ST9301-CS080111
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Contractor's Affidavit of Final Payment
THE STATE OF TEXAS)
)
COUNTY OF DALLAS)
CONTRACTOR'S AFFIDAVIT OF
FINAL PAYMENT AND RELEASE
BEFORE ME, the undersigned authority, on this day personally appeared Robert Caudill(Affiant"), who,
after being by me duly sworn, deposes and says that he Vice President for Tiseo Paving Co. , a
Corporation (corporation, partnership, trade name) of Dallas County, State of Texas (the
"Contractor", which said Contractor was awarded the contract for the E. Sandy Lake Road (the Work"),
for a total consideration Four Million Seven Hundred Twenty Three Thousand Eight Hundred Seventy
Seven Dollars and 43 Cents) to be paid to the said Contractor (the "Contract"), and that Affiant has full
power of authority to make this affidavit.
That The City of Copoell(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 my 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 Fifty Six Thousand One Hundred Fifty Two Dollars and 69 Cents
(56.152.69) as FULL AND FINAL PAYMENT 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 harmless 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. This affidavit is given pursuant to the final payment
provisions of the Contract, and shall not be deemed to alter or modify the terms and provisions of said
Contract.
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Robert Caudill, Vice President
(Print Name)
SUBSCRIBED AND SWORN TO BEFORE ME, this the 11th day_ of January ,A. D. 2008
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Melanie R. Tavlor
(Printed Name of Notary)
My commission expires
01/04/2011
CITY OF COPPELL
CHANGE OR EXTRA WORK ORDER
PROJECT:
Sandy Lake Road Project ST 93-01
CONTRACTOR: Tiseo Paving Company, Inc.
OWNiR:
City of CoppeD
CHANGE ORDER NO.: Two (2)
DATE: March 9, 2007
Item Description
Quantity Unit Unit Price
Total
ADD: Adj water meter/meter can
to sidewalk grade &
reconnect to lift station
1 LS 1200.00
$1,200.00
Total Revision to Contract Amount
$1,200.00
$4,828,324.41
($ 30,128.63)
$1,200.00
$4,799,395.78
o Day
480 Calendar Days
Previous contract amount
Net decrease in contract amount Change Order #112/1/06
Net increase in contract amount Change Order #2 319/07
Revised contract amount
Net increase in contract time of completion
Revised Contract time of completion
The contractor hereby accepts this Contract adjustment as a final and complete adjustment in full
accord and satisfaction of a1lpast and future liability originating under any clause in the Contract by
reason of this revision to the Contract. .
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Recommen d by City Engineer
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Date
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Date
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Agreed to by Contractor
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Date
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