DR9503-CS 960603 CONTRACTOR'S AFFIDAVIT OF
FINAL PAYMENT & RELEASE
THE STATE OF TEXAS
COUNTY OF DALLAS
BEFORE ME, the undersigned authority, on this day personally appeared
Angela Dominguez ("Affiant"), who, after being by me duly sworn, deposes and says
that she is President of Renaissance Contractors, Inc., a corporation of Dallas
County, State of Texas (the "Contractor"), which said Contractor was awarded the
contract dated the 27th day of February, 1996, for the construction of the Outflow
Structure at Andrew Brown Jr. Community East (the "Work"), for a total
consideration of $24,961.25 to be paid to the said Contractor (the "Contract"), and that
Affiant has full power of authority to make this affidavit.
That City of Coppell (the "Owner") has approved the final estimate on said
Work, and that the said Contractor has fully satisfied and paid any and all claims that
may be covered by Chapter 53 of the Texas Property Code, and Article 5160 of the
Revised Civil Statutes of the State of Texas, or any other applicable statutes or charter
provisions, and that all just bills for labor and materials have been paid and discharged
by said Contractor insofar as they pertain to the Work in question.
That in addition to any funds which may have been previously paid by the
Owner, the Contractor hereby accepts the amount of $24,961.25 as FULL AND
FINAL under the aforementioned Contract, and hereby waives and releases any right
Affiant and/or the Contractor may have to pursue claims of any nature against the
Owner arising out of or in any manner connected with the performance of the Work
and/or the Contract, including but not limited to claims of third parties that supplied
material and/or labor for the Work for or through the Contractor ("Subcontractors"), as
well as claims for delay, additional compensation or for recovery of liquidated damages
which may have been withheld by the Owner. The Contractor shall defend, hold
hamdess and indemnify the Owner from any such claims of such Subcontractors. The
Contractor further releases the Owner from any claim or liability arising from any act
or neglect of the Owner related to or connected with the Contract, and shall not be
deemed to alter or modify the terms and provisions of said Contract.
By
Angela Dominguez
'~.) ~/[,b(/' SUBSCRIBED AND, A.D.SWORN/)t TO BEFORE ME, this the ~ day of
~tr~-~-'- -- ''~; ;idillil 1:8[I.W[[I. ~ I'q~"ta~?P~blic, i~l for the State of Texas
My commission expires
Renaissance Contractors. Inc.
INVOICE
To: City of Coppell Invoice No. 9603-1
P.O. Box 478
Coppell, TX 75019 Period ending: 5/25/96
Project: Andrew Brown Jr. Customer Ref No. DR 95-03
Community Park East
Outflow Structure Contract No. 9603
Original contract sum: $24,961.25
2. Net change by change orders or additional work: $0.00
' 3. Contract sum to date $24,961.25
:14. Total completed & stored to date $24,961.25
5. Retainage (0%) $0.00
6. Total earned less retainage $24,961.25
Less previous invoices $0.00
8. Less backcharges to date: $0.00
Current payment due: $24,961.25
Date:
ANDREW BROWN JR. COMMUNITY PARK EAST
OUTFLOW STRUCTURE DR 95-03
MONTHLY PAY ESTIMATE - DETAILED BREAKDOWN
A B C D E F G H I J K L M
Item No. Description Unit Qty. Unit Amount Work Completed Materials Total Completed Balance to Retalnage
Price rom Previous Period This Period Presently Stored and Stored to Date % ]~ininh 0%
Qty Amount Qty Amount (Not in G or H) (G+H+I) (J/F) (F-J)
1 Remove & relay 48" rcp If 12.00 $362.00 $4,344.00 0.00 $0.00 12.00 $4,344.00 $0.00 $4,344.00 100.00% $0.00 $0.00
2 48" rcp If 4.00 $540.00 $2,160.00 0.00 $0.00 4.00 $2,160.00 $0.00 $2,160.00 100.00% $0.00 $0.00
3 Type 'A' headwall ea 1.00 $3,400.00 $3,400.00 0.00 $0.00 1.00 $3,400.00 $0.00 $3,400.00 100.00% $0.00 $0.00
4 Deep foundation drilled shaft ea 2.00 $1,650.00 $3,300.00 0.00 $0.00 2.00 $3,300.00 $0.00 $3,300.00 100.00% $0.00 $0.00
5 Remove & reinstall 48" gate valve ea 1.00 $800.00 $800.00 0.00 $0.00 1.00 $800.00 SO.tX} $800.00 100.00% $0.00 $0.00
( 6" reinforced concrete apron cy 6.00 $350.00 $2,100.00 0.00 SO.00 6.00 $2,100.00 $0.00 $2,100.00 100.00% SO.00 $0.00
Enkamat 7020 or equivalent sf 1000.00 $1.61 $1,610.00 0.00 $0.00 1000.00 $1,610.00 $0.00 $1,610.00 100.00% SO.00 SO.00
8 Backfill of sandy clay cy 135.00 $36.75 $4,961.25 0.00 $0.00 135.00 $4,961.25 $0.00 $4,961.25 100.00% SO.00 $0.00
9 Rock rabble 12"-18" dia cy 4.50 $508.00 $2,286.00 0.00 $0.00 4.50 $2,286.00 $0.00 $2,286.00 100.00% SO.00 $0.00
TOTAL $24,961.25 $0.00 $24,961.25 $0.00 $24,961.25 100.00% $0.00 $0.00