APPENDICES.pdf
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- Solicitation number
- 2023-IFB-AIA-159
- Issued by
- Los Angeles County, California
About this file
The document is a set of appendices for a public works contract with the City of Pasadena, California, specifically for the Fire Station 31 Seismic Retrofit and Tenant Improvements project located at 135 S Fair Oaks Ave. The appendices include multiple administrative and contractual forms such as Payment and Performance Bonds, Construction Administration Forms, and placeholders for Hazardous Materials and Geotechnical Surveys. The Construction Administration Forms section contains 16 different types of forms including Change Orders, Conditional and Unconditional Waiver and Release forms, Work Directives, Affidavit of Final Completion, Contractor General Warranty Form, and Sworn Statements regarding Insurance Obligations.
The appendices provide comprehensive documentation for managing the contractual and financial aspects of the construction project, with forms designed to protect both the contractor and the City of Pasadena. The Payment and Performance Bonds, in particular, ensure that the contractor will fulfill their obligations and that subcontractors and suppliers will be paid. The various waiver and release forms are specifically structured according to California Civil Code sections, providing legal protections for progress and final payments. While specific financial details are not disclosed in these forms, they establish a framework for transparent and structured project administration, including mechanisms for change orders, payment releases, and warranty provisions.
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APPENDICES
Appendix 1 Payment and Performance Bonds
Appendix 2 Construction Administration Forms
Appendix 3 Hazardous Materials Survey [USED/NOT USED]
Geotechnical Survey [USED/NOT USED] Appendix 4
Appendix 5 Federal Minimum Wages [APPLICABLE/NOT
APPLICABLE
APPENDIX 1
Payment and Performance Bonds
PAYMENT BOND
(Labor and Material Bond)
KNOW ALL PERSONS BY THESE PRESENTS THAT:
WHEREAS, the City of Pasadena has awarded to
(Name, address, and telephone number of Contractor) designated as the “Contractor” or “Principal” herein, a Contract for the Work described as follows: Fire Station 31 – Sesimic Retrofit and Tenant Improvements located at 135 S Fair Oaks Ave in the City of Pasadena (hereinafter “Building”), which Contract and all Contract Documents set forth therein are incorporated herein and made a part hereof by this reference.
WHEREAS, by the terms of said Contract Documents, as well as Civil Code Section 9550, Principal is required to furnish a bond for the prompt, full and faithful payment to any Claimant, as hereinafter defined, for all labor, materials or services used or reasonably required for use in the performance of the Work of the Project, concurrently with delivery to the City of Pasadena of the signed Contract;
NOW THEREFORE, we the undersigned Principal, and
(Name, address, and telephone number of Surety) as Surety are held and firmly bound to the CITY OF PASADENA (“Obligee”) for payment of the penal sum of ($ ), this amount being not less than one hundred percent (100%) of the total Contract Sum, in lawful money of the United States of America, for the payment of which sum, well and truly to be made, we hold and firmly bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if said Principal, shall fail to pay any of the persons named in Civil Code Section 9100 (“Claimants”), for all labor, materials or services used or reasonably required for use in performance of the Work of the Project, or for any amounts due under the Unemployment Insurance Code with respect to work or labor performed by any such Claimant on the Project, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the Contractor and subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to such work and labor, that the surety or sureties herein will pay for the same in an amount not exceeding the sum specified in this bond, otherwise the above obligation shall be void.
In case suit is brought upon this bond, the said Surety will pay a reasonable attorneys’ fee to be fixed by the court. Principal and Surety agree that this Payment Bond shall not be considered a part of the Contract. Principal and Surety further agree that this Payment Bond is a separate obligation of the Principal and its Surety, and that any attorneys’ fee provision contained in this Payment Bond shall not apply to the Contract. In the event there is any litigation between the parties arising from the breach of the Contract, each party will bear its own attorneys’ fees in the litigation.
This bond shall inure to the benefit of any of the persons named in Civil Code Section 9100 as to give a right of action to such persons or the assigns in any suit brought upon this bond.
The Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, addition, modification or supplement to the terms of the Contract, or to the Work to be performed thereunder, or to the Contract Documents, shall in any way affect or release the obligations of the Surety under this bond, and Surety does hereby waive notice of any such change, extension of time, alteration, addition, modifications, or supplement to the terms of the Contract, or to the Work, or to the Contract Documents.
IN WITNESS WHEREOF, two (2) originals of this instrument, each of which shall for all purposes be deemed an original hereof, have been duly executed by the Principal and Surety, on the day of , 20___, the name of each corporate party being hereto affixed and duly signed by its undersigned representative pursuant to authority of its governing body.
Surety Name
By:
(Signature)
Printed Name/Attorney-in-Fact
Principal Name
(Printed Name)
Its:
(President/Vice-President/Chairman of the Board)
(Corporate Seal)
(Secretary/Assistant Secretary/
CFO/Assistant Treasurer)
(Attach Attorney-in-Fact Certificate, Corporate Seal and Surety Seal)
NOTE:
1. Execution of this bond must be acknowledged by both PRINCIPAL and SURETY before a Notary Public and Notary’s certificate of each acknowledgement must be attached.
2. A corporation must execute this bond by duly authorized officers or agents, and a certified copy of a resolution of its Board of Directors authorizing such execution, or other evidence of authority for such execution, must be attached if executed by persons other than the officers listed in Section 313, California Corporations Code.
PERFORMANCE BOND
KNOW ALL PERSONS BY THESE PRESENTS THAT:
WHEREAS, the City of Pasadena has awarded to
(Name, address, and telephone number of Contractor) designated as the “Contractor” or “Principal” herein, a Contract for the Work described as follows: Fire Station 31 – Sesimic Retrofit and Tenant Improvements located at 135 S Fair Oaks Ave in the City of Pasadena (hereinafter “Building”), which Contract and all Contract Documents set forth therein are incorporated herein and made a part hereof by this reference.
WHEREAS, by the terms of the Bidding Documents and Contract Documents, Principal is required to furnish a bond guaranteeing the, prompt, full and faithful performance of its obligations under the Contract Documents, concurrently with delivery to the City of Pasadena of the signed Contract.
NOW THEREFORE, we, the undersigned Principal, and
(Name, address, and telephone number of Surety) as Surety are held and firmly bound unto the CITY OF PASADENA (“Obligee”) in the penal sum of ($ ), this amount being not less than one hundred percent (100%) of the total Contract Sum, in lawful money of the United States of America, for the payment of which sum, well and truly to be made, we hold and firmly bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, by these presents for the prompt, full and faithful performance of the Contract Documents, which are hereinabove incorporated by reference.
THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the Principal shall promptly, fully and faithfully perform each and all of the obligations and things to be done and performed by the Principal in strict accordance with the terms of the Contract Documents as said Contract Documents may be modified or amended from time to time; and if the Principal shall indemnify and save harmless the Obligee and all of its officers, agents and employees from any and all losses, liability and damages, claims, judgments, stop notices, costs, and fees of every description, whether imposed by law or equity, which may be incurred by the Obligee by reason of the failure or default on the part of the Principal in the performance of any or all of the terms or the obligations of the Contract Documents, as they may be amended and supplemented including, but not limited to, Principal’s liability for Obligee’s damages (including direct and consequential damages incurred by the Obligee for: rental expenses; losses of use, income, profit, business, and reputation; increased financing costs; and loss of management or employee productivity or of the services of such persons) caused by Principal’s delays, as well as Principal’s liability for other delay damages or liquidated damages, and any warranties or guarantees required thereunder; then this obligation shall be void; otherwise, it shall be, and remain, in full force and effect.
The Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, addition, modification or supplement to the terms of the Contract, or to the Work to be performed thereunder, or to the Contract Documents, shall in any way affect or release the obligations of the Surety under this bond, and Surety does hereby waive notice of any change, extension of time, alteration, addition, modification, supplement to the terms of the Contract, or to the Work to be performed thereunder, or to the Contract Documents.
The guarantees contained herein shall survive the final completion of the Work called for in the Contract Documents with respect to the obligations and liabilities of the Principal which survive such final completion.
In case suit is brought upon this bond, the said Surety will pay a reasonable attorneys’ fee to be fixed by the court. Principal and Surety agree that this Faithful Performance Bond shall not be considered a part of the Contract. Principal and Surety further agree that this Faithful Performance Bond is a separate obligation of the Principal and its Surety, and that any attorneys’ fee provision contained in this Faithful Performance Bond shall not apply to the Contract. In the event there is any litigation between the parties arising from the breach of the Contract, each party will bear its own attorneys’ fees in the litigation.
IN WITNESS WHEREOF, two (2) originals of this instrument, each of which shall for all purposes be deemed an original hereof, have been executed by Principal and Surety, on the day of , 20___, the name of each corporate party being hereto affixed and duly signed by its undersigned representatives pursuant to authority of its governing body.
Surety Name
Printed Name/Attorney-in-Fact
Principal Name
(President/Vice-President/Chairman of the Board)
(Secretary/Assistant Secretary/
CFO/Assistant Treasurer)
(Attach Attorney-in-Fact Certificate, Corporate Seal and Surety Seal)
NOTE:
1. Execution of this bond must be acknowledged by both PRINCIPAL and SURETY before a Notary Public and Notary’s certificate of each acknowledgement must be attached.
2. A corporation must execute this bond by duly authorized officers or agents, and a certified copy of a resolution of its Board of Directors authorizing such execution, or other evidence of authority for such execution, must be attached if executed by persons other than the officers listed in Section 313, California Corporations Code.
APPENDIX 2
Construction Administration Forms
Construction Administration Forms
1. Change Order
2. Construction Change Directive
3. Unilateral Change Order
4. Work Directive
5. Conditional Waiver Upon Progress Payment
6. Unconditional Waiver Upon Progress Payment
7. Conditional Waiver Upon Final Payment
8. Unconditional Waiver Upon Final Payment
9. Declaration to Procure Progress Payment (Conditional)
10. Declaration to Procure Progress Payment (Unconditional)
11. Declaration to Procure Final Payment (Conditional)
12. Declaration to Procure Final Payment (Unconditional)
13.
14.
Affidavit of Final Completion
Contractor General Warranty Form
15. Consent of Surety to Release of Retention or Final Payment
16. Sworn Statement and Warranty Regarding Continuing Insurance Obligations
CHANGE ORDER
Agreement Date: Change Order #:
To: Date Issued:
The following change is hereby made a part of the Contract Documents enumerated in the Agreement Between Owner and Contractor on the date referenced above and shall be performed under the same terms and conditions as required by the original Contract Documents. Except as modified herein, the original Contract Documents and all prior amendments shall remain in full force and effect and all of the terms of the Contract Documents are hereby incorporated in this Change Order.
Description of this Change and Approved CPR/COR’s:
[Description of changes to Drawings and/or Specifications, insert CPR/COR # and Description] requested by Owner.
Reason:
Credit/Add
Original Contract Sum ……………………………………………………... $ Net change by previous Change Orders…………………………………. $ Contract Sum prior to this Change Order was…………………………… $ Contract Sum will be increased/decreased by this Change Order in the amount of ………………………………………………………………..
Adjusted Contract Sum including this Change Order is ……………... $ Contract Time will be increased/decreased by: ………………………… ________ days Calendar Date of Substantial Completion as of this Change Order…...
This Change Order is in full compromise and settlement of all adjustments to Contract Time and Contract Sum, and compensation for any and all delay, extended or additional field and home office overhead, disruption, acceleration, inefficiencies, lost labor or equipment productivity, differing site conditions, construction interferences and other extraordinary or consequential damages (hereinafter called “Impacts”), including any ripple or cumulative effect of said Impacts on the overall Work under the Contract arising directly or indirectly from the performance of Work described in this Change Order. By execution of this Change Order, Contractor agrees that this Change Order constitutes a complete accord and satisfaction with respect to all claims for schedule extension, Impacts, or any costs of any nature, character or kind arising out of or incidental to this Change Order.
City of Pasadena
100 North Garfield Avenue Pasadena, CA 91101
BY:
Name:
DATE:
OWNER
ARCHITECT:
ARCHITECT
CONTRACTOR
CONSTRUCTION CHANGE DIRECTIVE
Distribution to: OWNER □ ARCHITECT □ CONTRACTOR □
PROJECT:
DIRECTIVE NO.: ____________
ADDRESS: ______________________________________
DATE: ___________________
CONTRACT DATE: ___________________
TO CONTRACTOR: ___________________
CONTRACT FOR: ___________________
You are hereby directed to make the following change(s) to this Contract:
PROPOSED ADJUSTMENTS
1. The proposed basis of adjustment to the Contract Sum is:
[ ] Lump Sum (increase)(decrease) of $ __________________.
[ ] Unit Price of $ ______________ per _______________.
[ ] Daily time and materials records of actual costs plus a Contractor Fee for overhead and profit, as provided in Subparagraph 7.3.11 of AIA Document A201-2017, subject to a Not-To-Exceed Amount of
[ ] as follows:
2. The Contract Time is proposed to (be adjusted) (remain unchanged). The proposed adjustment, if any, is (an increase of days) (a decrease of days).
If Contractor disagrees with the proposed adjustments he must submit his own proposal within 10 days of date pursuant to Contract Documents or proposed adjustment will become final and binding on Contractor.
When signed by the Owner and Architect and received by the Contractor, this document becomes effective IMMEDIATELY as a Construction Change Directive (CCD), and the Contractor shall proceed with the change(s) described above.
100 N. Garfield Avenue
ARCHITECT:
CONTRACTOR
UNILATERAL CHANGE ORDER
Distribution to: OWNER X ARCHITECT X CONTRACTOR X
PROJECT: UNILATERAL CHANGE NO:
ADDRESS:
ISSUE DATE:
CONTRACT DATE:
TO CONTRACTOR: CONTRACT FOR:
The following changes are hereby made a part of the Contract Documents enumerated in the Agreement Between Owner and Contractor on the date referenced above. Except as modified herein, the original Contract Documents and all prior amendments shall remain in full force and effect and all of the terms of the Contract Documents are hereby incorporated in this Unilateral Change Order.
Description Add/Deduct
TOTAL
Original Contract Sum ………………………………………………………. $ Net change by previous Change Orders and Construction Change Directives ………………………………………………………………………
Contract Sum prior to this Unilateral Change Order was………………… $ Contract Sum will be increased/decreased by this Unilateral Change Order in the amount of ……………………………………………………….
Adjusted Contract Sum including this Unilateral Change Order is… $ Contract Time will be increased/decreased by: ………………………….. ________ days Date of Substantial Completion as of this Unilateral Change Order is…..
When signed by the Owner and Architect and received by the Contractor, this document becomes effective IMMEDIATELY as a Unilateral Change Order (UCO).
ARCHITECT:
WORK DIRECTIVE
Distribution to: OWNER □ ARCHITECT □ CONTRACTOR □ FIELD □ OTHER □
PROJECT: (Name, Address) WORK DIRECTIVE NO.:
Project: ______________________________________________________ DATE:
ADDRESS: __________________________________________________
TO CONTRACTOR: __________________________________________ CONTRACT DATE:
(Name, Address):
CONTRACT FOR:
You are hereby directed to continue performance of the following Work, without delay, pending resolution of the dispute concerning such Work and maintain the cost data described in paragraph 7.3.4 of the General Conditions for the performance of such Work:
Provide labor and material according to the scope, procedures and schedule identified in Exhibit F, at no cost to the
Owner.
Work to commence on ___________________, 20_____.
Neither the issuance of this Work Directive nor the requirement for the Contractor to maintain cost data constitutes approval by the Owner of a change in the Work or Modification of the Contract Documents.
CONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT
[California Civil Code § 8132]
NOTICE: THIS DOCUMENT WAIVES THE CLAIMANT’S LIEN, STOP PAYMENT NOTICE, AND
PAYMENT BOND RIGHTS EFFECTIVE ON RECEIPT OF PAYMENT. A PERSON SHOULD NOT RELY
ON THIS DOCUMENT UNLESS SATSIFIED THAT THE CLAIMANT HAS RECEIVED PAYMENT.
Identifying Information
Name of Claimant:
Name of Customer:
Job Location:
Owner:
Through Date:
Conditional Waiver and Release
This document waives and releases lien, stop payment notice, and payment bond rights the claimant has for labor and service provided, and equipment and material delivered, to the customer on this job through the Through Date of this document. Rights based upon labor or service provided, or equipment or material delivered, pursuant to a written change order that has been fully executed by the parties prior to the date that this document is signed by the claimant are waived and released by this document, unless listed as an Exception below. This document is effective only on the claimant’s receipt of payment from the financial institution on which the following check is drawn:
Maker of Check:
Amount of Check: $
Check Payable to:
Exceptions
This document does not affect any of the following:
(1) Retentions.
(2) Extras for which the claimant has not received payment.
(3) The following progress payments for which the claimant has previously given a conditional waiver and release but has not received payment:
Date(s) of waiver and release:
Amount(s) of unpaid progress payment(s):
(4) Contract rights, including (A) a right based on rescission, abandonment, or breach of contract, and
(B) the right to recover compensation for work not compensated by the payment.
Signature
Claimant’s Signature:
Claimant’s Title:
Date of Signature:
UNCONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT
[California Civil Code § 8134]
NOTICE TO CLAIMANT: THIS DOCUMENT WAIVES AND RELEASES LIEN< STOP
PAYMENT NOTICE, AND PAYMENT BOND RIGHTS UNCONDITIONALLY AND STATES
THAT YOU HAVE BEEN PAID FOR GIVING UP THOSE RIGHTS. THIS DOCUMENT IS
ENFORCEABLE AGAINST YOU IF YOU SIGN IT, EVEN IF YOU HAVE NOT BEEN PAID. IF
YOU HAVE NOT BEEN PAID, USE A CONDITIONAL WAIVER AND RELEASE FORM.
Identifying Information
Name of Claimant:
Name of Customer:
Job Location:
Through Date:
Unconditional Waiver and Release
This document waives and releases lien, stop payment notice, and payment bond rights the claimant has for labor and service provided, and equipment and material delivered, to the customer on this job through the Through Date of this document. Rights based upon labor or service provided, or equipment or material delivered, pursuant to a written change order that has been fully executed by the parties prior to the date that this document is signed by the claimant are waived and released by this document, unless listed as an Exception below. The claimant has received the following progress payment:
(1) Retentions.
(2) Extras for which the claimant has not received payment.
(3) Contract rights, including (A) a right based on rescission, abandonment, or breach of contract, and (B) the right to recover compensation for work not compensated by the payment.
CONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
[California Civil Code §8136]
NOTICE: THIS DOCUMENT WAIVES THE CLAIMANT’S LIEN, STOP PAYMENT NOTICE,
AND PAYMENT BOND RIGHTS EFFECTIVE ON RECEIPT OF PAYMENT. A PERSON
SHOULD NOT RELY ON THIS DOCUMENT UNLESS SATSIFIED THAT THE CLAIMANT HAS
RECEIVED PAYMENT.
Identifying Information
Name of Claimant:
Name of Customer:
Job Location:
Owner:
Conditional Waiver and Release
This document waives and releases lien, stop payment notice, and payment bond rights the claimant has for labor and service provided, and equipment and material delivered, to the customer on this job. Rights based upon labor or service provided, or equipment or material delivered, pursuant to a written change order that has been fully executed by the parties prior to the date that this document is signed by the claimant are waived and released by this document, unless listed as an Exception below. This document is effective only on the claimant’s receipt of payment from the financial institution on which the following check is drawn:
Maker of Check:
Amount of Check: $
Check Payable to:
Exceptions
This document does not affect any of the following:
Disputed claims for extras in the amount of: $
Signature
Claimant’s Signature:
UNCONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
[California Civil Code §8138]
NOTICE TO CLAIMANT: THIS DOCUMENT WAIVES AND RELEASES LIEN, STOP
PAYMENT NOTICE, AND PAYMENT BOND RIGHTS UNCONDITIONALLY AND STATES
THAT YOU HAVE BEEN PAID FOR GIVING UP THOSE RIGHTS. THIS DOCUMENT IS
ENFORCEABLE AGAINST YOU IF YOU SIGN IT, EVEN IF YOU HAVE NOT BEEN PAID. IF
YOU HAVE NOT BEEN PAID, USE A CONDITIONAL WAIVER AND RELEASE FORM.
Identifying Information
Name of Claimant:
Name of Customer:
Job Location:
Unconditional Waiver and Release
This document waives and releases lien, stop payment notice, and payment bond rights the claimant has for labor and service provided, and equipment and material delivered, to the customer on this job. Rights based upon labor or service provided, or equipment or material delivered, pursuant to a written change order that has been fully executed by the parties prior to the date that this document is signed by the claimant are waived and released by this document, unless listed as an Exception below. The claimant has been paid in full.
Disputed claims for extras in the amount of: $
ISSUED FOR BID
2/10/2022
APPENDIX 2 – CONSTRUCTION ADMINISTRATION FORMS
00 04 02-10
DECLARATION TO PROCURE PROGRESS PAYMENT AND RELEASE OF CONTRACT RIGHTS
[Name of Releasing Company As It Appears On The Release]
[Project]: _____________________________________________________________________
[Through Date As It Appears On The Release]
The company named above has executed a Conditional Waiver and Release Upon Progress Payment, pursuant to Cal.
Civil Code section 8132 through the date shown above. The statutory form of release provides that it does not release extras furnished before the Through Date for which payment has not been received or the right to recover compensation for furnished labor, services, equipment or material that was not compensated by the progress payment. The statutory release also provides that it does not cover contract rights, including rights based on rescission, abandonment or breach of contract.
In order to induce payment of the amount shown in the statutory release, the undersigned individual hereby declares that the company named above did not furnish any extras or any labor, services, equipment or material before the Through Date that was not compensated by the progress payment, except for the items listed below.
By execution of this document, the company also hereby releases all contract rights and all other legal and equitable claims that it has with regard to labor, service, equipment or material furnished through the Through Date including rights and claims for direct and indirect costs based on rescission, abandonment, breach of contract, delay, disruption or acceleration.
This Declaration and Release of Contract Rights is conditional, and shall be effective only when the check described on the statutory Conditional Waiver and Release form that accompanies this document has been properly endorsed and paid by the bank upon which it is drawn.
EXCEPTIONS
[Record Any Exceptions In This Space. If No Exceptions, Write “None.”]
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Signed at
__________________________________ California, on [Location] [Date of Signature]
[Signature]
[Print Name]
[Title]
NOTE: This form is designed to accompany a statutory
CONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT.
00 04 02-11
DECLARATION TO PROCURE PROGRESS PAYMENT AND RELEASE OF CONTRACT RIGHTS
[Project]: _____________________________________________________________________
[Through Date As It Appears On The Release]
The company named above has executed an Unconditional Waiver and Release Upon Progress Payment, pursuant to Cal. Civil Code section 8134 through the date shown above. The statutory form of release provides that it does not release extras furnished before the Through Date for which payment has not been received or the right to recover compensation for furnished labor, services, equipment or material that was not compensated by the progress payment.
The statutory release also provides that it does not cover contract rights, including rights based on rescission, abandonment or breach of contract.
In order to induce payment of the amount shown in the statutory release, the undersigned individual hereby declares that the company named above did not furnish any extras or any labor, services, equipment or material before the Through Date that was not compensated by the progress payment, except for the items listed below.
By execution of this document, the company also hereby releases all contract rights and all other legal and equitable claims that it has with regard to labor, service, equipment or material furnished through the Through Date including rights and claims for direct and indirect costs, based on rescission, abandonment, breach of contract, delay, disruption or acceleration.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
UNCONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT.
00 04 02-12
DECLARATION TO PROCURE FINAL PAYMENT AND RELEASE OF CONTRACT RIGHTS
[Project]
[Date As It Appears On The Release]
The company named above has executed a Conditional Waiver and Release Upon Final Payment, pursuant to Cal. Civil Code section 8136 on the date shown above.
In order to induce payment of the amount shown in the statutory release, the undersigned individual hereby declares that the company named above did not furnish any extras or any labor, services, equipment or material on the Project that was not compensated by the final payment, except for the items listed below.
By execution of this document, the company also hereby releases all contract rights and all other legal and equitable claims that it has with regard to labor, service, equipment or material furnished on the Project including rights and claims for direct and indirect costs based on rescission, abandonment, breach of contract, delay, disruption or acceleration.
This Declaration and Release of Contract Rights is conditional, and shall be effective only when the check described on the statutory Conditional Waiver and Release form that accompanies this document has been properly endorsed and paid by the bank upon which it is drawn.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
CONDITIONAL WAIVER AND RELEASE UPON FINAL PAYMENT.
00 04 02-13
DECLARATION TO PROCURE FINAL PAYMENT AND RELEASE OF CONTRACT RIGHTS
[Project]
[Date As It Appears On The Release]
The company named above has executed an Unconditional Waiver and Release Upon Final Payment, pursuant to Cal. Civil Code section 8138 on the date shown above.
In order to induce payment of the amount shown in the statutory release, the undersigned individual hereby declares that the company named above did not furnish any extras or any labor, services, equipment or material on the Project that was not compensated by the final payment, except for the items listed below.
By execution of this document, the company also hereby releases all contract rights and all other legal and equitable claims that it has with regard to labor, service, equipment or material furnished on the Project including rights and claims for direct and indirect costs based on rescission, abandonment, breach of contract, delay, disruption or acceleration.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
UNCONDITIONAL WAIVER AND RELEASE UPON FINAL PAYMENT.
APPENDIX 2 – CONSTRUCTION ADMINISTRATION
FORMS
AFFIDAVIT OF FINAL COMPLETION
To: City of Pasadena
From:
Project: ________________________________________________
ADDRESS: ________________________________________________
Contract No.: ____________________________
Contract Date: ___________________________
I, , declare to the best of my knowledge and belief that:
1. I am the person and officer of
(“Contractor”) as indicated on the execution line of this affidavit; I am duly authorized to make this affidavit and to execute and deliver the attached Application for Final Payment and I am familiar with the terms and conditions of the construction contract for the Project (“Contract”);
2. The Work of the Contract has been completed in strict accordance with the Contract Documents;
3. No lawful debts of Contractor for labor or materials or other claims are outstanding for the Work.
4. No Federal Excise Tax has been included in the Contract Price;
5. No additional compensation, over and above the amount set forth in the enclosed Application for Final Payment is due Contractor under the Contract for the Work and any changes in the Work;
6. Upon receipt of Final Payment in the amount of $ , Contractor, on behalf of itself and its Subcontractors and Suppliers acknowledges that City and any and all employees of City and its authorized representatives will thereby be released from any and all Claims or liability for additional sums for Work or changes in the Work and Contractor encloses herewith an original duly executed and complete conditional waiver and release upon final payment in accordance with California Civil Code section 8138 from Contractor and from
7. Contractor has obtained release of all claims by Subcontractors, Suppliers and others against Contractor and the Project;
8. Contractor has no reason to believe that any third party has a valid claim against the Contractor, the Work, the Project or the City which has not been communicated in writing by the Contractor to City as of the date of this affidavit;
9. Any guarantees and warranties are in full force and effect;
10. I understand that this affidavit is made for the purpose of inducing City to consent to release of retention and to make Final Payment to Contractor and City will rely upon the accuracy of the matters stated in this affidavit.
I declare, under penalty of perjury of the laws of the State of California that the foregoing is true and correct.
Executed this day of , 20__ at , California.
(Name)
(Title)
CONTRACTOR GENERAL WARRANTY FORM
To: City of Pasadena
From:
Contract No.:
We, ______________________________, performed work at the above referenced project per our contract agreement and do hereby warrant that all labor and materials furnished and work performed are in accordance with the contract documents and authorized modifications thereto, and will be free from defects due to defective materials or workmanship for a period of one year from Date of Final Completion. This warranty commences on ____________ (Date of Final Completion) and expires on _____________ (One year from Commencement Date and/or Correction Date).
Should any defect develop during the warranty period due to improper materials, workmanship or arrangement, the defect, including adjacent work displaced, shall be made good by the undersigned at no expense to the Owner.
Written notice of defective work will be given to the Contractor. Should the Contractor fail to correct defective work within a reasonable time after receiving written notice, the Owner may, at his option, correct defects and charge the Contractor costs for such correction. The Contractor agrees to pay such charges upon demand.
Nothing in the above shall be deemed to apply to work which has been abused or neglected by the Owner.
Signature Date
Printed Name
Title
CONSENT OF SURETY TO RELEASE OF RETENTION OR FINAL PAYMENT
To Owner: City of Pasadena
Pasadena, CA 91101
Attention:
To Contractor: _______________________________________
Contract Date:
Bond No(s):
In accordance with the provisions of the Contract between Owner and Contractor, as indicated above, as Surety on bond number(s) , hereby consents to [full/partial] release of [retention/final payment] to Contractor and agrees that neither payment, nor any other act pursuant to final payment to Contractor, shall exonerate, abrogate, relieve or in any way discharge any duties or obligations of the Surety to Owner or any other obliges under the bond(s).
IN WITNESS, WHEREOF, consent to the foregoing is hereby given this _____________ day of _____________, 20___.
[INSERT NAME OF SURETY]
By
(Signature of authorized representative)
Its (Printed name and title)
STATE OF ______________ )
) ss.
COUNTY OF ____________ )
[Attach notary acknowledgement and power of attorney]
SWORN STATEMENT AND WARRANTY
REGARDING CONTINUING INSURANCE OBLIGATIONS
FROM:
(Name or Title of Person Making Declaration) [insert Contractor name and address]
TO: City of Pasadena
PROJECT:
ADDRESS:
DECLARATION
Attached hereto is a true and correct copy of the current Certificate of Insurance and Additional Insured Endorsement which complies with the insurance requirements of the aforementioned Project as set forth in the Construction Contract and incorporated into the undersigned’s Contract (“Contract”).
I declare under penalty of perjury under the laws of the State of California that the above statement is true and correct.
Signed on ________________, 20___, at _______________________________
(Date) (City, State)
(Signature of Individual Who is Making Declaration)
APPENDIX 3
Hazardous Materials Survey
APPENDIX 4
Geotechnical Survey
APPENDIX 5
Federal Minimum Wages
| KNOW ALL PERSONS BY THESE PRESENTS THAT: |
| WHEREAS the City of Pasadena has awarded to: |
| undefined: |
| NOW THEREFORE we the undersigned Principal and 1: |
| NOW THEREFORE we the undersigned Principal and 2: |
| as Surety are held and firmly bound to the CITY OF PASADENA Obligee for payment of the: |
| undefined_2: |
| day of: |
| 20: |
| the name of each corporate party: |
| being hereto affixed and duly signed by its undersigned representative pursuant to authority of its: |
| Surety Name: |
| Principal Name: |
| Printed NameAttorneyinFact: |
| Printed Name: |
| PresidentVicePresidentChairman of: |
| Printed Name_2: |
| SecretaryAssistant Secretary: |
| KNOW ALL PERSONS BY THESE PRESENTS THAT_2: |
| WHEREAS the City of Pasadena has awarded to_2: |
| undefined_3: |
| NOW THEREFORE we the undersigned Principal and 1_2: |
| NOW THEREFORE we the undersigned Principal and 2_2: |
| as Surety are held and firmly bound unto the CITY OF PASADENA Obligee in the penal sum: |
| undefined_4: |
| hereto affixed and duly signed by its undersigned representatives pursuant to authority of its: |
| day of_2: |
| 20_2: |
| Surety Name_2: |
| Principal Name_2: |
| Printed NameAttorneyinFact_2: |
| Printed Name_3: |
| PresidentVicePresidentChairman of_2: |
| Printed Name_4: |
| SecretaryAssistant Secretary_2: |
| Agreement Date: |
| Change Order: |
| To: |
| Date Issued: |
| Reason: |
| undefined#1: |
| Original Contract Sum: |
| undefined_2#1: |
| Net change by previous Change Orders: |
| undefined_3#1: |
| Contract Sum prior to this Change Order was: |
| undefined_4#1: |
| the amount of: |
| undefined_5: |
| Adjusted Contract Sum including this Change Order is: |
| Contract Time will be increaseddecreased by: |
| days: |
| Calendar Date of Substantial Completion as of this Change Order: |
| 1: |
| 2: |
| BY: |
| Name: |
| DATE: |
| ARCHITECT 1: |
| ARCHITECT 2: |
| ARCHITECT 3: |
| BY_2: |
| Name_2: |
| DATE_2: |
| BY_3: |
| Name_3: |
| DATE_3: |
| Lump Sum increasedecrease of: |
| CONTRACTOR: Off |
| DIRECTIVE NO: |
| DATE_4: |
| CONTRACT DATE: |
| CONTRACT FOR: |
| per: |
| Name_4: |
| DATE_5: |
| DATE_6: |
| BY_4: |
| Name_5: |
| DATE_7: |
| PROJECT: |
| UNILATERAL CHANGE NO: |
| ISSUE DATE: |
| Original Contract Sum_2: |
| undefined_6: |
| undefined_7: |
| Directives: |
| Contract Sum prior to this Unilateral Change Order was: |
| undefined_8: |
| Order in the amount of: |
| undefined_9: |
| Contract Time will be increaseddecreased by_2: |
| days_2: |
| 100 N Garfield Avenue 1: |
| 100 N Garfield Avenue 2: |
| 100 N Garfield Avenue 3: |
| BY_5: |
| BY_6: |
| Name_6: |
| Name_7: |
| DATE_8: |
| DATE_9: |
| 1_2: |
| 2_2: |
| Work to commence on: |
| OWNER: Off |
| ARCHITECT: Off |
| CONTRACTOR_2: Off |
| FIELD: Off |
| OTHER: Off |
| 20#1: |
| undefined_10: |
| BY_7: |
| Name_8: |
| DATE_10: |
| Name of Claimant: |
| Name of Customer: |
| Job Location: |
| Owner: |
| Through Date: |
| Maker of Check: |
| Amount of Check: |
| Check Payable to: |
| Dates of waiver and release: |
| Amounts of unpaid progress payments: |
| Claimants Title: |
| Name of Claimant_2: |
| Name of Customer_2: |
| Job Location_2: |
| Owner_2: |
| Through Date_2: |
| undefined_11: |
| Claimants Title_2: |
| Name of Claimant_3: |
| Name of Customer_3: |
| Job Location_3: |
| Owner_3: |
| Maker of Check_2: |
| Amount of Check_2: |
| Check Payable to_2: |
| Disputed claims for extras in the amount of: |
| Claimants Title_3: |
| Name of Claimant_4: |
| Name of Customer_4: |
| Job Location_4: |
| Owner_4: |
| Disputed claims for extras in the amount of_2: |
| Claimants Title_4: |
| Project: |
| Location: |
| Print Name: |
| Title: |
| Project_2: |
| Location_2: |
| Print Name_2: |
| Title_2: |
| Location_3: |
| Print Name_3: |
| Title_3: |
| Location_4: |
| Print Name_4: |
| Title_4: |
| Project_3: |
| ADDRESS: |
| Contract No: |
| Contract Date: |
| I: |
| I am the person and officer of: |
| Contractor as indicated on the execution line of this affidavit I am duly authorized to make this: |
| Upon receipt of Final Payment in the amount of: |
| payment in accordance with California Civil Code section 8138 from Contractor and from: |
| undefined_12: |
| Executed this: |
| 20_2#1: |
| California: |
| Name_9: |
| Title_5: |
| Project_4: |
| ADDRESS_2: |
| our contract agreement and do hereby warrant that all labor and materials furnished and work: |
| Date: |
| Printed Name#1: |
| Title_6: |
| Attention: |
| To Contractor 1: |
| To Contractor 2: |
| To Contractor 3: |
| Project_5: |
| ADDRESS_3: |
| Contract Date 1: |
| Contract Date 2: |
| above: |
| as Surety on bond numbers: |
| hereby consents to fullpartial release of retentionfinal payment to Contractor: |
| IN WITNESS WHEREOF consent to the foregoing is hereby given this 1: |
| IN WITNESS WHEREOF consent to the foregoing is hereby given this 2: |
| 20_3: |
| By: |
| Its: |
| STATE OF: |
| COUNTY OF: |
| Name or Title of Person Making Declaration: |
| PROJECT 1: |
| PROJECT 2: |
| 1_3: |
| 2_3: |
File details come from the government source that posted it. Updated .