HomeMy WebLinkAboutE&B Paving, Inc/Eng/CO #14/36,320.43/Hawthorne & Carey RAB – Project #16-ENG-09TO:
E&B Paving, Inc.
17042 Middletown Ave
Noblesville, IN 46060
CITY OF CARMEL
CONTRACT CHANGE ORDER NO.: 14
DATE: January 2 2018
PROJECT NAME:_ Hawthorne & Carey RAB
CITY REQ. NO.: I6 -ENG -09
CITY PO NO.:
CITY PO DATE:
U-6
You are directed to make the following changes in this Contract:
Overrun contract amount due to additional items and work within the contract.
Exhibits A and B are attached for reference.
SCHEDULED ADJUSTMENT
ITEM AMOUNT (1-) OR (-) DAYS
EW Item #112 Item overrun S36,320.43 I Each 536,320.43 0 Days
II. The following referenced Documents further describe the changes outlined in Paragraph I,
and are to be considered a part of this Change Order: R.F.P.: N/A W.D.C. No.:
N/A Other: Attached itemized statement of quantities
The changes result in the following adjustment of Contract Price and Contract Time:
Contract Price prior to this Change Order S 686,671.73
Contract Price will be increased/decreased by this Change Order S 36,320.43
New Contract Price including this Change Order S 722,992.17
Contract Time Prior to this Change Order 45 Days _ Open to Traffic
Net increased/decreased resulting from this Change Order 0 Days
Current Contract Time including this Change Order 45 Days Open to Traffic
This Change Order is for full and final settlement of all direct, indirect, impact costs and time
extensions incurred at any time resulting from the performance of the changed work.
The Above Changes Are The Above Changes Are Approved:
Recommended Accepted:
American Structurepoint, Inc. E&B Paving, Inc.
ENGINEER CONTRACTOR
7260 Shadeland Station 17042 Middletown Ave.
Address
Indianapolis, IN 46256
C' Zip
By:
r
Phone: 317-547-5580
Date: l ",:D 5- / t
Address
Noblesville, IN 46060
City/S
By:
Phone: 317-773-4132 _
Date: /- ZIr . /8
Jere h ng.
Chnstine S. Pauley, Clerk-
Treasurer� /
Date:
Line Number Item Number Unit Original Change Order Authorized Quantity Placed Percent Used Over/Under
Quantity Quantity Quantity to Date (Placed) Authorized Amount
1350 2001
LS
1.00
0.00
1.00
1.00
100.00%
$0.00
CONSTRUCTION ENGINEERING
1360 2002
LS
1.00
0.00
1.00
1.00
100.00%
$0.00
MOBILIZATION AND DEMOBILIZATION
1370 2003
LS
1.00
0.00
1.00
1.00 '
100.00%
$0.00
CLEARING RIGHT OF WAY
1380 2004
EACH
1.00
0.00
1.00
1.00 •
100.00%
$0.00
HEADWALL, REMOVE
1390 2005
CYS
554.00
0.00
554.00
564.00 •
101.81%
$9()0.00
EXCAVATION, COMMON
1400 2006
CYS
440.00
0.00
440.00
0.00 •
0.00%
4440.00
BORROW
1410 2007
CYS
5.00
0.00
5.00
0.00 '
0.00%
4275.00
SEDIMENT, REMOVE
Item Overruns: 136th St. / Hawthorne Dr. &
Carey RAB's
Page 10 of 16
01/17/2018
Line Number Item Number
Unit
Original
Change Order
Authorized
Authorized Amount.
0.00
Quantity
Quantity
Quantity
1420 2008
'TON
12.00
0.00
12.00
TEMPORARY CHECK DAM
0.00%
-$750,00
1,015.50 -
88.15%
1430 2009
EACH
8.00
0.00
8.00
TEMPORARY INLET PROTECTION
-$490.00
3,564.00
.100.00%
$0.00
1440 2010
EACH
8.00
0.00
8.00
INLET FILTERS
230.09 ,
102.26%
S422.47
592.90 •
1450 2011
TON
0.60
0.00
0.60
TEMPORARY MULCH
0.00%
-$25,140.00
509.00-
34.25%
1460 2012
LFT
1,152.00
0.00
1,152.00
TEMPORARY SILT FENCE
1470 2013
TON
100.00
0.00
100.00
NO. 2 STONE
1480 2014
LBS
70.00
0.00
70.00
TEMPORARY SEED MIXTURE
1490 2015
SYS
3,564.00
0.00
3,564.00
SUBGRADE TREATMENT, TYPE IC
1500 2016
CYS
104.10
0.00
104.10
STRUCTURE BACKFILL, TYPE 1
1510 2017
TON
75.00
0.00
75.00
COMPACTED AGGREGATE NO. 53
1520 2018
TON
225.00
0.00
225.00
HMA, SURFACE, TYPE 'C', 9.5mm
1530 2019
TON
375.00
0.00
375.00
HMA, INTERMEDIATE, TYPE 'C', 19,0mm
1540 2020
TON
1,027.00
0.00
1,027.00
HMA, BASE, TYPE 'C', 25.Omm
1550 2021
TON
419.00
0.00
419.00
NMA, INTERMEDIATE, TYPE 'C', OG,
19.Omm 19.Omm
1560 2022
LFT
1,486.00
0.00
1,486.00
JOINT ADHESIVE, SURFACE
1570 2023
LFT
1,486.00
0.00
1,486.00
JOINT ADHESIVE, INTERMEDIATE
Item Overruns: 136th St. / Hawthorne Dr. & Carey RAB's Page 11 of 16
Quantity Placed
Percent Used
Ovor/Under
to Date
(Placed)
Authorized Amount.
0.00
0,00%
-$780.00
8.00 •
100.00%
$0.00
0.00.
0.00%
-$2,800.00
0,00-
0.00%
-$750,00
1,015.50 -
88.15%
-$204.75
189.59.
189.59%
$2.239.75
0.00.
0.00%
-$490.00
3,564.00
.100.00%
$0.00
49.94 •
47.97%
-$2,708.00
47.01 •
62.68%
-$979.65
230.09 ,
102.26%
S422.47
592.90 •
158.11%
$13,074.00
888.87 •
86.55%
-$6,906.50
0.00-
0.00%
-$25,140.00
509.00-
34.25%
•$97.70
397.00 -
26.72%
-$163.35
01/17/2018
Line Number Item Number
Unit
Original
Change Order
Authorized
Authorized Amount
0.00.
Quantity
Quantity
Quantity
1580 2024
LFT
1,486.00
0.00
1,486.00
LIQUID ASPHALT SEALANT
100.24%
$22.20
156.30-
89.31%
1590 2025
TON
2.70
0.00
2.70
ASPHALT FOR TACK COAT
$720.00
6.50-
100.00%
$0.00
1600 2026
SYS
192.20
0.00
192.20
DECORATIVE CONCRETE PAVEMENT, TRUCK APRON,
7 IN.
102.70%
$195.00
1610 2027
SYS
245,00
0.00
245.00
SIDEWALK, CONCRETE {4 IN,)
1.00 •
50.00%
-$250.00
0.00:
1620 2028
SYS
175.00
0,00
175.00
CURB RAMP, CONCRETE
1630 2029
SYS
27.00
0.00
27.00
DETECTABLE WEARING SURFACE
1640 2030
LFT
138.00
0.00
138.00
CURB, CONCRETE
1650 2031
LFT
6.50
0.00
6.50
CURB, TURNOUT
1660 2032
LFT
1,094.00
0.00
1,094.00
COMBINED CURB & GUTTER, CONCRETE, TYPE II
1670 2033
LFT
243.00
0.00
243.00
COMBINED CURB & GUTTER, CONCRETE, TYPE III
1680 2034
LFT
482.00
0.00
482.00
ROLLED CURB & GUTTER CONCRETE, MODIFIED
1690 2035
TON
4.20
0.00
4.20
RIPRAP, REVETMENT
1700 2036
SYS
5.60
0.00
5.60
GEOTEXTILES
1710 2037
EACH
2.00
0.00
2.00
MOB. & DEMOB. FOR SEEDING
1720 2038
kGAL
4.10
0.00
4.10
WATER
1730 2039
SYS
1,135.20
0.00
1,135.20
SODDING
Item Overruns: 136th St. / Hawthorne Dr. & Carey RAB's Page 12 of 16
Quantity Placed
Percent Used
Over/Under
to Date
(Placed)
Authorized Amount
0.00.
0.00%
-$297.20
2.70.
100.000%
$0.00
149.00 .
77.52'%
-$1,944.00
7.45.60 .
100.24%
$22.20
156.30-
89.31%
-$2,281.40
30.10 •
111.48%
$279.00
162.00-
117.39%
$720.00
6.50-
100.00%
$0.00
1,129.00 ,1
103.20%
$490.00
243.00.
100.00%
$0.00
495.00-
102.70%
$195.00
0.00'
0.00%
-$399.00
0.00.
0.00%
-$84.00
1.00 •
50.00%
-$250.00
0.00:
0.00%
-$4.10
1,432.60.
126.20%
$1,040.90
01/17/2018
AGGREGATE FOR UNDERDRAINS
0.00
0.00
1780 2044
SYS
0.00
GEOTEXTIL.ES FOR UNDERDRAINS
4.00 •
100.00%
1790 2045
EACH
4.00
INLET, J10
100.00%
$0.00
1800 2046
EACH
2.00
INLET, M10
-$3.100.00
0.00
1810 2047
EACH
3.00
MANHOLE, C4
0.00
1.00
1820 2048
EACH
5.00
CASTING, ADJUST TO GRADE UNDISTRIBUTED
169.00
1830 2049
LS
1.00
MAINTAINING TRAFFIC
4.00
6.00 .
1840 2050
LFT
169.00
SIGN POST, SQUARE TYPE 1 REINFORCED ANCHOR BASF.
1850 2051
EACH
4.00
DECORATIVE STREET SIGNS, INSTALLED
75.00
87.50 .
1860 2052
SFT
49.20
SIGN, SHEET, WITH LEGEND, 0.080 IN.
181.00.
88.08%
1870 2053
SFT
75.00
SIGN, SHEET, WITH LEGEND, 0.100 IN.
449.63%
$24,616.80
1880 2054
LFT
205.50
CONDUIT, STEEL, GALVANIZED, 2 IN.
1890 2055
LFT
338.50
CONDUIT, PVC 4 IN. SCHEDULE 80
0.00
0.00
0.00
0.00%
$0.00
0.00
4.00
4.00 •
100.00%
$0.00
0.00
2.00
2.00 •
100.00%
$0.00
0.00
3.00
2.00.
66.67%
-$3.100.00
0.00
5.00
0.00
0.00%
-$1,825.00
0.00
1.00
1.00
100.00%
$0.00
0.00
169.00
194.00-
114.79%
$492.50
0.00
4.00
6.00 .
150.00%
$4,628.00
0.00
49.20
53.16.
108.05`%
$68.51
0.00
75.00
87.50 .
116.67%
$237.50
0.00
205.50
181.00.
88.08%
-$551.25
0.00
338.50
1,522.00 •
449.63%
$24,616.80
[tem Overruns: 136th St. / Hawthorne Dr. & Carey RAB's Page 13 of 16 01/17/2018
Line Number Item Number Unit
Original Change Order
Authorized
to Date
Quantity Quantity
Quantity
1900 2056 LFT
338.50
0.00
338.50
CONDUIT PVC 4 IN. SCHEDULE 80 WITH 3 1.25
IN. INNERDUCTS
8.00 •
100.00%
1910 2057 LFT
502.50
0.00
502.50
4 1C NO. 4 Cu CONDUCTOR IN PLASTIC DUCT
100.00%
$0.00
11.00•
1920 2058 EACH
8.00
0.00
8.00
LIGHT POLE, ORNAMENTAL 30 FT E.M.H., 8 FT.
MAST ARM, DECO WRAP BASE
100.00%
1930 2059 EACH
8.00
0.00
8.00
LIGHTING FOUNDATION, CONCRETE, W GROUNDING, 30 IN. X 96 IN.
104.27%
$78.30
1940 2060 EACH
8.00
0.00
8.00
LUMINAIRE, LED, 152 WATT
$0,00
106.00•
106.00%
1950 2061 EACH
1.00
0.00
1.00
HANDHOLE, STREET LIGHTING
100.00%
$0.00
2.00 ,
1960 2062 EACH
1.00
0.00
1.00
SERVICE POINT, 11, METERED
1970 2063 EACH
1.00
0.00
1.00
IRRIGATION CONTROLLER BOX
1980 2064 LFT
192.00
0.00
192.00
TRANSVERSE MARKING, THERMOPLASTIC, CROSSWALK, WHITE, 24 IN.
1990 2065 LFT
1,359.00
0.00
1,359.00
LINE, THERMOPLASTIC, SOLID, WHITE, 4 IN,
2000 2066 LFT
56.00
0.00
56.00
LINE, THERMOPLASTIC, DOTTED, WHITE, 8 IN.
2010 2067 LFT
64.00
0.00
64.00
TRANSVERSE MARKING, THERMOPLASTIC, YIELD LINE, WHITE, 24 IN.
2020 2068 LFT
100.00
0.00
100.00
LINE, THERMOPLASTIC, SOLID WHITE, 6 IN.
2030 2069 LFT
1,243.00
0.00
1,243.00
LINE, THERMOPLASTIC, SOLID, YELLOW, 4 IN.
2040 2070 LFT
208.00
0.00
208.00
LINE, THERMOPLASTIC, SOLID YELLOW, 8 IN.
2050 2071 EACH
2.00
0.00
2.00
SNOWPLOWABLE RAISED PVMT MARKING (BLUE)
Item Overruns: 136th St. / Hawthorne Dr. &ainp; Carey RAB's Page 14 of 16
Quantity Placed
Percent Used
Over/Under
to Date
(Placed)
Authorized Amount
1,050.00.
310.19%
$24,475.60
757.00 .
150.65%
$2,926.75
8.00 •
100.00%
$0.00
8.00 ,
100.00%
$0.00
8.00.
100.00%
$0.00
11.00•
1,100.00%
$7,450.00
1.00,*
100.00%
$0.00
1.00.
100.00%
$0.00
168.00.
87.50%
-$240.00
1,417.00.
104.27%
$78.30
44.00.
78.57%
-$72.00
64.00 •
100.00%
$0,00
106.00•
106.00%
$15.30
1,643.00
132.18%
$540.00
208.00•
100.00%
$0.00
2.00 ,
100.00%
$0.00
01/17/2018
Line Number Item Number Unit Original Change Order
Authorized
Quantity Placed
Percent Used
Over/Under
Quantity
Quantity
Quantity
to Date
(Placed)
Authorized Amount
2060 2072 SYS 13.60
0.00
13.60
7.40 •
54.41%
-$818.40
CENTERCURB, "TYPE D, CONCRETE
2070 2073 EACH 2.00
0.00
2.00
2.00.
100.00%
$0.00
HYDRANT ASSEMBLY, REMOVE/REPLACE AND ADJUST TO GRADE
2080 2074 EACH 4.00
0.00
4.00
4.00
100.00%
$0.00
ADJUST VALVE TO GRADE
2083 720-96999 EACH 0.00
2.00
2.00
2.00
100.00%
$0.00
FIRE HYDRANT ASSEMBLY
2084 621-90853 EACH 0.00
1.00
1.00
1.00.
100.00%
$0.00
TAPPING SLEEVE WITH VALVE
2085 805-78925 EACH 0.00
1.00
1.00
1.00 •
100.00%
$0.00
CONTROLLER CABINET FOUNDATION, PI
2086 621-06570 CYS 0.00
125.00
125.00
125.00
100.00%
$0.00
TOPSOIL
2087 802-04993 LS $0.00
$2,750.00
$2,750.00
1.00
100.00%
$0.00
SIGN
2088 807-04744 LS $0.00
$323.21
$323.21
1.00
100.00%
$0.00
LIGHTING
2090 2075 EACH 4.00
0.00
4.00
4.00.
100.00%
$0.00
RECTANGULAR RAPID FLASHER BEACON W PUSH BUTTON ACTIVATION
2100 2076 LFT 400.00
0.00
400.00
484.00 -
121.00%
$54.60
CABLE, POLE CIRCUIT, THWN, NO. 10, COPPER, STRANDED, 1 C
2110 2077 EACH 4.00
0.00
4.00
8.00
200.00%
$147.60
CONNECTOR KIT, UNFUSED
2120 2078 EACH 4.00
0.00
4.00
8.00.
200,00%
$158.40
CONNECTOR KIT, FUSED
2130 2079 EACH 18.00
0.00
18.00
24.00
133.33%
$67.20
MULTIPLE COMPRESSION FITTING, NON- WATERPROOFED
2140 2080 EACH 8.00
0.00
8.00
8.00 '•
100.00%
$0.00
INSULATION LINK, NON -WATERPROOFED
2150 2081 EACH 8.00
0.00
8.00
8.00
100.00%
$0.00
INSULATION LINK, WATERPROOFED
Item Overruns: 136th St. / Hawthorne Dr. & Carey RAB's
Page 15 of 16
01/17/2018
Line Number Item Number
Unit
Original
Change Order
Authorized
Authorized Amount
595.40•
Quantity
Quantity
Quantity
2160 2082
SYS
412.00
0.00
412.00
MILLING, ASPHALT
100.00%
$0.00
86.00 •
100.00%
2170 2100
EACH
2.00
0.00
2.00
ORNAMENTALTREE, 8 Fr. HEIGHT
$0.00
36.00 •
116.13%
$2,298.35
2180 2101
EACH
23.00
0.00
23.00
EVERGREEN SHRUB, NO. 3 CONTAINER
22.00.
81.48%
-$375.00
2190 2102
EACH
26.00
0.00
26.00
DECIDIOUS SHRUB, NO. 3 CONTAINER
2200 2103
EACH
86.00
0.00
86.00
ORNAMENTAL GRASS, NO 1 CONTAINER
2210 2104
EACH
487.00
0.00
487.00
PERENNIAL, NO. 1 CONTAINER
2220 2105
LS
1.00
0.00
1.00
IRRIGATION SYSTEM
2230 2106
LIFT
31.00
0.00
31.00
MASONRY WALL
2240 2107
EACH
50.00
0.00
50.00
DECIDIOUS SHRUB, NO. 1 CONTAINER
2250 2108
EACH
186.00
0.00
186.00
PERENNIAL, PLUG CONTAINER
2260 2109
CYS
27.00
0.00
27.00
HARDWOOD MULCH
2270 2110
CYS
108.00
0.00
108.00
TREE AND SOIL PLANTING MIX
(242 Items)
Quantity Placed
Percent Used
Over/Under
to Date
(Placed)
Authorized Amount
595.40•
144.51%
$1,834.00
2.00 •
100.00%
$0.00
23.00 .
100.00%
$0.()()
26.00.
100.00%
$0.00
86.00 •
100.00%
$0.00
487.00,
100.00%
$0.00
1.00 •
100.00%
$0.00
36.00 •
116.13%
$2,298.35
50.00.
100.00%
$0.00
186.00•
100.00%
$0.()0
22.00.
81.48%
-$375.00
108.00
100.00%
$0.00
Project Overruns: $90,296.73
Project Underruns: $53,976.30
Project Variance: $36,320.43
Item Overruns: 136th St. / Hawthorne Dr. & Carey RAB's Page 16 of 16 01/17/2018
16 -ENG -09 Cam and Hawthorne
............................. . ............................ ....................... 3 ...... ........................................... ........ .............. .............................. ............ . ................................................ . ........
............................................. ....................... ...........................................................
Overruns :Under Runs
...................................................................................... ................ . ............ ........................................................................
........... . ........................ ................ . ................................. ............................... I ...................................................... .............................. ........................................................................
........................................ ....................... ........................................................... .........................................................................................
-440.001 `Original Contract Amount
.............................. ...................... ........................................................... ............................................................................ ..........
. .................. ..... ..... . ............................. ..........................................
-275.001 1
22,835.11!Change Order Amount
......................................
..................... .................................................................................... ............................................................ . ............ .. . ... -.j ........ ..... ....... .............. . .................................
-780,00:-contract Sum
I.
..................................................... . .............. I .............. ............ . .......................................................... .......... I. ... . ........................................
-2,800.00: $36,320.43 Over Run Amount
........................................................................
$22.20 -750.00 SZZZ, 2.1 !Adiusted Contract Amount
....................................................... 3..
...................... ....... . .........................
$279.00
. ........ ............. .................................................................................... ...... ..Adjusted
-204.75!
...............I................... .. ....................... ........................................................... ................................. I .................................................... .............................. ........... . ...........................................................
$720.00 -490.001
............ I ..............................................
....................... ........................................................
$490.00 1
........................................ . ......... I ....... ....................... ............................................
...; ..................... I ................................. ..... I .............. .......................... ........................................................................
-2,708.00::
. .............0. ..............
$195.00
I ............................. . .............................. ......................
-979.65!
................... ....... I .......................... ...... ................. ................................... . ................................. . .............. T. ......................... ............................................... ...................
.................................... ........ ......................................................._...-6,
.90 -6,906.SO::
......................... ................. . ...... ............................................................................... . ... .............................................................................. . ..... ? .............................. ............................................... ......... ..............
.00 1 -25,140.00";
I
........... . .............................$750.00........ I ....... ; ....................... ............ I ........................
.....-97.7 0 . ........ ... j ...................... I ............................................................... I .............................. ......................................................................
..
»....«-97 711
................................................................................$...4......9......2.......5......0....... - ....................................................
i
I ....... y.1...6..3....3...5.. 4i ................................................................................................. ................................................. .....
►...........................».....«.................................................i...........................
..........................
......................i...............»...»..........................................................................................
$4,62•
.............................»...... 8.00 ....................... .. 297.20**......................................... ............... ...................................................................................... ............................... ........................................................................
$68.51:-1,944.00::
$237.50'i ........................ I .......................................... .......... ..................................».
...... -2,........... . ..281.40 4 .............................................................................. . ....... .....................
....................... «.......524,616.80 -... . . ....................... ................. ............... ... ...... 1-1 399.00 .. . .... ... ....... ...... I ..................... I .............. 41 ...... ............................... ......................... ............................... . ............
' :
................................»524,475.60.p...................................... ... -84.00.............. ....................................... 4.4 ......................................... I ..................... I ................ . .... .............................. ........................................................................
4
..................................................... ...... ............. .................................. ........... .......................... . ............................. . ...........................
............................ . .....
..............................»$7,450.00. .......................................... ................................«.....».......»4.10
.............................. ? ........................................................................
. ............................................ . ................................ ........ ...................»......... .................. . . ......... ...................... . ................
-4. 10 1
...».......».......»............................. ...... ...................................................................................
.... ......... I..........................$....................................................-.3
. ............................ . ......................................................... .............................. .....................................................................
,. ....................... . ............................................................................».«.....................................................................
$15.30
-1,825,00
-100....0.0..
..................................$540.00. .................... 551.25. ........................................................... ............ ...............................................................I.............I..........................
...7..8.....3...0
...
........................................................... 4 ....................... .............................. 4 ................. I ..................... ............. I ................................ ............... ....
$54.60 -240.00!
.................... ................ . .................... ....................... ......................................... ...................... ... . ...................................... .. . .. .............. . ............. .................................. . ..................... ...........
$147.60.72.00::
................................; .... ...........
..................... ....................... ............................................................ .. .................................................................. .............................. ................... . ...................................................
$IS8.40 -818.40::
................................... ...................... ...........................................
.................. ................ ...... .................
$ 67 . 20
. ..375..........00:: ..... ..................................... . ...................... ........................... I ............................................
-
................................... ....................... ........................................................... .................................... ........................... .............................. . ........................................................................
.................................... ............... . ...... ........................................................... ...................................................................................... .............................. ? ........................................... . ...........................
AFFIDAVIT AND FINAL CONDITIONAL WAIVER OF CLAIMS AND LIENS AND RELEASE OF RIGHTS
STATE: OF_ Indiana _
COUNTY OF Hamilton
7lic undersigneli, Otho is the S_ � �(designatr title! of MAS Marken Releasor'). +thich is the
•e.Id6Ct •k-bA- V, _ (designate whether subcontractor, supplier, or otherwise) for the d�_Q _ Sg{ _(dtaignatc
file type of worst, supplies or serrices rendered) with respect to the improvements constructed or being constructed on the Preremise% hereafter identified,
on behalf of the Releasor acknowledges and confirms that its contract with E & B Paving. Inc. (E & B), with respect to the Premises noted below. is in
the total amount of $ , as noted in the Final Invoice identified below, which includes all extras and change orders.
The Releasor acknowledges and agrees this waiver is being provided to induce the Owner and E & B to make Final Payment to Rcluasor with
respect to its Final Invoice. With respect to Final Invoice. Releasor further states that the final total value of its work completed and materials and
equipment stored is S _. Of that amount. as reflected in the Final Invoice. S _ has been received (the
receipt and sufficiency of which is hereby acknowledged by Rcirasor). and a total of is being held as retainage. Further. the
Final Invoice reflects a current and final amount due and payable of S_ _85 00
In consideration of the amounts and sums received, and conditional upon the receipt of the ahu%a noted due and payable final amount of
S 85.00 , the Releasor does hereby waive and release to the Owner and E & B any and all claims, liens and rights to liens upon the
Premises (including any improvcmenls thereon) described below. said claims, liens and rights to liens being on account of all labor, services, materials,
equipment, fixture or apparatus famished by or through the Releasor. The Premises as to which said claims, liens and rights to liens are hereby released
are identified as follow -
Project Name _ __ __ 112163509 -Carey & Hawthorne RAB - Final Retainage__ - __
Address of Project:
City - County __— -- State
Owner
General Contractor. E & B Paving, Inc.
The Releasor further rgrreserus and warrants that it is duly authorized and empowered to execute and deliver this Final Waiver: that it has
properly performed till work and furnished all the materials and equipment ol'the specified quality per the contract plans and specifications and in a good
and workmanlike manner; that it has paid. or will No paying from the Final invoice amounts received, for all the labor, materials, equipment, and
services that it has used or supplied with respect to the Premises: and that it has no other outstanding and unpaid Invoices for PayincriVrfentions,
holdbacks, charge backs or unbilled work or materials against the Owner or E & B with respect to the Premises.
The Releasor further agrees to reimburse. hold harmless. det'end and indemnify Owner and E & B for any losses or expenses they may suffer or
incur as a result of any claims• liens or rights to a lien released hereunder which may he asserted by the undersigned, or by any laborer• materialman or
subcontractor ol'the Releasor (of an tier). or by an other pan claiming through Releasor. Relca%or's obligations under this paragraph include, without
implied limitation. all attorneys' fees and costs incurred by either the Uwner or li & B in the defense of any such claim. lien or right kr )yen.
In addition, for and in consideration of the amounts and sums received, and conditioned upon its receipt of the above nott� ti 'Ro ile final
amount of S 85.00 the Releasor hereby waives, release and relinquishes any and all claims, rights or cause:� chopnil may
have against the Owner or E & B or any of their respective officers, directors, partners, manhers, employees. agents, couspltarttsl to
subc'cmtractors or ntaterialmen, arising out of or relating to the above -noted Premises or subject contract. _ 1986
Signed and delivered this day of Jwl20 /�nIAN�` • C,
ndividual r �(' M c) ..•
Title r
Before me, the undersigned Notary Public in and for the said County and State. personally appeared e" and
acknowledged execution of floe foregoing aflidav it as his voluntary act and decd and further stated that the facts recited arc true of his personal
knowledge
Aly Commission Expires:_ notary Public (.!�"'"_` _ �
- — Residence County /1P
'��``IN C.Jp ,'f
A�
�s ��� •,.....••
�`r�q'•FxPaEsw!a••P
�'zrrr Pavv��
rCF'N01
AFFIDAVIT AND FINAL CONDITIONAL WAIVER OF CLAIMS AND LIENS AND RELEASE OF RiCIITS
STATE OF_Indiana_
COUNTY OF Hamilton
The undersigned, who is the (designate title) of Roudebush Grading Releasor-'), which is the
_(designate whether subcontractor, supplier, or otherwise) for the _ (designate
the type of work, supplies or services rendered) with respect to the improvements constructed or being constricted on the Premises hereatler identified,
on betialfofthe Releasor acknowledges and confirms that its contract with E & B Paving, Inc. (E & B), with respect to the Premises noted below, is in
the total amount of Sas noted in the Final Invoice identified below, which includes all extras and change orders.
The Releasor acknowlWges and agrees this waiver is being provided io induce the Owner and f & B to make Final Pa.%meet to Releasor with
respect to its Final Invoice. With respect to Final Invoice, Releasor further states that the final total value of its work completed and materials and
equipment stored is S- _ _ Of that amount, as reflected in the Final Invoice. S_ -_ has been received (the
receipt and sufficiency of which is hereby acknowledged by Releasor), and a total of S_ -_ is being held as retainage. Further, the
Final invoice reflects a current and final amount due and payable ofS_746.74-- _
In consideration of the amounts and sums received, and conditional upon the receipt of the above noted due and payable final amount of
S 746.74 the Rele mor docs hereby waive and release to the Owner and E & B any and all claims, liens and rights to liens upon the
Premises (including any improvanents theram) described below: said claims, liens and right,; to liens being on uox:ount of all labor, services, nwterials,
equipment, fixtures or apparatus furnished by or through the Releasor. The Premises as to %hich said claims, liens and rights to liens are hereby released
are identified as follows:
Project NanteU216i509 - Carey & Hawthorne RAH- Final Retainage -
Address of Project:__._ __
City- --- - C'ounty_.
Ow•ne
General Contractor: E & B Paying, Inc.
State
The Releasor further represents and warrants that it is duly authorized and empowered to execute and deliver This Final Waterer; that it has
properly performed all work and furnished all the materials and equipment of the specified quality per the contract plans and specifications and to a good
and workmanlike mariner; that it has paid, or will be paying from the Final Invoice amounts rvutived, for all the labor, materials, equipment, and
services that it has used or supplied with respect to the Promises. and that it has no other outstanding and unpaid Invoices for PayrnenO.Clentions,
holdbacks, charge backs or unbiblod work or materials against the Ownct or E & B with respect to the I m- raises.
The Releasor further agrees to reimburse, hold hamiless, defend and indemnify Owner and E & B for any losses or expenses they may suffer or
incur as a result of any claims, liens or rights to a lien released hereunder which may be asserted by the undersigned, or by any laborer, matcrialman or
subcontractor of the Reieasor (of any tier), or by any other party claiming through Releasor. Reicasor's obligations under this paragraph include. without
implied limitation, all attorney-,' fees and costs incurred by either the Owner or b & B in the defense of any such claim, lien or right to lien.
In addition, for and in consideration of the amounts and sums received, and conditioned upon its receipt of the above tinted due and payable final
amount of S_746.74_ , the Rcleasor hereby waives. releases and relinquishes any and all claims, rights or causes of action whatsoever it
may have against tee Owner or E & B or any of their respective officers, directors,partners, partrs, menhber' , employees, agents, consultants, contractors,
subcontractors or materialmeu, arising out of or relating to the above -noted Premises or subject contract.
Signed and delivered this C _ ..day of "v 30
(I�di+ridtj r{i talion Name)
B _ _
---
�,V �C e -V,
Before me, the undersigned Notary Public in and for the said County and State, personally appeared_ and
acknowledged execution of-thc foregoing affidavit as his voluntary act and deed and norther stated that the Facts rtcited are true of his personal
knowledge.
My Commission Expires: Lr--
-- Notary Public_ ':S �_i v. c d__ .LN --a c,
Residence County_ , \\.3n , �— `
SIEPHAN1 LYNk;
State a r:e,ana
r.`ry' Corttansscnn I:sprec
AFFIDAVIT AND FINAL CONDITIONAL %VAI1'ER OF CLAIAIS AND I.If.NS AND RELEASE OF RICH'1'S
STATE OF Indiana_
COUNTY OF Hamilton
•llfe undersigned, who is life aimr ��rt _ (designate title) of USI Consultants Releasor"), which is the
___(designate whether subcontractor, supplier, or Otherwise) for the (ticsignatc
.� ..,
the type of work, supplies or sen -ices rendered) with respecti to the improvements constructed or being constructed on the PrentSsi( hereaficr identified.
on behalf of the Releasor acknowledges and confirms that its contract with h & B Paving, Inc. (E & B), with respect to the Premises noted below, is in
the total amount of s 112- 00, 06 , as noted in life Final Invoice identified below, which includes all extras and change orders.
The Releasor acknowledges and agrees this A%Ivcr is being provided to induce the Owner and E & B to make Final Payment to Releasor with
respect to its Final Invoice. With respect to Final Invoice, Rcicasor further states that the final total value of its %%wk completed and materials and
equipment stored is S_ I,?- o O ; e lel _. Of that amount, as reflected in the Final Invoice. S $Z ' O , o 0
receipt and sufficiency of which is hereby acknowledged by Releasor), and a total of S _ _ �2 d . O o being held as retainaghas eFurtheen r received (the
Final Insolce reflects a current and final amount due and payable of $_920.00_ _
In consideration of the amounts and sums received, and conditional upon the receipt of the above noted due and payable final amount of
$920.00 the Rcicasor does hereby waive and release to the Owner and E & B any and all claims, liens and rights to liens upon life
Premises (including any improvements thereon) described below; said claims, liens and rights to liens being on account of all labor, services, materials,
equipment, fixtures or apparatus furnished by or through the Releasor. Thc Premises as to which said claims, liens and rights to liens are hereby released
are identified as follows:
Project Name— _ 02163309 - Carey & Hamhomc RAB- Final Retainage.
Addrew; of Project:_
City County State
Owner
General Contractor: E & B Paving, Inc.
The Rcicasor further represents and warrants that it is duly authorized and empowered to execute and deliver this Final %Vaiwer; that it has
properly perforn►ed all work and furnished all the materials and equipment of the specified quality per the contract plans and speritications and in a good
and workmanlike manner; that it has paid, or will be paying from the Final Invoice amounts received, for all tine labor, materials, cquipn►cmt, and
services that it has used or supplied with respect to the Premises; and that it has no other outstanding and unpaid Invoices for Paymcmt/retentions,
holdhacks, charge backs or unbilled work or materials against the Owner or E & B with respect to the Premises.
11►c Releasor further agrees to reimburse, hold harmless, defend and indemnify Owner and E & B for any losses or expenses they nary suffer or
incur as a result of any claims, liens or rights to a lien released hereunder which may be asserted by the undersigned, or by any laborer, materialman or
subcontractor of the Releasor (of any tier), or by any other party claiming through Rceasor. Rcicasor's obligations under this paragraph include. without
implied limitation, all attorneys' fees and costs incurred by either file Owner or F & B in lire defense of any such claim, lien or right to lien.
In addition, for and ii consideration of the amounts and sums received, and conditioned upon its receipt of the above noted due and payable final
amount of S- __ _920.00 , the Rcicasor hereby waives, releases and relinquishes tiny and all claims, rights or causes of action whatsoever it
may have against the Owner or E & B or any of their respective officers, directors, partners, members, employees, agents, consultants, contractors,
subcontractors or materialme►, arising out of or relating to the above -noted Premises or subject contract.
Signed and delivered this_ 30-
0v=_day of *4'/' 20/7
(Ind • lion Nalm)
Bl':
Title y� --
Before nue, the undersigned Notary Public in and for the said County and State, personally appeared___ N/ e
acknowledged execution of the foregoing of idavil as his voluntary act and deed and further stated that the facts recited are�his pera and
knowledge.
My Commission Expires: _ �2/Z�gpyp -- __ _ _NotaryPuh
Residence owN E y'•
JACOB MICHAEL GARDNER
PrI I'V♦ M...
Hancock County
sWMy Commission Expires
December 28, 2020
AFFIDAVIT ANTI FINAL. ( ONDITIONAL WAIVER OF CLAIMS AND LIENS AND RELEASE OF RIGHTS
STATE OF Indiana
COUNTY OF Hamilton
The undersigned, who is the _ (designate (ick) of Fox Contracturs Releasor"), which is the
_ (designate whether sudx contractor supplier, or otherwise) for the __ _ (designate
the type of work, supplies or services tendered) with respect to the improvements constructed or being constructed on the Premises hereafter identified,
on behalf of the Releasor acknowledges and confirms that its contract with E & B Paving, Inc. (F. & B), with respect to the Premises noted below, is in
Ute total amount of $ , as noted in the Final Invoice identified below, which includes all extras and change orders
'11he Releasor acknowledges and agrees this waiver is Irving provided to induce the Owner and F & B to make Final Payment to Releasor with
respect to its Final Invoice. With respect to Final Invoice, Releasor further states that the Final total value of its work completed and materials and
equipment stored is S_. Of that amount, as rcfleTted in the Final Invoice, S _ _ _has been received (the
receipt and sufficiency of which is hereby acknowledged by Releasor), and a total of S :_ _ is being held as retainage. Further, the
Final Invoice reflects a current and final amount due and payable of S19,971.11) ✓�
In consideration of the amounts and sums received, and conditional upon lite receipt of the above noted due and payable final amount of
5 . _ 19;171.1 Uthe Releasor dons hereby wave and release to the Owner and E & B any and all claims, liens and rights to liens upcm the
Premises (including any improvements thereon) described below; said claims, lieu and rights to liens being on account of all labor, services, materials,
equipment, fixtures or apparatus furnished by or through the Releasor. The Premises as to which said claims, liens and rights to liens are hereby released
arc iolentified as follows:
Project Name_ 02163509 _ Carey & Hawthorne RAB- Final Rclainage
Address of Projccc____
City _ County State
Owner
General Contractor: E & B Paving, Inc.
The Releasor further represents and warrants that it is duly authorizer( and empowered to execute and deliver this Final Walver; that it has
properly performed all work and Fihmishel all the materials and equipment of the specified quality per the contract plans and specifications and in a good
and workmanlike manner; that it has paid, or will be paying from the Final Invoice amounts received, for all the labor, materials, equipment, and
services that it has used or supplied with respect to the Premises; and that it has no other outstanding and unpaid Invoices for Paymentln9cntions,
holdbacks, charge backs or unbilled work or materials against the Owner or E & n with respect to the Premises.
The Releasor further agrees to reimburse, hold harmless, defend and indemnity Owner and E & B fur any losses or expenses they may suffix or
incur as a result of any claims, liens or rights to a lien released hereunder which may be asserted by the undersigned, or by any laborer, matcrialman or
subcontractor of the RCiceSnr (of any tier), or by any other party claiming through Rcleusor. Relc sor's obligations under this paragraph include, without
implied limitation. all attorneys' fees and costs incurred by either the Owner or T-.& R in the defense ofany such claim, lien or right to lien.
In addition, for and in consideration of the amounts and sums received, and conditioned upon its receipt of the above noted due and payable final
amount of S 19,971.10 , the Releasor hereby waives, releases and relinquishes any and all claims, rights or causes of action whatsoever it
may, have against the Owner or E & B or any of their respective officers. directors, partners, members, employees. agents, consultants, contactors,
subcontractors or materialmen, arising out of or relatin /it) the aim) v-c,•nnotel Premises or subject contract.
Signal and delivered this UkJ day of 2J-7- .
(Indirie�icd nr C natio h 'ret!��
Title f► [�
Before me, the undersigned Notary Public in and for the said County and State, personally iippezhraf��rA Qand
acknowledged execution of the foregoing affidavit as his voluntary act and decd and further stated that the facts recited are true of his personal
knowledge
My Commission Expires: Notary Public..?'!
Resickncc Cot nt!^f' t✓'1
a
AMY J SMITH, Notary Public
Resident of Huntington County, Indiana
My Commission Expires January 16, 2025
AFFIDAVIT AND FINAL CONDITIONAL WAIVER OF CLAIMS AND LIENS AND RELEASE OF RiGHTS
STATE OF Indiana
COUNTY OF Hamilton
The undersigned, who is the (designaretitle) of_ Indiana Sign & Barricade Releasor"), which is the
(designate whether subcontractor, supplier, or otherwise) for the (designate
the type of work, supplies or services rendered) with respect to the improvements constructed or being constructed on the Premises hereafter identified,
on behalf of the Releasor acknowledges and confirms that its contract with E & B paving, Inc. (E & B), with respect to the Prcmises noted below, is in
the total amount of S ft as noted in the Final Invoice identified below, which includes all extras and change orders.
The Releasor acknowiedges and agrees this waiver is being provided to induce the Owner and E & B to maize Final Payment to RdeMOr with
mpect to its Final Invoke. With respect to Final Invoice, Releasor further states that the final total value of its work completed and materials and
equipment stored is $ Of that amount, as reflected in the Final invoice, $ has been roceivod (the
receipt and sufficiency of which is hereby acknowledged by Releasor), and a total of S is being held as retainage. Further, the
Final InvOlee reflects a current and final amount due and payable of S_ 921.65_
In cansideration of the amounts and sums received, and conditional upon the receipt of the above noted due and payable final amount of
S 921.65_ the Releasor does hereby waive and release to the Owner and E & B any and all claims, liens and rights to liens upon the
Premises (including any improvements thereon) described below; said claims, liens and rights to liens being on account of all labor, services, materials,
equipment, fixtures or apparatus furniahed by or through the Releasor. The Premises as to which said claims, liens and rights to liens are herby released
aro identified as follows:
Project Name 02163509 — Carey & Hawthorne RAB— Final Retainage
Address of Project:
City,
Owner
County
General Contractor. E & B Paving, Inc.
The Releasor further represents and warrants that it is duty authorized and empowered to execute and deliver this Final Waiver; that it has
properly performed all work and furnished all the materials and equiptnent of the specified quality per the contract plwu and apecificatiorr, and in a good
and workmanlike manner; that it has paid, or will be paying from the Final Invoice amounts received, for all the labor, materials, equipment, and
services that it has us or supplied with respect to the Premises; and that it has no other outstanding and unpaid Invoices for Paymentlretentions,
holdbacks, charge backs or unbilled work or materials against the Owner or E & B with respect to the Premises.
The Releasor further agrees to reimburse, hold harmless, defend and indetnnify Owner and E & B for any losses or expenses they may suffer or
incur as a result of any claims, liens or rights to a lien released hereunder which may be asserted by the undersigned, or by any laborer, materiahnan or
subcontractor of the Releasor (of any tier), or by any other party claiming through Releasor. Releasor's obligations tinder this paragraph include, without
implied limitation, all attorneys' fees and costs incurred by either the Owner or E & B in the defense of any such claim, lien or right to lien.
in addition, for and in consideration of the amounts and sums received, and conditioned upon its receipt of the above noted due and payable tinal
amount of S-921.65 , the Releasor hereby waives, releases and relinquishes any and Fill claims, rights or causes of action whatsoever it
may have against the Owner or E & B or any of their respective offices, directors, partners, mcrnbers, employees, agents, consultants, contractors,
subcontractors or materialmen, arising out of or relating to the above -noted Premises or subject contract.
Signed and delivered this --L0_1 day of t°/ 20/,2.
(1 flail or Corporation Na;,;;.—)
BY:
Title 1,es��t.�
Before me, the undersigned Notary Public in and for the said County and State, personally appeare4 and
acknowledged execution of the foregoing affidavit as his voluntary act and deed and further stated that the facts ted are true of hi personal
knowledge.
My CtImmissif�I Expires:7LOI �Q,� � _ __Notary Public- �/ �Onl
��\Utlt t)rrrJ�
X�p, K G/QS,O Residence County �--�sy,..l
..eCon 04"'.
V,
0 . �otpa`r PUBO -
en g 40
C NOiARY SE h -
•��4 � ;cis 07 Ob �rya�
��u+tttnntten��.
AFFIDAVIT AND FINAL CONDITIONAL WAIVER OF CLAIMS AND LIENS AND RELEASE OF RIGHTS
STATE OF Indiana
COUNTY OF on Hamilt_
.5The undersigned, who is the �s y�� i -k (designate title) of Broady -Campbell Releasor"), which is the
.v Q-- kz-A'C'"\- {designate whether subcontractor, supplier, or otherwise) for the
the type of work, supplies or services rendered with (designate
respect to the improvements constructed or beint constructw,nn the P ises hereaAer identified,
on behalf of the Releasor acknowledand confirms that its contract with E & B Paving, Inc. (E & e), with respect to the Premises noted below, is in
the total amount of; 3`i HOZ --IT as noted in the Final Invoice identified below, which includes all extras and change orders.
The Releasor acknowledges and agrees this waiver is being provided to induce the Owner and E & B to make Final Payment to Releasor with
equip to its Finred i Invoice. With re ed to Final Invoice, Releasor further states that the final total value of its work comp(oted and materials and
equipment stored is S�((�� . j _ . Of that amount, as reflected in the Final Inypice, 5 �} lD'l C.L,)
receipt and sufficiency of which is hereby acknowledged by Releasor), and a total of S i_bus been received (the
Final invoice reflects a current and final amount due and payable of $ 1,654.81 being held as retainage. Further, the
In consideration of the amounts and sums received, and conditional upon the receipt of the above noted due and payable final amount of
$_ ____ 1,654.81 , the Releasor does hereby waive and release to the Owner and E & B any arid all claims, liens and rights to liens upon the
Premises (including any improvements thereon) described below; said claims, liens and rights to liens being on account of all labor, services, materials,
equipment, fixtures or apparatus furnished by or through the Releasor. The Premises as to which said laims, liens and rights to liens are hereby released
are identified as follows: c
Project Name_ _ _02163509 - Carey & Hawthorne RAA- Final Retainage
Address of Project:
C
County �_ -City
State
Owner, --
General Contractor. E & B Paving, Inc.
The Releasor further represents and warrants that it is duly authorized and empowered to execute and deliver this Final Waiver, that it has
properly performed all work and furnished all the materials and equipment of the specified quality per the contract plans and specifications and in a good
and workmanlike manner: that it has paid, or will be paying front the Final Invoice amounts received, for all the labor, materials, equipment, and
services that it has used or supplied with respect to the Promises; and that it has no other outstanding and unpaid Invoices for Payment/rct en (ions,
holdbacks, charge hacks or unbilled work or materials against tate Owner or E & B with respect to the Premises.
The Releasor further agrees to reimburse, hold harmless, defend and indemnify Owner and F & B for any losses or expenses they may suffer or
incur as a result of any claims, liens or rights to a lien released hereunder which may be asserted by the undersigned, or by any laborer, materialman or
subcontractor of the Releasor (of any tier), or by any other party claiming through Releasor. Rcleasor's obligations under this paragraph include. without
implied limitation. all attorneys' fees and costs incurred by either the Owner or E & B in the defense of ani such claim. lien or right to lien.
in addition, for and in consideration of the amounts and sums received, and conditioned upon its receipt of the above not due and payable final
amount of 51,654.81 _. the Releasor hereby waives, releases and relinquishes any and all claims, rights or causes of action whatsoever it
may have against the Owner or E & B or any of their respective officers, directors, partners, members, employees, agents, consultants, contractors,
subcontractors or materialmen, arising out of or relating to the above -noted Premises or subject contract.
Signed and delivered this ')_day of�o�
20 �S
(Int n Name)
BY:
1itic —
f
Before me, the undersigned Notary Public in and for the said County and State, personally appeared
ucknowledged execution of the foregoing afnd
fidavit as his voluntary act and deed and further stated that the facts recited arc true of his personal
knowledge.
%1y Commission Expires: Notary Public
Residence County_y • `- j DENIS E. BROADY
Seat
Notary Public . State of Indiana
Hamilton County
My Commission Expires Mar 31, 2024