MA FY08/09-CL091014 File:932 [TX][PUBLIC][OWNER] Customer: PROCON PAVING AND CONST INC
Recording Requested by and Return to: P.O. #:
Rental One Project: CITY OF COPPELL
Rec ID: 2RQ0L74RO
4101 Gateway Dr Job #: MULTI
Colleyville, TX 76034 Cert No.: 7009 0080 0000 0086 1430
1ST NOTICE TO PUBLIC ENTITY OR CONTRACTOR
AND REQUEST FOR COPY OF PUBLIC BOND - BALANCE DUE
TO THE OWNER OR REPUTED OWNER 1. The following is a general description of
CITY OF COPPELL the labor,service,equipment or materials
ENGINEERING DEPT ATT: KEITH MARVIN furnished or to be furnished by the undersigned:
255 PARKWAY BLVD Construction Equipment
COPPELL, TX 75019 2. Balance Due: $6,498.82
TO ORIGINAL OR REPUTED CONTRACTOR 3. The name of the person who furnished
PROCON PAVING AND CONST INC that labor, service, equipment or
10361 BRICKHAM RD materials is:
DALLAS, TX 75220 Rental One
4101 Gateway Dr
Colleyville, TX 76034
4. The name of the person who contracted for
TO LENDER, SURETY OR BONDING CO. purchase of that labor, service, equipment
SURETEC INSURANCE COMPANY or material is:
9737 GREAT HILLS TRAIL STE 320 PROCON PAVING AND CONST INC
AUSTIN, TX 78759 10361 BRICKHAM RD
DALLAS, TX 75220
Acct /Bond# 4370965
5. The description of the jobsite is:
CITY OF COPPELL
VARIOUS ROAD WORK REPAIRS
COPPELL, TX 75019
County of DALLAS
REQUEST FOR COPY OF PAYMENT BOND AND NAME OF SURETY COMPANY
TO CONTRACTING BODY: CITY OF COPPELL ENGINEERING DEPT ATT: KEITH MARVIN or State Comptroller
This is to respectfully request the information from you, within 10 days of your receipt of this notice as
provided by Chapter 2253, Texas Government Code, Section 2253.024.
The undersigned claimant hereby declares that he has supplied or will supply labor or materials as
described above, that payment has not yet been made therefore, and that he hereby requests that the
contracting body furnish a certified copy of the Payment Bond, if any, to the claimant, at the address
listed above, and the current address of the contracting public entity.
NOTICE TO CONTRACTING BODY
IN ACCORDANCE WITH TEXAS GOVERNMENT CODES THE ATTACHED INVOICES OR STATEMENTS ARE A TRUE AND
ACCURATE
ACCOUNT OF MATERIALS, EQUIPMENT OR LABOR SUPPLIED DURING THE MONTH OF SEPTEMBER, 2009.
THE UNDERSIGNED SUBCONTRACTOR, MATERIALMAN OR LABORER HAS AN UNPAID BALANCE DUE OF $6,498.82. A COPY OF
THE
STATEMENT OR BILLING IS ATTACHED.THE UNDERSIGNED 1ILT. LOOK TO THE GENERAL CONTRACTOR, AND HIS SURETIES,
FOR
PAYMENT IF THE BILL IS NOT PAID.
I declare that I am authorized to file this claim on behalf of the claimant. I have read the
foregoing
document and know the contents thereof; the same is true of my own knowledge. I declare under penalty
of
perjury that the foregoing is true and correct. Executed at Colleyville, Texas on 10/14/2009 for RENTAL
ONE.
Prepared by:
Jeff Swanson, C e it ager Phone: (817) 545 -8999 Fax: (817) 581 -0400
PROOF OF SERVICE BY MAIL AFFIDAVIT
I declare that I served a copy of the above document, and any related documents, by certified or
registered
mail, postage prepaid, or other certified delivery, addressed to the above named parties, at the
addresses
listed above, on 10/14/2009. I declare under penalty of perjury that the foregoing is true and
correct.
Executed at Colley ill , exas on 10/14/2009.
Prepared by:
Jeff Swanson, C ed t anager
RENTAL ONE
P.O. BOX 489 Page: 1
COLLEYVILLE, TX 76034 Remit To:
P.O. BOX 489
2440 HIGHWAY 287 N COLLEYVILLE, TX 76034
MANSFIELD, TX 76063
817 - 473 -2420 817 - 545 -8999
Customer: 4413
PROCON PAVING AND CONST INC 4 WEEK BILL
10361 BRICKHAM RD
DALLAS, TX 75220
Invoice #... 234046 -0003
Invoice date 9/04/09
Date out.... 7/10/09 10:00 AM
Job Site: Billed thru. 9/04/09
ROAD WORK Job Loc RIVERCHASE S OF SANDY
Job No 2 - ROAD WORK - ROAD
RIVERCHASE S OF SANDY LAKE RD P.O. #
D -1B -X Ordered By.. MAJED
COPPELL, TX 75019 Terms Net 10 Days
C #: 972 - 830 -9212 J #: 972 - 830 -9212
Qty Equipment # Min Day Week 4 Week Amount
1 SKID STEER 50HP 1750 LB 160.00 160.00 495.00 950.00 950.00
4690 Make: BOBCAT Model: S175 Ser #: A3L520096
HR OUT1 381.00 HR IN1 TOTAL: 381.00
SMOOTH
1 500 LB HYDRAULIC HAMMER 195.00 195.00 585.00 1750.00 1750.00
2650 Make: KENT Model: KF4QT Ser #: 9754
Sub- total: 2700.00
iT x• 2 2 2 7
a 5
2 7
Tot 922. 5
BILLS : d OR F „; '... E
D.�` OUR 0g$ 8/07/ �: THR�C3`> 9/04109 10 : '
:
[F'THE EQUIPMENTTOOES NOT, WORK MULTP
ILE SHIFTS OR ? C EI • USTOMR:S RESPONSIBLE: FOR
PROPERLY, NOTIFY THE OFFICE AT ONCE OVERTI RATES MAY APPLY REFUE DAMAGES OR R •
1. Loss /Damage Waiver (11% of gross rental charges)will be charged unless customer is a commercial account which elects to provide its own insurance coverage under Paragraph 13 to follow.
Loss /Damage Waiver is NOT INSURANCE and does not cover upset, overturned, tire or overhead damage or accessory items regardless of fault.
2. Customer must call to release equipment and is responsible for released equipment until it is picked up.
3. Customer is fully responsible for the theft of items rented.
I have had thg opportunity to read the terms. and conditions on both sides of this a reeent, 1 have received and understand the safes instructions
on the operation of the equipment I am renting. I have received a complet m
e copy of this agreement and e agree to the terms and conditions on both
sides (Carefully read the terms and conditions on the reverse s of this page)
X
CUSTOMER SIGNATURE DATE NAME PRINTED DELIVERED BY DATE
Terms: NET 10 DAYS
RENTAL ONE Page: 1
P.O. BOX 489
COLLEYVILLE, TX 76034 Remit To
P.O. BOX 489
2440 HIGHWAY 287 N COLLEYVILLE, TX 76034
MANSFIELD, TX 76063
817 - 473 -2420 817- 545 -8999
Customer: 4413
PROCON PAVING AND CONST INC 4 WEEK BILL
10361 BRICKHAM RD
DALLAS, TX 75220
Invoice #... 235216 -0003
Invoice date 9/15/09
Date out.... 7/21/09 4:00 PM
Job Site: - Billed thru. 9/15/09
OF COPPICE Job Loc COR OF CHERRYBARK &, C
CITY
Job No 2 - CITY OF COPPELL
COR OF CHERRYBARK & P.O. #
MOCKINGBIRD, D -1A -Z Ordered By.. MAJED
COPPELL, TX 75220 Terms Net 10 Days
C #: 972 - 830 -9212 J #: 972 - 830 -9212
Qty Equipment # Min Day Week 4 Week Amount
1 BACKHOE 14' 2WD 215.00 215.00 645.00 1150.00 1150.00
4451 Make: JOHN DEERE Model: 310J W /FORK BAR Ser #: T0310JX15938
HR OUT1 682.00 HR IN1 TOTAL: 682.00
1 24" DIRT BUCKET - 310G N/C
4554 Make: JOHN DEERE Model: 24" DIRT BUCKET Ser #: 1903431
1 OVER BUCKET FORKS BACKHOE 20.00 20.00 60.00 180.00 180.00
4894 Make: STAR Model: LBA170 Ser #: *
SALES ITEMS:
Qty Item n
t u >
1 DIESEL-MY-TAX `<: : >: >:. EA 2 6 0 26.60
0
E
T XAS :' ' 'E E
S L O << O V
.ICI R.. M EHI M'[.
ub- total: 1356.60
Ta x 109.73
9 3
'' -. ''''Total: 1466.33
BILLED FOR FOUR WEEKS 8/18/09 THRU 9/15/09 04:00 PM
IP TFIE EQUIPMENT 10ES NOTWORK MULTIPLE •SHIFT$ OR CUSTOMER Is RESPONSIBLE FOR
PROPERLY, NOTIFY THE OFFICPAT ONCE OVERTIME RATES MAY APPLY REFUELING, DAMAGES :DR REPAIRS
1. Loss /Damage Waiver (11% of gross rental charges)will be charged unless customer is a commercial account which elects to provide its own insurance coverage under Paragraph 13 to follow.
Loss /Damage Waiver is NOT INSURANCE and does not cover upset, overturned, tire or overhead damage or accessory items regardless of fault.
2. Customer must call to release equipment and is responsible for released equipment until it is picked up.
3. Customer is fully responsible for the theft of items rented.
I have had the opportunity to read the terms. and conditions on both sides of this a reernent, 1 have received and understand the safef;V instructions
on the operation of the equipment am renting. 1 have received a complete copy of this agreement and agree to the terms and conditions on both
sides. (Carefully read the I e terms and conditions on the reverse s of this page)
X
CUSTOMER SIGNATURE DATE NAME PRINTED DELIVERED BY DATE
Terms: NET 10 DAYS
. RENTAL ONE Page: 1
P.O. BOX 489
COLLEYVILLE, TX 76034 • Remit To:
P.O. BOX 489
2440 HIGHWAY 287 N COLLEYVILLE, TX 76034
MANSFIELD, TX 76063
817 - 473 -2420 817 - 545 -8999
Customer: 4413
PROCON PAVING AND CONST INC RENTAL RETURN
10361 BRICKHAM RD
DALLAS, TX 75220
Invoice #•.. 235216 -0004
Invoice date 9/16/09
Date out.... 7/21/09 4:00 PM
Date in 9/16/09 2:39 PM
Job Site: Job Loc COR OF CHERRYBARK &, C
CITY OF COPPELL Job No 2 - CITY OF COPPELL
COR OF CHERRYBARK & P.O. #
MOCKINGBIRD, D -1A -Z Ordered By.. MAJED
COPPELL, TX 75220 Terms Net 10 Days
C #: 972 - 830 -9212 J #: 972 - 830 -9212 Last billed. 9/15/09
Qty Equipment # Min Day Week 4 Week Amount
1 BACKHOE 14' 2WD 215.00 215.00 645.00 1150.00 57.50
4451 Make: JOHN DEERE Model: 310J W /FORK BAR Ser #: T0310JX15938
HR OUT1 682.00 HR IN1 843.00 TOTAL: 161.00
1 24" DIRT BUCKET - 310G N/C
4554 Make: JOHN DEERE Model: 24" DIRT BUCKET Ser #: 1903431
1 OVER BUCKET FORKS BACKHOE 20.00 20.00 60.00 180.00 9.00
4894 Make: STAR Model: LBA170 Ser #: *
SALES ITEMS:
Qty Item n
u �`
.;:.;;
2 0 DIESEL: > < s > ` ::,.
6 95.00
-
U :?FEE
0;. i�E� TAXES '
RE -F L
C UD
E °`_ -
S
TAX
H IV
1 DIE IE
:.;::;:. >:;
A 1:::3 0 1.33
EXA S
T "� E SEL OR MO
.�3
VEHICLE '`
:::::::TAX
....... ``''Si`i'-total
67.83
Fuel: 95.00
Tax: 5.49
Total: 168.32
FINAL BILL: 9/15/09 04:00 PM THRU 9/16/09 02:39 PM.
!F TH EQUIPMENT DOES NOT WORK MULTIPLE SHIFTS GR CUSTOMER >IS R FOR
PROPERLY, NOTIFY THE OFF10E AT ONCE OVERTIME RATES MAY APPLY REFUELING, DAMAG OR REPAIRS
1. Loss /Damage Waiver 111% of gross rental chargeslwill be charged unless customer is a commercial account which elects to provide its own insurance coverage under Paragraph 13 to follow.
Loss /Damage Waiver is NOT INSURANCE and does not cover upset, overturned, tire or overhead damage or accessory items regardless of fault.
2. Customer must call to release equipment and is responsible for released equipment until it is picked up.
3. Customer is fully responsible for the theft of items rented.
ICI have thg oppoity to rad the term, d c and on oth id of thigeernt, hae received ad understanh8 satiy, inucions
n the ope ration of the rtun equipm 1 am ren 1 have received b a complete cops ar
y 01 this rle agree1 v
ment and agree to the terms d a conditions str on t both
sides. (Carefully read the terms and conditions . on the reverse side of this page)
X
CUSTOMER SIGNATURE DATE NAME PRINTED DELIVERED BY DATE
Terms: NET 10 DAYS
.RENTAL ONE Page: 1
P.O. BOX 489 .
r""- T rYVTT T,F. `�'X '76074 Remit To:
P.O. BOX 489
2440 HIGHWAY 287 N COLLEYVILLE, TX 76034
MANSFIELD, TX 76063
817 - 473 -2420 817- 545 -8999
Customer: 4413
PROCON PAVING AND CONST INC RENTAL RETURN
10361 BRICKHAM RD
DALLAS, TX 75220
Invoice #... 234046 -0004
Invoice date 9/16/09
Date out.... 7/10/09 10:00 AM
Date in 9/16/09 3:11 PM
Job Site: Job Loc RIVERCHASE S OF SANDY
ROAD WORK Job No 2 - ROAD WORK - ROAD
RIVERCHASE S OF SANDY LAKE RD P.O. #
D -1B -X Ordered By.. MAJED
COPPELL, TX 75019 Terms Net 10 Days
C #: 972 - 830 -9212 J #: 972 - 830 -9212 Last billed. 9/04/09
Qty Equipment # Min Day Week 4 Week Amount
1 SKID STEER 50HP 1750 LB 160.00 160.00 495.00 950.00 599.69
4690 Make: BOBCAT Model: S175 Ser #: A3L520096
HR OUT1 381.00 HR IN1 475.00 TOTAL: 94.00
Meter #1 from prior exchange is 25.800
1 500 LB HYDRAULIC HAMMER 195.00 195.00 585.00 1750.00 1104.69
2650 Make: KENT Model: KF4QT Ser #: 9754
SALES ITEMS:
Qty Item numbe.r... Unit Price
20.3
DIESEL : >:
6.43
E- -
R F
E
F
. ::. U> TAXES:: >CLUI}
:ub-
S total
1704.38
.38
Fuel:
96.43
Tax:
140.61
0.61
> Tot 1:
a 1941.42
.42
FINAL BILL: 9/04/09 10:00 AM THRU 9/16/09 03:11 PM.
IF. T'I-IE EQUIPMENT DU NOT •WORIf MULTIPLE SHIFTS OR CUSTOMER IS RESPONSIBLE FOR
I.
PROPERLY, NOTIFY TH OFfIOE A T ONCE OVERTIM •RATES MAY APPLY REFUELING, DAMAGES OR REPAIRS
1. Loss /Damage Waiver (11% of gross rental chargeslwill be charged unless customer is a commercial account which elects to provide its own insurance coverage under Paragraph 13 to follow.
Loss /Damage Waiver is NOT INSURANCE and does not cover upset, overturned, tire or overhead damage or accessory items regardless of fault.
2. Customer must call to release equipment and is responsible for released equipment until it is picked up.
3. Customer is fully responsible for the theft of items rented.
I have had the opportunity to read the terms. and conditions on both sides of this agreement, I have received and understand the afety. instruction
on the operation of the equipment I am renting. I have received a complete copy o this agreement and agree to the terms and conditions on both
sides. (Carefully read the terms and conditions on the reverse s of this page)
X
CUSTOMER SIGNATURE DATE NAME PRINTED DELIVERED BY DATE
Terms: NFT 10 HAYS
File: 885 [TX] [PUBLIC] ✓-- 17
Recording Requested by and Return to: Customer: PROCON PAVING AND CONST INC
Rental One Project: CITY OF COPPELL
Rec ID: 2QW0W8VF2
4101 Dr
Col l Gateway T N #: M a ULT� // _�^ yti[� / `...,���
Colleyville, Dr 76034 Cert No.: L�7(/ ! 6 7142
NOTICE OF INTENT TO FILE A LIEN OR A CLAIM ON A PUBLIC BOND
TO THE OWNER OR REPUTED OWNER TO THE LENDER, SURETY OR BONDING CO.
CITY OF COPPELL SURETEC INSURANCE COMPANY
ENGINEERING DEPT ATT: KEITH MARVIN
255 PARKWAY BLVD 9737 GREAT HILLS TRAIL SUITE 320
COPPELL, TX 75019 AUSTIN, TX 78759
TO THE ORIGINAL \REPUTED CONTRACTOR FROM THE LIEN OR STOP NOTICE CLAIMANT
PROCON PAVING CONST INC Rental One
10361 BRICKHAM RD 4101 Gateway Dr
DALLAS, TX 75220 Colleyville, TX 76034
The undersigned claimant, Rental One, intends to file a claim against public bond
and stop notice, where appreciable, against the building, erection or improvement
described as the CITY OF COPPELL VARIOUS ROAD WORK REPAIRS project, located at
, COPPELL, TX 75019.
The specific contract information is for Our Job /Invoice # MULTI(note attached
statement, if any).
The name and address of the owner or reputed owner is: CITY OF COPPELL ENGINEERING
DEPT ATT: KEITH MARVIN, 255 PARKWAY BLVD, COPPELL, TX 75019.
Said improvements or services are described as follows: Construction Equipment.
The amount is due from PROCON PAVING AND CONST INC, 10361 BRICKHAM RD, DALLAS, TX 75220.
The amount due is $6,383.25, including service charges or interest at the rate of 0.000 %
per annum.
The last date said materials or improvements were furnished was 08/20/2009.
In accordance with Texas Government Codes the attached invoices or statements are a true
and accurate account of materials, equipment or labor supplied during the month of July,
2009.
Unless we receive payment by 10/29/2009 a claim may be filed.
NOTICE TO CONTRACTORS AND PUBLIC ENTITIES
*If you have complied with the law regarding the 10 percent retainage and you have
withheld payment to the contractor sufficient to cover any written notice of claim and
have paid that amount, if any, to the claimant, any lien claim filed on your property by
a subcontractor or supplier, other than a person who contracted directly with you, will
not be a valid lien on your property. In addition, except for the required 10 percent
retainage, you are not liable to a subcontractor before you receive written notice of the
claim.
*IF OUR BILL IS NOT PAID, YOU MAY BE PERSONALLY LIABLE AND YOUR PROPERTY SUBJECTED TO A
LIEN UNLESS YOU WITHHOLD PAYMENTS TO THE CONTRACTOR FOR THE PAYMENT OF OUR STATEMENT OR
UNLESS THE BILL IS OTHERWISE PAID OR SETTLED.
VERIFICATION
I declare that I am authorized to file this claim on behalf of the claimant. I have read
the foregoing document and know the contents thereof; the same is true of my own
knowledge. I declare under penalty of perjury that the foregoing is true and correct.
Executed at Co11:y ille, T-xas on 10/14/2009 for RENTAL ONE.
Prepared by: A ■
Jeff Swanson, Cr,'.Ii ana Phone: (817) 545 -8999 Fax: (817) 581 -0400
NOTICE OF CLAIM ON BOND; AND STATEMENT OF ACCOUNT
TO THE PUBLIC AGENCY: TO THE GENERAL CONTRACTOR OR
CITY OF COPPELL PRIME CONTRACTOR:
PROCON PAVING CONST INC
ENGINEERING DEPT ATT: KEITH MARVIN
255 PARKWAY BLVD 10361 BRICKHAM RD
COPPELL TX 75019 DALLAS,TX 75220
Contract Number Contract Number
FROM:BOND OR LIEN CLAIMANT TO THE LENDER, SURETY OR BONDING COMPANY:
Rental One SURETEC INSURANCE COMPANY
4101 Gateway Dr 9737 GREAT HILLS TRAIL SUITE 320
Colleyville,TX 76034 AUSTIN,TX 78759
Contract Number 4370965
PLEASE TAKE NOTICE that the undersigned claimant is looking to the Prime contractor, and to its
sureties, for payment of the following claim.
RENTAL ONE has a claim in the amount of $6,383.25, including service charges or interest at the
rate of 0.000% per annum, for labor performed or materials furnished for the public work of
improvement commonly known as CITY OF COPPELL VARIOUS ROAD WORK REPAIRS project, located at ,
COPPELL, TX 75019, in the County of DALLAS.
The specific contract information is for Our Job /Invoice # MULTI.
The claimant furnished the following kind of labor, services, equipment, materials or service
charges: Construction Equipment.
The approximate dates of performance were from 07/08/2009 through 08/20/2009.
The name of the party to whom the material was furnished or supplied, or for whom the labor was
done or performed, is PROCON PAVING AND CONST INC, 10361 BRICKHAM RD, DALLAS, TX 75220.
To the unpaid balance due of $6,383.25, please add anticipated service charges, interest, court
costs and attorney fees of ( T r ` r� n� �� GL n/y�rf�
STATEMENT OF AMOUNT DUE
Attached to this Notice of Claim is an itemized statement of the amount which is due. The amount
claimed, as listed above and on the account, is just and correct, and all just and lawful offsets,
payments, and credits known to the claimant have been al:t The accc.unt includes the amount
of any retainages applicable to the account that have become due by virtue of the terms of the
contract between the claimant and the prime contractor or between the claimant and a
subcontractor. The account also includes the value of partial completion and units and unit
prices, if applicable. A true copy of the written agreement is attached hereto, which includes
the agreement, if any, for the retention of funds.
Dated 10/14/2009 f cl ima Rental One, 4101 Gateway Dr, Colleyville, TX 76034
Prepared by: ///
Jeff Swanson, rec1i anager
f VERIFICATION
AFFIDAVIT TO STATE COMPTROLLER
I declare that I am authorized to file this claim on behalf of the claimant. I have read the
foregoing Claim and the attached Account. The amount claimed is just and correct, and all just and
lawful offsets, payments, and credits known to the claimant have been allowed. I declare under
penalty of perjury that t i, fo -go g is true and correct. Executed at Colleyville on 10/14/2009.
Prepared by: ��
ir
Jeff Swanson, Credit M. _! r
ACKNOWLEDGEMENT BY NOTARY PUBLIC
State of Texas )
County of Tarrant )
On 10/14/2009 before me, Ann Marie Pena,a Notary Public in and for said
State, personally appeared:
[ X ] personally known to me - OR -
[ ] proved to me on the basis of satisfactory evidence:
to be the person(s) whose name(s) is /are subscribed to the attached
instrument and acknowledged to me that he /she /they executed the same in
his /her /their authorized capacity(ies), and that by his /her /their
signature(s) on the instrument the person(s), or their entity upon behalf
for which the person(s) acted, executed the instrument.
Subscribed and Sworn before me on
this date of 10/14/2009. •
% Vile- 2-ii/ef
Ann Marie Pena Signatu
CAPACITY CLAIMED BY SIGNER
[ X ] Individual(s) [ ] Partner(s) [ ] Attorney -in -fact
[ ] Subscribing Witness [ ] Guardian /Conservator [ ] Trustee(s)
[ ] Corporate Officer(s) [ ] Other:
Titles
Attention Notary: Although the information requested below is OPTIONAL, it
could prevent fraudulent attachment of this certificate to unauthorized documents.
Title or Type of Document: Lien / x ,%7
Number of Pages: /0 Date o Doeument: 10/14/2009
Signer(s) Other Than Named Above:
SWORN STATEMENT OF ACCOUNT
(Exhibit 'E)
State of Texas )
County of Tarrant )
BEFORE ME, the undersigned authority of this day, personally appeared Jeff
Swanson who, after being by me duly sworn did depose and say:
1. My name is Jeff Swanson. My position is Credit Manager of Rental One,
and I am duly authorized to make this affidavit:
BY:
Je S a n, Credit Manager
Sworn before me on 10/14/2009 , the undersigned, a Notary Public in and for
Ann Marie Pena NotarANN MARIE PENA ate ar �u "4,
3 : 4 : : e :�= y Publi, St of f es as
. �€ My Commiss Exp
/ / .`g
, . 4. 3 ,4 Aitb + <• March ?7, 2012 - -
Signature /"
Attention Notary: Although the information requested below is OPTIONAL, it could prevent the
fraudulent attachment of this certificate to unauthorized documents.
Title or Type of Document: Lien /)/)/
`lC--)
Number of Pages: G V Date of cument: / 01/
Signer(s) Other Than Named Above: , `
CLAIM AGAINST PAYMENT OR LIEN BOND; AND CLAIM AGAINST FUNDS HELD IN TRUST
OWNER OR PUBLIC AGENCY GENERAL OR PRIME CONTRACTOR
CITY OF COPPELL PROCON PAVING CONST INC
ENGINEERING DEPT ATT: KEITH
255 PARKWAY BLVD 10361 BRICKHAM RD
COPPELL,TX 75019 DALLAS,TX 75220
BOND OR LIEN CLAIMANT LENDER, SURETY OR BOND COMPANY
Rental One SURETEC INSURANCE COMPANY
4101 Gateway Dr 9737 GREAT HILLS TRAIL SUITE
Colleyville,TX 76034 AUSTIN,TX 78759
Bond No. 4370965
TO ALL BONDING COMPANIES, SURETIES, PRINCIPAL CONTRACTORS AND OWNERS OF THIS PROJECT:
This notice is provided for you in compliance with the terms and provisions of Chapter
2253, Texas Government Code, Section 2253.041 -.047. Attached is a Sworn Statement
regarding this claim.
Notice is hereby given that we are the claimant furnishing labor, services, equipment or
materials of the type described on the enclosed lien claim for the work of improvement
known as the CITY OF COPPELL VARIOUS ROAD WORK REPAIRS project, located at , COPPELL, TX
75019, for which you are one of the known lenders, bonding companies or sureties.
The specific contract information is for Our Job /Invoice # MULTI.
Such labor, services, equipment or materials were contracted for by PROCON PAVING AND
CONST INC, 10361 BRICKHAM RD, DALLAS, TX 75220, who is one of the contractors or the
General Contractor of this job.
There is due to Rental One the sum of $6,383.25 which has not been paid. This is to
notify you that in the event payment is not made in full to our company suit will be
brought against the sureties of this project for recovery of said sum.
The time of the commencement of performance of labor or the furnishing of materials was
07/08/2009. The time of the cessation of performance of labor or the furnishing of
materials was 08/20/2009. The date the debt became due was 08/10/2009.
To the unpaid balance due of $6,383.25, please add anticipated service charges, interest,
court costs and attorney fees of ( TO 9i
Please acknowledge receipt of our claim and advise us how soon it will be paid in full.
If you have any questions, please feel free to call me as soon as possible.
Dated: 10/14/2009
Prepared by:
Jeff Swanson, CreocAl ger
Rental One
(817) 545 -8999 Fax: (817) 581 -0400
Kral 1ti- mi......
P.O. BOX 489 Page: 1
COLLEYVILLE, TX 76034 Re To:
P.O. BOX 489
1630 S. INTERSTATE 35 EAST COLLEYVILLE, TX 76034
DALLAS, TX 75146
214 - 216 -9000 817- 545 -8999
Customer: 4413
PROCON PAVING AND CONST INC RENTAL RETURN
10361 BRICKHAM RD
DALLAS, TX 75220
Invoice #••. 233845 -0001
Invoice date 8/05/09
Date out.... 7/08/09 3:39 PM
Date in 8/05/09 3:29 PM
Job Site: Job Loc MOCKINGBIRD, COPPELL
CITY OF COPPELL Job No 1 - CITY OF COPPELL
MOCKINGBIRD P.O. #
COPPELL, TX 75220 Ordered By.. ED
Terms Net 10 Days
C #: 972 - 830 -9212 J #: 972 - 830 -9212
BLAS 972- 830 -9212
Qty Equipment # Min Day Week 4 Week Amount
1 CONCRETE SAW 65 HP 185.00 185.00 595.00 1495.00 1495.00
850 Make: TARGET Model: PRO 66 26 Ser #: 416300
HR OUT1 586.70 HR IN1 633.50 TOTAL: 46.80
SALES ITEMS:
Qty Item number Unit Price
1 C16021FXXL EA 18.450 18.45
SURVEYORS VEST XXL ORANGE
1 EAR0002 :.:.. ... : EA 12.990 12.99
EAR SAF E:> :::> 0 >::
...;:<: >:: >:: >:: >:::«<>:.;.
EA E'y IRL AMP .75
1 E
AR 0 0 0 ; : ::;::: :. EA -In so :. >:. >:
EAR S P M
IxL
i'ub total: 1527.19
Tax:
125.99
.......................
"" "Tota 1653.18 l
IF THE EQUIPMENT:OOE$ NOT WORK MULTIPLE SHIFTS OR CU$TOMFR IS •RESPONSIBLE FOR
PROPERLY, NOTIFY THE OFFICE AT •ONCE OVERTIM RATE MAY APPLY REFUELING. DAMAGES OR REPAIRS
1, Loss /Damage Waiver 111% of gross rental chargeslwill be charged unless customer is a commercial account which elects to provide its own insurance coverage under Paragraph 13 to follow.
Loss /Damage Waiver is NOT INSURANCE and does not cover upset, overturned, tire or overhead damage or accessory items regardless of fault.
2. Customer must call to release equipment and is responsible for released equipment until it is picked up.
3. Customer is fully responsible for the theft of items rented.
I have had the opportunity to read the terms, and conditions on both sides of this agreement, I have received and understand the safety instrucijons
on the operation of the equipment am renting. I have received a complete copy oT this agreement and agree to the terms and conditions on both
sides. (Carefully read the terms and conditions on the reverse s of this page)
X
CUSTOMER SIGNATURE DATE NAME PRINTED DELIVERED BY DATE
Terms: NET 10 DAYS
ltyil∎ S., v.....
P.O. BOX 489 Page: 1
COLLEYVILLE, TX 76034
Remit To:
P.O. BOX 489
2440 HIGHWAY 287 N COLLEYVILLE, TX 76034
MANSFIELD, TX 76063
817 - 473 -2420 817 - 545 -8999
Customer: 4413
PROCON PAVING AND CONST INC 4 WEEK BILL
10361 BRICKHAM RD
DALLAS, TX 75220
Invoice #... 234046 -0002
Invoice date 8/07/09
Date out.... 7/10/09 10:00 AM
Billed thru. 8/07/09
Job Site: Job Loc RIVERCHASE S OF SANDY
ROAD WORK Job No 2 - ROAD WORK - ROAD
RIVERCHASE S OF SANDY LAKE RD P.O. #
D -1B -X Ordered By.. MAJED
COPPELL, TX 75019 Terms Net 10 Days
C #: 972- 830 -9212 J #: 972- 830 -9212
Qty Equipment # Min Day Week 4 Week Amount
1 SKID STEER 50HP 1750 LB 160.00 160.00 495.00 950.00 950.00
4690 Make: BOBCAT Model: S175 Ser #: A3L520096
HR OUT1 381.00 HR IN1 TOTAL: 381.00
SMOOTH
1 500 LB HYDRAULIC HAMMER 195.00 195.00 585.00 1750.00 1750.00
2650 Make: KENT Model: KF4QT Ser #: 9754
DELIVERY CHARGE 50.00
PICKUP
H.Cx0.
50.0
0
b-
tot al:
2800.00
Tax
231.00
To
tai
3031.00
LED `�.< < >��
BIL >::;:;.., <;.::�` > :
3
00
.:.;;:.;:.:.: 9 TH`?<� >8s� 0 7/ 0 9 l O;: »:: fit::.
tF • THE EtEUlPMENT IV ES NOT WORK MULTIPLE SHIF $ Ofd ......... USTOMER 1S RESPONSIBLE I OR
PROPERLY, NOTIFY THE; 01 FI EAT ONCE OVERTIME RATES MAY APPLY REFt1ELIN0i, DAMAGES OR REPAIRS,
1. Loss /Damage Waiver (11 16 of gross rental charges/will be charged unless customer is a commercial account which elects to provide its own insurance coverage under Paragraph 13 to follow.
Loss /Damage Waiver is NOT INSURANCE and does not cover upset, overturned, tire or overhead damage or accessory items regardless of fault.
2. Customer must call to release equipment and is responsible for released equipment until it is picked up.
3. Customer is fully responsible for the theft of items rented.
I have had thg opportunity to read the terms. and conditions on both sides of this agreement, I have received and understand the safety. instructions
on the operation of the equipment 1 am renting. I have received a complete copy df this agreement and agree to the terms and conditions on both
sides. (Carefully read the terms and conditions on the reverse s of this page)
X
CUSTOMER SIGNATURE DATE NAME PRINTED DELIVERED BY DATE
Terms: NET 10 DAYS
RENTAL ONE Page: 1
P.O. BOX 489
COLLEYVILLE, TX 76034 Remit To:
P.O. BOX 489
2440 HIGHWAY 287 N COLLEYVILLE, TX 76034
MANSFIELD, TX 76063
817 - 473 -2420 817 - 545 -8999
Customer: 4413
PROCON PAVING AND CONST INC 4 WEEK BILL
10361 BRICKHAM RD
DALLAS, TX 75220 Invoice #... 235216 -0001
Invoice date 8/19/09
Date out.... 7/21/09 4:00 PM
Job Site: Billed thru. 8/18/09
Job Loc COR OF CHERRYBARK &, C
CITY OF COPPELL Job No 2 - CITY OF COPPELL
COR OF CHERRYBARK & P.O. #
MOCKINGBIRD, D -1A -Z Ordered By.. MAJED
COPPELL, TX 75220 Terms Net 10 Days
C #: 972 - 830 -9212 J #: 972 - 830 -9212
Qty Equipment # Min Day Week 4 Week Amount
1 BACKHOE 14' 2WD 215.00 215.00 645.00 1150.00 1150.00
4451 Make: JOHN DEERE Model: 310J W /FORK BAR Ser #: T0310JX15938
HR OUT1 682.00 HR IN1 TOTAL: 682.00
1 24 DIRT BUCKET - 310G N/C
1033 Make: JOHN DEERE Model: 24 - 310 Ser #: 121757
1 OVER BUCKET FORKS BACKHOE 20.00 20.00 60.00 180.00 180.00
4894 Make: STAR Model: LBA170 Ser #: *
SALES ITEMS:
Item tem n
u
...:?��' .::::::.:::.. !: > :: >; Unit` > >:::::_;:«< >: . c e : >:<: »<::>: «: >> • . . . . . . . . . . . . . . . . .
1 DIESEL.:: :..
TAX ;::: >II >: :. EA 2 6 0
!�. 26.60
S '< E E
O '�� V
R...�! EHIC <.
:<: >:::«:>
TEXAS
........ '�`�� � TAX MN
DEL V
I
`,'' CHARGE G
50.00
PICKUP
CHAR
50.00
Sub - total: 1456.60
Tax: 117.98
Total: 1574.58
BILLED FOR FOUR WEEKS 7/21/09 THRU 8/18/09 04 :00 PM
EF TH E QUIPMENT DQES NL1T WORK PE MULTi SHIFTS OR CUSTOMER>18 R ON
ESPSIBLE F:OR
PROP NOTIFY THE OFFICE AT ONCE OVERTIME. RATES MAY APPLY REFJELING, DAMAGES OR REPAIRS
1. Loss /Damage Waiver (11% of gross rental charges)will be charged unless customer is a commercial account which elects to provide its own insurance coverage under Paragraph 13 to follow.
Loss /Damage Waiver is NOT INSURANCE and does not cover upset, overturned, tire or overhead damage or accessory items regardless of fault.
2. Customer must call to release equipment and is responsible for released equipment until it is picked up.
3. Customer is fully responsible for the theft of items rented.
I have had thQ opportunity to read the terms. and conditions on both sides of this agreement, I have received and understand the safety. instructions
on the operation of the equipment I am renting. I have received a complete copy o this agreement and agree to the terms and conditions on both
sides. (Carefully read the terms and conditions on the reverse s of this page)
X
CUSTOMER SIGNATURE DATE NAME PRINTED DELIVERED BY DATE
Terms: NET 10 DAYS
RENTAL ONt.
P.O. BOX 489 Pale: 1
COLLEYVILLE, TX 76034 Re To:
P.O. BOX 489
2440 HIGHWAY 287 N COLLEYVILLE, TX 76034
MANSFIELD, TX 76063
817 - 473 -2420 817- 545 -8999
Customer: 4413
PROCON PAVING AND CONST INC SALES INVOICE
10361 BRICKHAM RD
DALLAS, TX 75220
Invoice #... 238485 -0001
System date. 8/20/09
Invoice date 8/20/09 2:50 PM
Job Site: Job Loc MOCKINGBIRD & SANDY LA
PROCON PAVING AND CONST INC Job No
10361 BRICKHAM RD P.O. #
DALLAS, TX 75220 Ordered By..
Terms Net 10 Days
C #: 972 - 830 -9212 J #: 972- 830 -9212
Qty Item number Unit Price Amount
1 FLAT REPAIR CHARGE EA 115.000 115.00
FLAT REPAIR CHARGE
REF FLAT INV 92162
REPAIRED CUSTOMERS OWN BACKHOE
Sub - total: 115.00
Tax: 9.49
Total: 124.49
EF 'SHE EQUIPMENT Of7E5 NOT WORK MULlrlPLE SH1F 'S OR CUSTOMER IS RESPONSIBLE FOR
PR LY
OPER, N T
OTLFY HE OFFICE AT ONCE OVERTIME RATM
ES AY APPLY REFUELING, DAMAGES OR REPAIRS
1. Loss /Damage Waiver (11% of gross rental charges)will be charged unless customer is a commercial account which elects to provide its own insurance coverage under Paragraph 13 to follow.
Loss /Damage Waiver is NOT INSURANCE and does not cover upset, overturned, tire or overhead damage or accessory items regardless of fault.
2. Customer must call to release equipment and is responsible for released equipment until it is picked up.
3. Customer is fully responsible for the theft of items rented.
I have had the opp rttun to read the terms, and conditions .on both sides of this ag4reement, I have received and understand the safet;v io instru ns on both
ctions
on the operation of the equipment I am renting. I have received a complete copy of this agreement and agree to the terms adit
sides. (Carefully read the terms and conditions on the reverse s of this page)
X
CUSTOMER SIGNATURE DATE NAME PRINTED DELIVERED BY DATE
Terms: NET 10 DAYS