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HomeMy WebLinkAboutDraw 3 • 1117-00 . FALCON NEST II , L.LC 1111 • March 14,2014 Diana L. Cordray Carmel Clerk Treasurer (317)571-2414 Via E-mail: DCordray aC�carmel.in.gov; csheeksna,carmel.in.gov; john.alexander(a regions.com; iake.taylor(c�starfinancial.com Re: Legacy TIF—Draw#3 Dear Diana Attached please find the Legacy TIF draw for the current month. If everything is in order, please sign the Request for Disbursement Form and forward this draw to the Trustee. Also attached is a budget sheet that will track all costs to date. Please let me know if you have any questions. • Sincerely, Rajai Zumot Member of SALT, LLC • 1356 13EVERLY RD SUITE 250 • MCLEAN. 'VA •22101 PI-IONE: (703) 893-7233 • FAX: (703) 893-5267 STATEMENT NO. 2 REQUESTING DISBURSEMENT OF FUNDS FROM PROJECT FUND PURSUANT TO SECTION 4.3 OF TH.E TRUST INDENTURE BETWEEN Tl li?. CITY OF CARMEL, INDIANA AND REGIONS BANK, AS TRUSTEE Pursuant to Section 4.3 of the Trust Indenture (the "Indenture") dated as of December 1, 2013, between the City of Carmel, Indiana (the `Issuer") and Regions Bank (the "Trustee"), the undersigned, as the Authorized Representative (as defined in the Indenture) of the Company, hereby requests and authorizes the Trustee, as depository of the Project Fund created by and as defined in the Indenture to pay to the Company or to the person(s) listed on the Disbursement Schedule attached hereto out of the moneys on deposit in the Project Fund, the aggregate sum of S 5,420.69 to pay such person(s) or to reimburse the Company in full, as indicated in the Disbursement Schedule, for advances, payments and expenditures made by it in connection with the items listed in the Disbursement Schedule. In connection with the foregoing request and authorization, the undersigned hereby certifies that: (a) the costs of an aggregate amount set forth in this written request have been made or incurred and were necessary for the construction of the Project and were made or incurred in accordance with the construction contracts, plans and specifications,or purchase contracts therefor then in effect or that the amounts set forth in such written request are for allowable Costs of Construction of the Project; (b) the amount paid or to be paid, as set forth in this written request, is reasonable and represents a part of the amount payable for the Costs of Construction of the Project all in accordance with the cost budget; and that such payment was not paid in advance of the time, if any, fixed for payment and was made in accordance with the terms of any contracts applicable thereto and in accordance with usual and customary practice under existing conditions; (c) no part of said costs was included in any written request previously filed with the Trustee under the provisions hereof;and (d) such costs are appropriate for the expenditure of proceeds of the Bonds under the Act. This statement and all exhibits hereto, including the Disbursement Schedule, shall be conclusive evidence of the facts and statements set forth herein and shall constitute full warrant, protection and authority to the Trustee for its actions taken pursuant hereto; and This statement constitutes the approval of the Company of each disbursement hereby requested and authorized. IN WITNESS WHEREOF, the authorized representative of the Company has set his hand as of the /2/day of /1'I24),' , 20 l/7 . FALCON NEST II LLC, an Indiana limited liability company By: SALT, LI.0 Membe By: Rajai Zurnot, • ber of SALT, LLC Pursuant to Section 4.3 of the Indenture the foregoing disbursement request is hereby approved: CI IF CARMEL, N$ NA i /4 /, pet. ana L.Cordrly,IAMC,Clerk-Treasurer 3 Legacy TIF Draw . Application No 3 Application Date: 14-Mar-14 Prepared By: Kathy Tekulve Telephone No: (317) 863-2052 Amount : $ 5,420.69 . Reference or Total Retainage Invoice Work This Invoice Code Contractor/Payee Number Completed Period Amount 2 Williams Creek Consulting 1402044 $ 2,870.00 $ 2,870.00 $ 2,870.00 $ - $ 2,870.00 3 •Stoeppelwerth &Assocs., Inc. i 187210 $ 700.00 $ $ 700.00 Stoeppelwerth &Assocs., Inc. 187212 $ 500.00 : $ 500.00 1 $ 1,200.00 $ - $ 1,200.00 10 Manley Finish Grading 5724 $ - $ 972.50 $ 972.50 $ - $ 972.50 $ 972.50 Management Fees 1037 $ 305.25 . $ 72.94 . $ 378.19 S 305.25 $ 72.94 . $ 378.19 Total ' $ 4,375.25 : $ 1,045 44 $ 5,420.69 $ - 1 of 1 PLATINUM PROPERTIES MANAGEMENT COMPANY, LLC INVOICE 1039 March 14, 2014 Zumot Real Estate Management, Inc. rzumot @zumot.net • Falcon Nest II, LLC 1356 Beverly Road Suite 300 McLean, VA 22101 Re: Development Service Fees - The Legacy TIF Draw Summary of March 2014 Construction Costs: Weihe Construction, Inc. $ 2,870.00 Stoeppelwerth & Assocs., Inc. $ 1,200.00 Manley Finish Grading $ 972.50 Total Monthly Costs $ 5,042.50 Development Fee @ 7.5% $ 378.19 Please remit payment to: Platinum Properties Management Company, LLC 9757 Westpoint Drive, Ste 600 Indianapolis, IN 46256 9757 Westpoint Drive,Suite 600, Indianapolis, IN 46256 (317) 818-2900 Williams Creek Consulting,Inc. 619 N.Pennsylvania Street Indianapolis,Indiana 46204 Office Phone:317.423.0690 Fax:317.423.0688 WILLIAMS CREEK CONSULTING February 28,2014 Tim Walter Project No: 01.0565.A.1 Falcon Nest II,LLC Invoice No: 1402004 C/O Platinum Properties 9757 Westpoint Drive Suite 600 Indianapolis, IN 46256 Project 01.0565.A.1 FALCON:Legacy Consulting Services Professional Services from February 01, 0_14 to February 28.2014 phase 01T Dry Detention Basin 0.00 phase 02F Stormwater Planning&Design Assistance Phase Two Master Infrastructure Fee Percent Previous Fee Current Fee Billing Phase Fee Complete Earned Silting Billing SW Planning&Design 6,000,00 100.00 6,000.00 6,000.00 0.00 Assist Phase Two Total Fee 6,000.00 6,000.00 6,000.00 0.00 Total Fee 0.00 0.00 phase 03T Client Requested Meetings 0.00 phase 04F Lake 1 Modifications Fee Percent Previous Fee Current Fee Billing Phase Fee Complete Earned Billing Billing Lake 1 Modifications 4,900.00 100.00 4,900.00 4,900.00 0.00 Total Fee 4,900.00 4,900.00 4,900.00 0.00 Total Fee 0.00 0.00 phase 05F Lake 2 Modifications Fee Percent Previous Fee Current Fee Billing Phase Fee Complete Earned Billing Billing Lake 2 Modifications 6,750.00 100.00 6,750.00 6,750.00 0.00 Total Fee 6,750.00 6,750.00 6,750.00 0.00 Total Fee 0.00 Project 01.0505��1 FALCON:LoQucy Consulting Services Invoice 1402004 0.00 phase 06T Master Infrastructure Phase II Revisions 0.00 phase 07T M1PI1 CD Revisions 0.00 phase O8T DD7&DO8Modifications 0.00 phase 00F Revisions to BMP planting plans Fee Percent Previous Fee Current Fee Billing Phase Fee Complete Earned Billing Billing Revisons to BMP plating 3.500{)0 100.00 3.500.00 3.500U0 0.00 plans Total Fee 3.500.00 3.500.00 3.500.00 0.00 Total Fee 0.00 $.0o phase 10F Community Drive Overtopping Analysis Fee Percent Previous Fee Current Fee Billing Phase Fee Complete Earned Billing Billing Community 4.100.00 100.00 4,100.00 1,230.00 2,870.00 Overtopping Analysis Total Fee 4.100D0 4.100I0 1230.00 2,870.00 Total Fee 2,870.00 $2,870.00 Total this Invoice /°L L & - ' \/� Y^ � » ' ` \ Page 2 4 -I- ► S T O E P P E L W E R T H ofc: 317.849.5935 7965 East 106th Street • \, e fax: 317.849.5942 Fishers,Indiana 46038-25D5 AtriAYS ON www.stoeppelwerth.com FALCON NEST II, LLC Invoice number 187210 0/0 PLATINUM PROPERTIES, LLC Date 03/07/2014 9757 WESTPOINT DRIVE SUITE 600 Project 55115PLA-M2A LEGACY-MASTER INDIANAPOLIS, IN 46256 INFRASTRUCTURE PHASE 2 Professional Services for the Period: February 2014 Contract Percent Total Prior Current Description Amount Complete Billed Billed Billed Preliminary Topographic Survey-Current Conditions 3,600.00 60.00 2,160.00 2,160.00 0.00 Overall Map 2,150.00 0.00 0.00 0.00 0.00 Subtotal 5,750.00 37.57 2,160.00 2,160.00 0.00 Final Design Site Design&Drainage Analysis 3,350.00 100.00 3,350.00 3,350.00 0.00 Construction Document Preparation 4,750.00 100.00 4,750.00 4,750.00 0.00 Project Management/Permitting 1,500.00 100.00 1,500.00 1,500.00 0.00 WCC Coordination/Rev basin 2,350.00 100.00 2,350.00 2,350.00 0.00 TIF•Storm Sewer Esmt Exhibits 2,190.00 35.00 766.50 766.50 0.00 Construction Plans-Change Order#1 4,350.00 100.00 4,350.00 4,350.00 0.00 Subtotal 18,490.00 92.30 17,066.50 17,066.50 0.00 Construction Services Staking-Pond#6 Area -(not to exceed) 1,950.00 100.00 1,950.00 1,950.00 0.00 Earthmoving 20,230.00 100.00 20,230.00 20,230.00 0.00 Watermain 1,000.00 100.00 1,000.00 1,000.00 0.00 Earthmoving 525,00 100.00 525.00 525.00 0.00 Storm Sewer 2,350.00 100.00 2,350.00 2,350.00 0.00 Curbs& Pavement 2,380.00 100.00 2,380.00 2,380.00 0.00 Subtotal 28,435.00 100.00 28,435,00 28,435.00 0.00 Completion Certifications Lakes&Swales 2,850.00 100.00 2,850.00 2,850.00 0,00 Watermain (Hydrant&Valve Locations only) 350.00 100.00 350.00 350.00 0.00 Storm Sewers 2,470.00 100.00 2,470.00 2,470.00 0.00 Street Centerline Monuments 510.00 100.00 510.00 510.00 0.00 Subtotal 6,180.00 100.00 6,180.00 6,180.00 0.00 Floodplain Flood Mitigation 3,500.00 80.00 2,800,00 2,100.00 700.00 Floodplain Compensatory Storage Cross Sections 4,800.00 100.00 4,800.00 4,800.00 0.00 Additional Flood Mitigation Calculations 850.00 0.00 0.00 0.00 0.00 Subtotal 9,150.00 83.06 7,600.00 6,900.00 700.00 Additional Services 0.00 0.00 17,210.00 17,210.00 0.00 Total 68,005.00 115.66 78,651.50 77,951.50 700.00 FALCON NEST II,LLC invoice number 187210 Project 55115PLA-M2A LEGACY-MASTER INFRASTRUCTURE PHASE 2 Dale 03/07/2014 Invoice total 1 700.00 .•a �1' Aging Summary � ,,1 14 Invoice Number invoice Date Outstanding Current Over 30 Over 60 Over 90 Over 120 187210 03/07/2014 700,00 700.00 Total 700.00 700.00 0.00 0.00 0.00 0.00 If any portion of this invoice is in dispute, it is the client's responsibility to notify Stoeppelwerth&Associates, Inc. in writing within thirty (30)calendar days from the date of the invoice. The client remains responsible for paying the undisputed portion of the invoice by the due date. Any invoices unpaid after 30 days shall incur a finance charge of one-and-one-half(1 %)percent of the invoiced amount per month, excepting any disputed portion of the invoiced amount. Payment thereafter shall be applied first to accrued interest and then to the unpaid principal amount. • I -:- ► S T O E P P E L W E R T H ofc: 317.8495935 7965 East 106th Street A fax: 317.849.5942 Fishers,Indiana 46038-2505 A L W A Y S O H www.stoeppelwerth.com FALCON NEST II, LLC Invoice number 187212 0/0 PLATINUM PROPERTIES, LLC Date 03/07/2014 9757 WESTPOINT DRIVE SUITE 600 Project 55115PLA-HP LEGACY- HOPEWELL INDIANAPOLIS, IN 46256 PARKWAY Professional Services for the Period: February 2014 Contract Percent Total Prior Current Description Amount Complete Billed Billed Billed Overall Design Outside Consultant Reveiw-Williams Creek 750.00 0.00 0.00 0.00 0.00 Subtotal 750.00 0.00 0.00 0.00 0.00 Final Design Design&Construction Document Preparation 10,550.00 100.00 10,550.00 10,550.00 0.00 Design&Const. Docs for Drainage Linear Ditch 825.00 100.00 • 825.00 825.00 0.00 Subtotal 11,375.00 100.00 11,375.00 11,375_00 0.00 Construction Services Construction Staking 3,450.00 65.00 2,242.50 2,242.50 0.00 Subtotal 3,450.00 65.00 2,242.50 2,242.50 0.00 Completion Certifications Watermain (Hydrant&Valve Locations only) 400.00 100.00 400.00 400.00 0.00 Storm Sewers 1,280.00 0.00 0.00 0.00 0.00 Sanitary Sewer Manholes 360.00 100.00 360.00 360.00 0.00 Drainage Swale from Linear Ditch to DD10 200.00 0.00 0.00 0.00 0.00 Subtotal 2,240.00 33.93 760.00 760.00 0.00 Monumentation Street Centerline Monuments 525.00 0.00 0.00 0.00 0.00 Subtotal 525.00 0.00 0.00 0.00 0.00 Additional Services 0.00 0.00 3,045.00 2,245.00 800.00 *STAKE VS6 BASIN THAT WAS ADDED INTO PLANS AFTER PROPOSAL WAS PREPARED AND STAKING WAS NOT .i 0 9 INCLUDED-$500 ! 1 *HAD TO CHECK STORM STAKES THAT WERE PREVIOUSLY STAKED DUE TO TIMING AND WEATHER DELAYS$300. Total 18,340.00 95.00 17,422.50 16,622.50 -800:00"' t g'f, ,.,,?,..„ .„. - ,„ . Invoice total A' Aging Summary " i500'�0 "'�-: Invoice Number Invoice Date Outstanding Current Over 30 Over 60 Over 90 Over 120 186721 02/07/2014 1,950.00 1,950.00 187212 03/07/2014 800.00 800.00 Total 2,750.00 2,750.00 0.00 0.00 0.00 0.00 FALCON NEST II.LLC Invoice number 187212 Project 55115PLA-HP LEGACY-HOPEWELL PARKWAY Dale 03107)2014 If any portion of this invoice is in dispute, it is the client's responsibility to notify Stoeppelwerth&Associates, Inc. in writing within thirty (30)calendar days from the date of the invoice. The client remains responsible for paying the undisputed portion of the invoice by the due date. Any invoices unpaid after 30 days shall incur a finance charge of one-and-one-half(1 %)percent of the invoiced amount per month, excepting any disputed portion of the invoiced amount Payment thereafter shall be applied first to accrued interest and then to the unpaid principal amount. APPLICATION FOR PAYMENT :=RC1ECT.+OrmE Legacy•tizsioentla,S'et-tton 1 Master korootrurtooe Phase 2 m.a9o4,4.Section 1 NAt Overlook 5...von I OWNETe Tate.en Ne-ai 4.ir_C CONSTR„.C-rroA,stANAGLn.PI 41murn Properae,,IA C ":_ON,RAC70q. ManIty fe‘Iy..--A7,1411111 eVie. No. 3724 coNTe.:.T. Reim Zoroat coorAc.r Tim wmte. CONTACT.2,-,torn ey AV P_ICA ND.%DATE. 22V231e. ADORES-S.: :.356 eevOlv RosAI Salt.31 ADDRESS 0757 WeeZee:rn Drwa 0.le SCO AODRASS 7411 Ty'est Ile'eon Ouc lc: P f a AINAti b-- 10% ) i.. .e..yr.yirg no 171GI nei4,..1,x1.S.IN 15255 5,,P aimine.5 45163 APPliOviD as Mr,.- .',3177 e 1 a-m W091)0M 17ja5066,791-1,347 On C C I . F G Htr-cr9 ipTiro K LeJ,K. .4.3,,I. L . W0114 rx,ernono Om .Szr.,,ittica I wen cer.cLelee tmliereis 19741 CeTepleurc • % e-e,..x, Fte..aThege. 19741 522„TO I - Net rj, Code Code Prtce One oo Pm..., lon-, tqtrot., Aml slev.0 ,^.,alt C.C7-_.A._ 5t1.1ktaSs_ Th.',Pe:1x; .e1.4-srYell I-We i This 00.-Flh Seeding.Grading 8 Erosion Control I Residential Phase 1,Section 1 (aka The Ridge at Legacy) 1 I LuyITN)Al ina Permanent Seeding $0.05/s1 $18.024.00 !...e,178.-00 58,178.00 43% 1817 80 (5817.80) 59.846.00 9817.80 LgY,,FN)Al 1315 Seeding Behind Curb in Buttditrg Line 943.04/sf $5,540.00 $5,540.00 55,540.00 100,4 9554.00 (5554.00) 5554.00 Lgy(FN)A 109 Temp Seed,Straw 8,Krimp Eidg Pads $1000/ec $15.400.00 $15,400.00 515.400(30 ler% 51.540.00 ($1 540.00) 5154000 Lgy(PN)Al 10c Erosion Centro]Blanker $0.115/sf 521,326.00 516.095.00 616.095 00 IFS 51.899 50 (51,609.50) 55.231,00 51.609:$91 Lgy(EN)Al 10c Turf Reinforcement Mat 59 5d8y $5,800.00 53,800.00 L9y(FN)Al 104 Silt Fence 51.20/5 514.040_00 $9,992 00 59,992.00 11•,... 5999 20 15999 20) $ .O4800 $900.20 Lgy(FN)Al 1121:1 Drop inlet Protccuon 51901ua $4,180.00 $4,180.00 54.180.00 1874 $41800 (5418.00) 5418.00 Lgy(FN)Al 10d Beehhn'nk...11 Protection 575iea $675.00 $875.00 Master Infrastructure Phase 2 '1-i F. Lgy Comm Dr ion Permanent Seeding 50 05/s1 $10,180.00 $8,150.00 58,150 00 st,s. $815.00 ($815.00) 52.03090 9815.00 - Lev FNI 105 ■emp Seed,Straw&Krirnp Future Pods 51000iac $45,230.00 137,000.00 937,000.00 et% 53,700.00 f.93.700,00 S8,2300 $3,700.00 Lgy FIJI 10c Erosion Control Blanket $0.11.-.Af 54,773.00 $414.00 541400 9% $41.40 ($41.40) 54.359.00 641.40 r-- Lgy Gomm Or 100 Drop Intel Protect-id:,-chair back $225/ea 51,575.00 51,575,00 51.5/5,00 toe% $157.50 ($157.50) 5157.50 Lgy FN1 10d Beehive Inlet Protection 575.4a 575.00 57500 The Meadows at Legacy Sec 1 Lgy 01 10a Permanent Seeding $0.05/st 54,899 00 54,699.00 $4,899.00 70120 544900 (5469.90) 5469.90 Lgy 01 10b Seeding Bonind Curt to Building Ling 50.04/sf 53,042 00 5:1.04200 53.042.00 100% $301.20 ($304.20) $30423 Lgy 01 100 Temp Seed,Straw&Krilelp Bldg Pads $1000/ac 57,390.00 57,39000 $7,390.00 1)4% ¶739 00 ($739.00) 5739.00 I gy 01 10c Erasion Control Blanket 50.115/sf 51,15000 51,150 00 $1,150,00 mew $115.00 ($115.00) $115.00 Lgy01 100 Sig Fence 51.20)1( 51,440 00 51.440,00 91,441 00 10115. 5144.00 ($144.00) 5144,00 Lgy 01 100 Drop Inlet PrOtectich Si gale-3 52,470,00 52.470,00 $2,470.90 wow ¶247.00 (5247.00) $247.00 Lgy 01 100 Beehive Inlet Protection $75/ea $525.00 5525,90 The Overlook at Legacy Sec 1 . Lay P1 lOa Permanent Seeding 50.05isf $4/5.00 5675.00 $875.00 toe" 567.50 ($67.50) 587.5,0 Lgy P1 10b Seeding Sebald Curb to&ILO/fit]LIM 50,04/sf $768.00 $768.00 $768.00 locr4 570.80 (570.80) 579.80 Lgy P1 105 Temp Seed,Straw 2(Crimp Bldg Pads 21000/ac 52,100.09 $2,100.00 $2,100.00 we% 5210 00 (5210 00) $210.00 Loy PI ioc Erosiod Control Blanket $0.115Isf 51,553,00 $1,553.00 Lev Pt 100 Silt Fere 11.2018 51,800.00 51,800.00 51,800.00 Ird•,:, 5180.90 (5180.00') 5180.00 Lgy Pt 10a Drop Inlet Pro•ection $190/ea $570.90 5570.00 5570.00 1910 ¶57.00 (557.00) 557.00 ' _.... TOT AL 5173.000 00 5132.528.00 513228s), on. $13,292.80 ($13,202.80) W.372 00 513262.80 Manley Finish Gra -, DATE INVOICE# I III"*r•_ �itazar•, 2/24/2014 5724 7437 W. Banton Circle New Palestine, IN 46163 Phone & Fax(317)895-85f16 BILL TO FALCON NEST li LLC C/O PLATINUM PROPERTIES 9757 WI/S'TPOINT DR.SUITE 600 INDIANAPOLIS,IN.46256 P.0,NO. TERMS PROJE(T LEGACY DUE.ON RECEIPT ti OUANI TY DESCRIPTION RATE AMOUNT RETAINAGE ON LEGACY RESIDENTIAL 1, I3,262.80 13,262.130 MASTER ERASE'I,MEADOWS 1,OVERLOOK 1 I HANK YOU FOR YOUR BUSINESS Tota V $13,2.62.80 Erosior Control, Retaining Walls, Straw Mulch Slit Seeding, Wetland & Prarie Gras!: Seeding � Il ^ g sg1 8 $ $ 2 S8 6' 2 :t5 858888 $ 3 $ 88 8 Pli%' 8 8 4 g 8 4 '3 e $ F. 1 1 Fg 'ygg gk B :F6,1 syyi f6z s4 g I ;+ I . g 6 S 01 il 4 /+ 3 8 b 8 $ 8 88 8 2 8 $ 8 $ 8 8 8 8 882 8 8 8 a i al 6`o2C. 1 ° g I s_— . $ 8 IN 8 8 8 8 8 $ h a g § & f�, 8 g 8 8 $ $ Mc g 8 8 $pg § l N y N h Z N Y 2 G Y 8 w d a .`; w 64; 8888888 8 8 8 8 8 8 8 8 8 8 8 8 8 $ 8 € 8 8 s ! m a r N r∎ . v o v1 " ni n ry N 5 Ii ! J II ii ^ N ~ N r S H ✓, H 4- M N w i I - 1 t li as ig i : UJiiii il € � 1I1 ' 'y Y 10. 1 ,. 1 a 1 1 _ LL 113 & 848a" 888 as3aa 8888888 dStd888 I a - P f 9 ! Z 0 6 0 0 7 0 0 d i n a a g q ' ¢ q AFi?TIDAV)IT AVID WAIVER OF'LIEN FINAL X _PARTIAL X PAYMENT TO FOLLOW JOHN MANLEY being duly sworn,state that he/she is the PRESIDENT of MANLEY FINISH GRADIN,3 INC.buying contracted with Platinum Propert es Management Co.,LLC to furnish certain materials and/or labor as follows: INVOICE 6724 for a project known as LEGACY ,located at CARMEL,Indian a ,and owned by FALCON NEST II LI _,and feather states: PARTIAL WAIVER: that the balance due by the owner is the sum of THIRTEEN THOUSAND TWO }IUND jED SIXTY-TWO 801100 Dollars(S13,262.80 ). Receipt of which is her{by acknowledged;or X The payment of which 1 as been promised as the sole consideration for this Affidavit and Partial Waiver of Lien which is given to and for sail amount.effective upon receipt of such paymen'_ FINAL WAIVR: that the final balance due by the owner is the sum of Dollars( ,)" Receipt of which is hereby acknowledged;or The payment of which t as been promised as the sole consideration for this Affidavit and Final Waiver of Lien which is given to and for sae I amount,effective upon receipt of such paymenm_ THEREFORE,the undersigned waives any I releases unto the Owner of said premises any ar.d all lien or claims whatsoever on the above-described property and improve:nents thereon on account of labor or material or both,furnished by the undersigned thereto,and further certifies d at no oth rr party has any claim or right to a lien on account of any work performed or material furnished to the and:rsigned for said project,and within the scope of this affidavit and waiver. MANLEY FINISH GRADING,INC._. Company Name, 1 utho> d Rep tative �.-- _1 PRESIDENT title -- WITNESS: 1.L umature LYNDA MANLEY Printed Name of Witnest