00 0.00 | $0.00 $0.00 $0.00 $0.00 0.00% $0.00 $0.00 GRAND TOTALS 84,993.00 $0.00 $0.00 $0.00 $84,993.00 $0.00 $84,993 ,00 100.00% $0.00 $0.00 Original Scheduled Value 84,993.00 G703-1992 CATHEY Construction& Development! DATE: June 6, 2014 STATE OF FLORIDA COUNTY OF BAY AFFIDAVIT OF GUARANTEE & LIEN RELEASE Having been first duly sworn, I (We) depose and say: That Cathey Construction & Development, LLC contracted with the Okaloosa Board of County Commissions for the Cell Phone Waiting Area Project at the Northwest Florida Regional Airport to furnish all labor, materials, equipment and incidentals necessary to complete the construction on above named project in accordance with the drawings and specifications as prepared by AVCON, Inc.. All bills for labor, materials, equipment, sublet portions and incidentals used to date, including but not limited to, federal, social security and unemployment taxes and insurance have been paid in full without exception. hereby waives and releases its lien and right to claim a lien or claim against the Owner including all claims, change orders, or demands whatsoever for labor, services, or materials furnished for the above-named project. As the undersigned Contractor, we herby guarantee and warrant all materials and workmanship installed by us on subject job in accordance with the requirements as specified. The guarantee shall be effective for a period of no less than one (1) year from the date of acceptance by the Owner. This affidavit is given in accordance with Florida Statutes to substitute proper payment and the undersigned represents that he is an authorized agent of Contractor and has authority to execute this Affidavit of Guarantee & Lien Release on behalf of Contractor. Cat nstructi Selopmbat, | LLC oo Y Title: President Sworn to and subscribed before me this S$ _ day of ee A 92014. EXPIRES Navember 08, 2015 (Notary Public) () ole he G OL ( FlordaNotaryService.com tbat Sede ante pasting. Me SEE SON wes MY COMMISSION wt 134020 407) 398-0153 CATHEY CONSTRUCTION & DEVELOPMENT- P.O, Box 13107-103 NORTH 30 STREET- MEXICO BEACH, FL 32410 PHONE: (850) 648-5100 - Fax: (850) 648-5100 OKALOOSA COUNTY NORTHWEST FLORIDA REGIONAL AIRPORT CONTRACTOR’S RELEASE OF LIENS CELL PHONE WAITING AREA CONTRACTOR’S RELEASE OF LIENS STATE OF: FLORIDA COUNTY OF: BAY Before me, the undersigned Notary Public in and for the said County and State personally appeared WILLIAM B CATHEY , representing the Contractor _CATHEY CONSTRUCTION & DEVELOPMENT, LLC. , who being duly sworn according to law deposes and says that all labor, materials, and outstanding claims and indebtedness of whatever nature arising out of the performance of the Contract with _ Okaloosa County , the Owner, for Cell Phone Waiting Area , Contract Dated 5-6-14, will be paid in full upon receipt of final payment in the amount of $ 84,993.00 , the Contractor releases and discharges the Owner and his authorized representatives from any liens or claims or any nature because of or arising from this Contract and/or its performance, which it has had, has or may have in the future. Le rnoae WillianrB: Cathe ey, President Sworn to and subscribed before me this day of ene Qoyy 0 Le Op eteicfl yaddena— (Notary Public) ~ en My Commission Expires: WW -& - COU ih H CECELIA ANDERSUi | we MY COMMISSION # EE 134020 Teer EXPIRES Novamber 08, 2015 (407) 388 0159 Florida Noturytorviee.com CONRELNS- 1 of 1 AVCON, INC. CATHEY™ Construction& Development: DATE: _ 06-06-14 STATE OF FLeliDA COUNTY OF WASHIMCTOV AFFIDAVIT OF GUARANTEE & LIEN RELEASE Having been first duly sworn, I (We) depose and say: That Thurman Construction LLC contracted with Cathey Construction & Development LLC for the a Complete Sitework Package including but not limited to demolition of existing landscaping, concrete curbs, sidewalks and ramps w/detectable warnings, all necessary clean fill sub-base material, lime rock base, new signage/striping/wheel stops, concrete islands and flumes, repair to existing irrigation lines as necessary, and testing of materials, etc,. at the Northwest Regional Airport located in Okaloosa County, Florida for the Cell Phone Waiting Area project to furnish all labor, materials, equipment and incidentals necessary to complete the construction on above named project in accordance with the drawings and specifications as prepared by Avcon, Inc. All bills for labor, materials, equipment, sublet portions and incidentals used to date, including but not limited to, federal, social security and unemployment taxes and insurance have been paid in full without exception. hereby waives and releases its lien and right to claim a lien or claim against the Owner including all claims, change orders, or demands whatsoever for labor, services, or materials furnished for the above-named project. As the undersigned Contractor, we herby guarantee and warrant all materials and workmanship installed by us on subject job in accordance with the requirements as specified. The guarantee shall be effective for a period of no less than one (1) year from the date of acceptance by the Owner. This affidavit is given in accordance with Florida Statutes to substitute proper payment and the undersigned represents that he is an authorized agent of Contractor and has authority to execute this Affidavit of Guarantee & Lien Release on behalf of Contractor. Thurman Construction, LLC Title: Ovopo zi. | (251040 T- Sworn to and subscribed before me this. > dayof SVN¢. , 2014. Kerdbel D Dasio _ Notary2ubliQona p, pais * MOE, x MY COMMISSION # EE 127272 shee... EXPIRES: November 28, 2015 “reo ck® Bonded Thru Budget Notary Services CaTHey CONSTRUCTION & DEVELOPMENT- P.O. Box 13107-103 NORTH 30” STREET- Mexico BEacu, FL 32410 Puone: (850) 648-5100 - Fax: (850) 648-5100 = = CATHEY Construction& Development: ——» DATE: _ 06-06-14 STATE OF Ftereipar COUNTY OF wactan AFFIDAVIT OF GUARANTEE & LIEN RELEASE Having been first duly sworn, I (We) depose and say: That SAMM Enterprises, Inc. contracted with Cathey Construction & Development LLC for the a Complete Electrical Package, at the Northwest Regional Airport located in Okaloosa County, Florida for the Cell Phone Waiting Area project to furnish all labor, materials, equipment and incidentals necessary to complete the construction on above named project in accordance with the drawings and specifications as prepared by Avcon, Inc. All bills for labor, materials, equipment, sublet portions and incidentals used to date, including but not limited to, federal, social security and unemployment taxes and insurance have been paid in full without exception. hereby waives and releases its lien and right to claim a lien or claim against the Owner including all claims, change orders, or demands whatsoever for labor, services, or materials furnished for the above-named project. As the undersigned Contractor, we herby guarantee and warrant all materials and workmanship installed by us on subject job in accordance with the requirements as specified. The guarantee shall be effective for a period of no less than one (1) year from the date of acceptance by the Owner. This affidavit is given in accordance with Florida Statutes to substitute proper payment and the undersigned represents that he is an authorized agent of Contractor and has authority to execute this Affidavit of Guarantee & Lien Release on behalf of Contractor. SAMM ENTERPRISES, INC. By: Ww Wali 0. Adasen Title: TPA Ok han Sworn to and subscribed before me this 4 day of Shwe , 2014, (Notary Public Lire (dmakong JENICE ARMSTRONG ; +, Notary Public - State of Florida f My Comm. Expires Mar 28, 2017 as Commission # FF 003042 Bonded Through National Notary Assn. CATHEY CONSTRUCTION & DEVELOPMENT- P.O, Box 13107-103 NORTH 30" STREET- MEXICO BEACH, FL 32410 PHONE: (850) 648-5100 - FAx: (850) 648-5100 D rom INSURANCE AGENCY, INC. RO. Box 129 * Apalachicola, FL 32329 * Phone (850) 653-2161 » Fax (850) 653-8946 * www.marksinsurance.com June 6, 2014 Y Northwest Florida Regional Airport 1701 Florida 85 Eglin AFB, FL 32542 Re: Cathey Construction General Liability Policy # 78120197-14 Gentlemen, Please be advised that this policy is written on an Occurrence basis, not a Claims-made basis. The Certificate of Liability Insurance that was provided to you dated 5/13/2014 indicates this fact. . a ; | . Please advise any questions. Regards, On Oke Wo — Chuck Marks, Agent CC: Cathey Construction & Development ) BD ACCORD — CERTIFICATE OF LIABILITY INSURANCE DATE (MMIODIYYYY) 05/13/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTR REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. ACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the the terms and conditions of the policy, certain p certificate holder in lieu of such endorsement(s) policy(ies) must be endorsed. if SUBROGATION IS WAIVED, subject to olicies may require an endorsement. A statement on this certificate does not confer rights to the PRODUCER NAMES Jayme