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ST0702-CL100315Chem I L ical ima A Lhoist Group Company 03/15/2010 Colonial Am. Cas. and Surety Bond Claim: 8977052 1400 AMERICAN LN, TWR I, 19TH SCHAUMBURG IL 60196 -1056 Gentlemen: Notice of Bond Claim Job #: 202818 Job Address: JRJ -29100 COPPELL ROAD SOUTH Y L j901 roc_ Supplier: Chemical Lime Company Amount Due: Gentlemen: Notice of Bond Claim Job #: 202818 Job Address: JRJ -29100 COPPELL ROAD SOUTH We understand you are the Surety on a Payment bond covering the above referenced project and that the Prime Contractor listed above is the Principal on the bond. If we are incorrect in these understandings, please advise immediately Our company furnished materials for use on the subject construction project. We hereby make claim for the balance due listed above which is unpaid as of this date. This notice is to perfect a bond claim under Chapter 2253 of the Texas Property Code on behalf of our company. A copy of this notice is being sent to the Governmental Authority who issued the contract on this project. The purpose of this letter is also to perfect a Claim against said Government Agency in the event your Bond was not furnished in compliance. Enclosed you will find the following: 1. Sworn statement of account 2. Invoice(s) identifying materials furnished. The nature of the materials furnished was lime slurry. If you have any question concerning the above, please call Alice Barboza, Credit Department at (817) 806 -1617. NOTE: This claim letter is merely to protect rights on the job. We realize that end -of -month shipments sometimes are on the following month's draw, thereby causing delay of payment. Sincerely, Alice Barboza Credit Department (817) 806 -1617 CMRRR: JRJ PAVING LP PO BOX 59934 DALLAS TX 75229 t ry yy �[t . t , 1 3 9 0 1 � °� F '{ '7 t ° 4 6 1 f.J f i L cc: First Class Mail CITY OF COPPELL 255 PARKWAY BLVD COPPELL TX 75019 -2602 PO Box 985004, Fart Worth, TX 76185 -5004 3700 Hulen Street, Fort Worth, TX 76107 Tnl• A17717R1Ad r— R17717A(1Aq COPPELL, TX 75019 Prime Contractor: JRJ PAVING LP Supplier: Chemical Lime Company Amount Due: 25,627.41 Delivery Months: December 2009 , We understand you are the Surety on a Payment bond covering the above referenced project and that the Prime Contractor listed above is the Principal on the bond. If we are incorrect in these understandings, please advise immediately Our company furnished materials for use on the subject construction project. We hereby make claim for the balance due listed above which is unpaid as of this date. This notice is to perfect a bond claim under Chapter 2253 of the Texas Property Code on behalf of our company. A copy of this notice is being sent to the Governmental Authority who issued the contract on this project. The purpose of this letter is also to perfect a Claim against said Government Agency in the event your Bond was not furnished in compliance. Enclosed you will find the following: 1. Sworn statement of account 2. Invoice(s) identifying materials furnished. The nature of the materials furnished was lime slurry. If you have any question concerning the above, please call Alice Barboza, Credit Department at (817) 806 -1617. NOTE: This claim letter is merely to protect rights on the job. We realize that end -of -month shipments sometimes are on the following month's draw, thereby causing delay of payment. Sincerely, Alice Barboza Credit Department (817) 806 -1617 CMRRR: JRJ PAVING LP PO BOX 59934 DALLAS TX 75229 t ry yy �[t . t , 1 3 9 0 1 � °� F '{ '7 t ° 4 6 1 f.J f i L cc: First Class Mail CITY OF COPPELL 255 PARKWAY BLVD COPPELL TX 75019 -2602 PO Box 985004, Fart Worth, TX 76185 -5004 3700 Hulen Street, Fort Worth, TX 76107 Tnl• A17717R1Ad r— R17717A(1Aq 7 � Ic am A Lhoist Group Company SWORN STATEMENT OF ACCOUNT THE STATE OF TEXAS COUNTY OF Tarrant BEFORE ME, the undersigned authority, personally appeared Alice Barboza, who, upon oath, stated that: I am the Credit Analyst and authorized agent for Chemical Lime Ltd., partnership under the laws of the State of Texas. Pursuant to a contract and /or agreement with JRJ PAVING LP on the project known as COPPELL, Texas, Chemical Lime Ltd. provided labor materials in connection with the improvements to the project generally described as lime products. The total price for the labor and /or materials provided by Chemical Lime Ltd. on the following unpaid invoices is as follows: Date of Invoice Approximated Date Invoice Number Of Delivery Amount Unpaid 12/03/2009 301651 137 12/01/2009 14,132.40 12/07/2009 301654275 12/07/2009 10,139.50 12/10/2009 301657299 12/10/2009 1,355.51 Total Amount Due: 25,627.41 The amount claimed herein for such materials is just and correct and all and lawfuly offsets, payments and credits known to Chemical Lime Ltd. have been allowed. True and correct copies of the unpaid invoices, which reasonably identify the labor and /or materials provided, the job and destination of delivery are attached hereto. Alice Barboza SUBSCRIBED and SWORN to BEFORE ME, this the day of 2010 to certify which witness my hand and seal of office. Notary Public in and for the State of Texas � '•: #: AxcclpM�r� i € MY C'OMhiSS14N EXPIRES fi,gF;` Noaer 011 ` s 8, F ! PO Box 985004, Fort Worth, TX 76185 -5004 3700 Hulen Street, Fort Worth, TX 76107 /; t North America Lhoist Group Remit To: Chemical Lime, Ltd. 5274 Paysphere Circle CHICAGO , IL - 60674 (800) 365 -6724 Bill -to: Customer No 121521 JRJ PAVING LP ATTN ACCOUNTS PAYABLE PO BOX 59934 DALLAS TX 75229 Payment Terms: Payment due on or before 01 /02/2010 Net Due 30 Days After Invoice DUPLICATE Invoice 1191414680 1 2/03/2009 Billing reference 301651 137 12/03/2009 Your PO Number 12603 Sold -to Customer 121521 JRJ PAVING LP ATTN ACCOUNTS PAYABLE Contract Number 0070055030 Payer 121521 Currency: USD BOL No Item Date Ref No Mat No 1 12/01/2009 105711351 Ship -to: 1163 Unit Material Description / Packaging Qty UoM Price Amount Tax Shipping point: MCKINNEY Means of transport: Truck 202818 / JRJ -29100 COPPELL ROAD SOUTH / COPPELL TX 75019 Lime Slurry / Bulk 10.165 TON 122.87 1,248.97 Total 12/01/2009 105711351 10.165 1,248.97 2 12/01/2009 105711425 Shipping point: HURST Means of transport: Truck 1163 Lime Slurry / Bulk 10.466 TON 122.87 1,285.95 Total 12/01/2009 105711425 10.466 1,285.95 3 12/0112009 105711886 Shipping point: HURST Means of transport: Truck 1163 Lime Slurry / Bulk 10.636 TON 122.87 1,306.84 Total 12/01/2009 105711886 10.636 1,306.84 4 12/01/2009 105712864 Shipping point: HURST Means of transport: Truck 1163 Lime Slurry / Bulk 10.890 TON 122.87 1,338.06 Total 12/01/2009 105712864 10.890 1,338.06 5 12/01/2009 105713760 Shipping point: MCKINNEY Means of transport: Truck Page 1 of 2 11hoist Notth America Lhoist Group Invoice 1191414680 12/03/2009 Billing reference 301651 137 12/03/2009 Currency: USD BOL No Unit Item Date Ref No Mat No Material Description / Packaging Qty UoM Price Amount Tax 1163 Lime Slurry / Bulk 10.506 TON 122.87 1,290.88 Total 12/01/2009 105713760 10.506 1 ,290,88 6 12/01/2009 105713839 Shipping point: MCKINNEY Means of transport: Truck 1163 Lime Slurry / Bulk 10.506 TON 122.87 1,290.88 Total 12/01/2009 105713839 10.506 1,290.88 7 12/01/2009 105713970 Shipping point: MCKINNEY Means of transport: Truck 1163 Lime Slurry / Bulk 10.515 TON 122.87 1,291.98 Total 12/01/2009 105713970 10.515 1,291.98 8 12/01/2009 105713994 Shipping point: HURST Means of transport: Truck 1163 Lime Slurry / Bulk 10.501 TON 122.87 1,290.26 Total 12/01 /2009 105713994 10.501 1,290.26 9 12/01/2009 105714296 Shipping point: HURST Means of transport: Truck 1163 Lime Slurry / Bulk 10.351 TON 122.87 1,271.83 Total 12/01/2009 105714296 10.351 1,271.83 10 12/01/2009 105714517 Shipping point: HURST Means of transport: Truck 1163 Lime Slurry / Bulk 10.466 TON 122.87 1,285.95 Total 12/01/2009 105714517 10.466 1,285.95 11 12/01/2009 105714602 Shipping point: HURST Means of transport: Truck 1163 Lime Slurry / Bulk 10.017 TON 122.87 1,230.80 Total 12/01/2009 105714602 10.017 1,230.80 ITEM SUMMARY: Mat No Description Qty UOM 1163 Lime Slurry 115.019 TON Sub Total 14,132.40 Tax 0.00 Total Due 14,132.40 Page 2 of 2 oist North America Lhoist Group Remit To: Chemical Lime, Ltd. 5274 Paysphere Circle CHICAGO , IL - 60674 (800) 365 -6724 Bill -to: Customer No 121521 JRJ PAVING LP ATTN ACCOUNTS PAYABLE PO BOX 59934 DALLAS TX 75229 Payment Terms: Payment due on or before 01/09/2010 Net Due 30 Days After Invoice DUPLICATE Invoice 1191414921 12/10/2009 Billing reference 301657299 12/10/2009 Your PO Number 12603 Sold -to Customer 121521 JRJ PAVING LP ATTN ACCOUNTS PAYABLE Contract Number 0070055030 Payer 121521 Currency: USD BOL No Unit Item Date Ref No Mat No Material Description / Packaging Qty UoM Price Amount Tax 1 12/10/2009 105740568 Shipping point: MCKINNEY Means of transport: Truck Ship -to: 202818 / JRJ -29100 COPPELL ROAD SOUTH / COPPELL TX 75019 1163 Lime Slurry / Bulk 11.032 TON 122.87 1,355.51 Total 12/10/2009 105740568 11.032 1,355.51 ITEM SUMMARY: Mat No Description Qty UOM 1163 Lime Slurry 11.032 TON Sub Total 1,35 Tax 5 .5 0.00 Total Due 1,355.51 Page 1 of 1 hoist North America Lhoist Group Remit To: Chemical Lime, Ltd. 5274 Paysphere Circle CHICAGO , IL - 60674 (800) 365 -6724 Bill -to: Customer No 121521 JRJ PAVING LP ATTN ACCOUNTS PAYABLE PO BOX 59934 DALLAS TX 75229 Payment Terms: Payment due on or before 01/06/2010 Net Due 30 Days After Invoice DUPLICATE Invoice 1191414783 12/07/2009 Billing reference 301654275 12/07/2009 Your PO Number 12603 Sold -to Customer 1 21 521 JRJ PAVING LP ATTN ACCOUNTS PAYABLE Contract Number 0070055030 Payer 121521 Page 1 of 2 Currency: USD BOL No Unit Item Date Ref No Mat No Material Description / Packaging Qty UoM Price Amount Tax 1 12/0712009 104682342 Shipping point: HURST Means of transport: Truck Ship -to: 202818 / JRJ -29100 COPPELL ROAD SOUTH / COPPELL TX 75019 1 163 Lime Slurry / Bulk 9.691 TON 122.87 1,190.73 Total 12/07/2009 104682342 9.691 1,190.73 2 12/07/2009 105722537 Shipping point: MCKINNEY Means of transport: Truck 1163 Lime Slurry / Bulk 10.032 TON 122.87 1,232.64 Total 12/07/2009 105722537 10.032 1,232.64 3 12/07/2009 105727810 Shipping point: MCKINNEY Means of transport: Truck 1163 Lime Slurry / Bulk 10.250 TON 122.87 1,259.43 Total 12/07/2009 105727810 10.250 1,259.43 4 12/07/2009 105729215 Shipping point: MCKINNEY Means of transport: Truck 1163 Lime Slurry / Bulk 10.229 TON 122.87 1,256.83 Total 12/07/2009 105729215 10.229 1,256.83 5 12/07/2009 105729402 Shipping point: HURST Means of transport: Truck Page 1 of 2 Lhoist North America Lhoist Group Invoice 1191414783 12/07/2009 Billing reference 301654275 12/07/2009 Sub Total Tax Total Due Page 2 of 2 10,139.50 0.00 10,139.50 I Currency: USD Item Date BOIL No Ref No Mat No Material Description / Packaging Qty UoM Unit Price Amount Tax 1 163 Lime Slurry / Bulk 11.652 TON 122.87 1,431.69 Total 12/07/2009 105729402 11.652 1,431.69 6 12/07/2009 105729505 1163 Shipping point: HURST Means of transport: Truck Lime Slurry / Bulk 10.103 TON 122.87 1,241.36 Total 12/07/2009 105729505 10.103 1,241.36 7 12/07/2009 105729584 1163 Shipping point: HURST Means of transport: Truck Lime Slurry / Bulk 10.397 TON 122.87 1,277.48 Total 12/07/2009 105729584 10.397 1,277.48 8 12/07/2009 105729686 1163 Shipping point: MCKINNEY Means of transport: Truck Lime Slurry / Bulk 10.168 TON 122.87 1,249.34 Total 12/07/2009 105729686 10.168 1,249.34 ITEM SUMMARY: Mat No Description 1163 Lime Slurry Qty UOM 82.522 TON Sub Total Tax Total Due Page 2 of 2 10,139.50 0.00 10,139.50 I ♦oN (D W m 0- o O� O � N a @ m O v � LL 0 m N W fS4 31M(1 0 0 g 1� t "�{ ;f1 (Fi �AS � 1 � V O 0 1 9 00 O � o X O 0) x m O it f`7 O W � � o3H U � w O ¢ W >-a»a F" `^ O U N U O W N W D W m Z O V W O Q N N W D D Q