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HomeMy WebLinkAboutDon Gardner Construction-6/4/2012eP4A IA Document G704 ' - 2000 Certificate of Substantial Completion PROJECT: (Name and address) PROJECT NUMBER: 2011-0002 2011 Waterloo Forestry Buil��'nCoQ aes for the City of Waterloo 1117 Campbell Ave R' General Waterloo, IA 50701 CONTRACT DATE: July 12, 2011 TO OWNER: (Name and address) City of Waterloo 715 Mulberry Street Waterloo, IA 50703 TO CONTRACTOR: (Name and address) Don Gardner Construction Co., Inc. 315 LaPorte Rd. Waterloo, IA 50702 OWNER ❑ ARCHITECT 0 CONTRACTOR 0 FIELD 0 OTHER 0 PROJECT OR PORTION OF THE PROJECT DESIGNATED FOR PARTIAL OCCUPANCY OR USE SHALL INCLUDE: The Work performed under this Contract has been reviewed and found, to the Architect's best knowledge, information and belief, to be substantially complete. Substantial Completion is the stage in the progress of the Work when the Work or designated portion is sufficiently complete in accordance with the Contract Documents so that the Owner can occupy or utilize the Work for its intended use. The date of Substantial Completion of the Project or portion designated above is the date of issuance established by this Certificate, which is also the date of commencement of applicable warranties required by the Contract Documents, except as stated below: AHTS Architects, PLC ARCHITECT Tarry R. Kurtz, PLA 5-22-12 DATE OF ISSUANCE A list of items to be completed or corrected is attached hereto. The failure to include any items on such list does not alter the responsibility of the Contractor to complete all Work in accordance with the Contract Documents. Unless otherwise agreed to in writing, the date of commencement of warranties for items on the attached list will be the date of issuance of the final Certificate of Payment or the date of final payment. Cost estimate of Work that is incomplete or defective: $ 0.00 The Contractor will complete or correct the Work on the list of items attached hereto within ( n/a ) days from the above date of Substantial Completion. Don Gardner Construction CONTRACTOR BY/ f ` D 'Gar DAT The Owner accepts the Work or designated aly complete and will assume full possession at (time) ` ® ,e/ /� (date). City of Waterloo OWNER = °s'" `' DATE The responsibilities of the Owner and Contractor for security, maintenance, heat, utilities, damage to the Work and insurance shall be as follows: (Note: Owner's and Contractor's legal and insurance counsel should determine and review insurance requirements and coverage.) 6,f(pecp— ce AIA Document G70472 — 2000. Copyright © 1963, 1978, 1992 and 2000 by The American Institute of Architects. All rights reserved. WARNING: This AIA° Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA® Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel, copyright@aia.org. 1-AIAnG7O4TM - 2000 Instructions Document Certificate of Substantial Completion GENERAL INFORMATION Purpose This document was developed to establish the date of Substantial Completion for the purpose of commencement of applicable warranties and to allow the Owner to occupy or utilize the Work or designated portion thereof. Related Documents This document was prepared for use under the terms of AIA Document A201, General Conditions of the Contract for Construction; and under the general conditions contained in AIA Document A107 and A105. Use of Current Documents Prior to using any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G704, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission from the MA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA). To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel, copyright@aia.org. COMPLETING THE G704 FORM After the words "Project or Designated Portion shall include:," insert a detailed description of the Project or portion(s) of the Project that have been accepted as being substantially complete. Determine Work to be completed. Provide a list of items that are to be completed or corrected. Determine dates for completion of the Work. Establish an amount to be withheld to complete the Work. EXECUTION OF THE DOCUMENT The G704 document should be executed in not less than triplicate by the Owner, Architect and Contractor, each of whom retains an original. AIA Document G704TM — 2000. Copyright © 1963, 1978, 1992 and 2000 by The American Institute of Architects. All rights reserved. WARNING: This AIA® Document Is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA® Document, or any portion of it, may result In severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel. copyright@aia.org. LIEN WAIVER acs# 11-500 PROJECT Waterloo Forestry Building FINAL PARTIAL STATE OF IOWA COUNTY OF BLACK HAWK The undersigned having the position of Modern Paint Appointed as ireeast ming duty sworn, states agent to execute this Lien Waiver. that t is duly authara and Modern paint That he does hereby certify that has famished alt materials and labor and has per€ortrred alt its on the above described project and the contract documents between Don Gardner Co and the Owner of the Don Gardner Construction project, Amount Three tho - -- r�� of Whig is hereby four hundredn x,40 100 acknowledged, represents Payment in full for labor performed hollers �B.r�O by the undersigned, Its subcontractors d b full by undersigned, material Vendors, suppliers and e been famished undersigned and hereby warrant that alit such subcontractors, and employ have gent employes have been paid in full by, materfial and lien rightsa for and in connection undersigned and herebyvendors, suppliers, agents and with the above described waives and releases butn,Y and all claims labor firmed and materials furnished onproject including net limited to the project these ibr The undersigned acknowledges that this to tre or impair ckn obli terse and the paymentof said fund shall not be co 9abon of the undersigned for or in ns ' d any way in specific shaft not alter or aim the warranty relation to work performed or installed and minty and guarantees obligations g ons of the undersigned. Executed this day of RECEIVED FEB 2 9 2012 with Witness PLEASE RETURN YOUR SIGNED LIEN WAIVER BY MAIL TO; OR FAX TO: ay. / DON GARDNER CONSTRUCTION 00. 315 LA PARTE RD. WATERLOO, R 50702 X12 (319) 234-2033 THANKS 111 This amount reflects all payments except Retainage due to you ire the amount of: 2012 0.0g1t9V0 #4.4,1/ 40404 litIP***142110cfsgt '0404141400 JitiiViVaklutMug-Atti fit:Nr./1041 :totipA. tii•o•-rativm tualgod To-o_onm 1 p,itfo-teiiiimitg igbg mi-4.amym NfTci*,160 :=0.12.-xV• o ssottVit. PI; fx4tros -.0tiaismOun-4.0.51kgegifcgi siOutdett put-AvAueM papA :fte ttlb IX:9$$ pat4411. OutiNiad 446m uo.tief4:1•4 4.0,05pOiln.4440:tiotwAigo Atig Argott-aaLL i P1450132-". 394 itta4slAgt:WMPIF:mizAe.•010 .tff4 0,4.1wooeopeporairisporiLL llgat*Viff Ye ;WWI otga4ag P*ct MR Mi4411:4N:rlitireprIMI*4 PoW740P4A0TO oM3- 004;Tiluccrortwo 444:4,0ii Pue:' surp !iv poR42vg9,1rakv4 SM 134:RIN Nopatki*Rpgn.Aq: pi al:Red .pa.q. Waft 'gsitgrdm tocittA4 1141,74 tloOlv-luax.MpnsIR loill-Voxeml:Pue•PatiamPPn Agri mt teoki:etioq t40.Aolcitat.:Ptio:Titret4ititOft •Pi.00aA teptc0.4 .t.40:4004rt§ liouftlaPPri ori44 *Itithi**1014t1llitt patii Atiol 404- *A ot4kato 1:16* moot AcIasat# 1.0.P.APAoatit.T0A: toz:ma • • 6,1..441 0,1304:Pu Akt. .4U 1:450:4•010.0.xik440. 041.pr,va• •ii2asqactgudtunoop:01•46:6:,moitto ipteitudputgaslap ;Mlle .pkTat U. SEX PAggablid Seti WS -14ei J1 .414w NB Miggir30944.• • Si .1044103 MAN 01P arigtii. iPAP2M qtrnikiMt/aVetagOre TOO -04W* pti.P41,0010•:M.V•t1 gt1:4o41 Si:14014MM 4113:44aq WI sOut : !4. g t%V.;.` ..4:01.4960A1941PPINNT-NL ZIOZ 6 Z 83J 1:13A13338 1 XIA.VrOPY111.404013ca v.0.50.1-40 1514201folif -itosalovi G01-01"44 :13-31'01fd OS- IT #130f 112AIVAA, Nan LLCM VVIUVCK JOB# 11-500 PROJECT: Waterloo Forestry Building FINAL PARTIAL STATE OF IOWA COUNTY OF BLACK HAWK XXX RECEIVED MAR 01 2012 The undersigned having the position of PaJ4r with Hawkeye Sheet Metal first being duly sworn, states that he is duly authorized and Appointed as its agent to execute this Lien Waiver. That he does hereby certify that Hawkeye Sheet Metal has furnished all materials and labor and has performed all its Don Gardner Construction on the above described project and the contract documents between Don Gardner Construction and the Owner of the project. Amount Five hundred thirty-five & no/100 Dollars $535.00 receipt of which is hereby acknowledged, represents payment in full for labor performed and materials furnished by the undersigned, its subcontractors material vendors, suppliers, agents and employees have been paid in full by undersigned and hereby warrant that alll such subcontractors, material vendors, suppliers, agents and employees have been paid in full by undersigned and hereby waives and releases any and all claims and lien rights for and in connection with the above described project including but not limited to those for labor performed and materials furnished on the project. The undersigned acknowledges that this release and the payment of said fund shall not be construced in any way to affect or impair any obligation of the undersigned for or in relation to work performed or installed and in specific shall not alter or affect the warranty and guarantees obligations of the undersigned. Executed this ;-® day of C-142012 Witness By 61-z,4-4 PLEASE RETURN YOUR SIGNED LIEN WAIVER BY 03/12/12 MAIL TO: DON GARDNER CONSTRUCTION CO. 315 LA PORTE RD. WATERLOO, IA 50702 OR FAX TO: (319) 234-2033 THANKS !!! This amount reflects all payments except Retainage due to you in the amount of: $0.00 LSCiY WAIVCK 308# 11-500 PROJECT: Waterloo Forestry Building FINAL PARTIAL STATE OF IOWA COUNTY OF BLACK HAWK The undersigned having the position of 'J 1- n 1 D t b RECEIVED MAR m 5 2012 with Waterloo Lumber Company first being duly sworn, states that he is duly authorized and Appointed as its agent to execute this Lien Waiver. That he does hereby certify that Waterloo Lumber Company has furnished all materials and labor and has performed all its Don Gardner Construction on the above described project and the contract documents between and the Owner of the project. Amount Four undred ei hteen & 4 Don Gardner Construction 100 Dollars $418,41 receipt of which Is hereby acknowledged, represents payment In full fo'r labor performed and materials furnished by the undersigned, its subcontractors material vendors, suppliers, agents and employees have been paid in full by undersigned and hereby warrant that all! such subcontractors, material vendors, suppliers, agents and employees have been paid in full by undersigned and hereby waives and releases any and all claims and Tien rights for and in connection with the above described project Including but not limited to those for labor performed and materials furnished on the project The undersigned acknowledges that this release and the payment of said fund shall not be construced in any way to affect or impair any obligation of the undersigned for or in relation to work performed or installed and in specific shall not alter or affect the warranty and guarantees obligations of the undersigned. '2-`4 day of P1ROA.At Witness Executed this By 2012 PLEASE RETURN YOUR SIGNED LiEN WAIVER BY 03112/12 MAIL TO; DON GARDNER CONSSTRUCTiON CO. 315 LA PORTE RIS. WATERLOO, iA 50702 OR FAX TO: (319) 234-2033 THANKS III This amount reflects all payments except Retainage due to you in the amount of: $0.00 L.LtN WA1VLK JOB# 11-500 PROJECT: Waterloo Forestry Building FINAL PARTIAL STATE OF IOWA COUNTY OF BLACK HAWK XXX RECEIVED MAR w 7 2012 The undersigned having the position of Vit Le with Doors Inc. first being duly sworn, states that he is duly authorized and Appointed as its agent to execute this Lien Waiver. That he does hereby certify that Doors Inc. has furnished all materials and labor and has performed all its Don Gardner Construction on the above described project and the contract documents between Don Gardner Construction and the Owner of the project. Amount Nine hundred five & no/100 Dollars $905.00 receipt of which is hereby acknowledged, represents payment in full for labor performed and materials furnished by the undersigned, its subcontractors material vendors, suppliers, agents and employees have been paid in full by undersigned and hereby warrant that alll such subcontractors, material vendors, suppliers, agents and employees have been paid in full by undersigned and hereby waives and releases any and all daims and lien rights for and in connection with the above described project including but not limited to those for labor performed and materials furnished on the project. The undersigned acknowledges that this release and the payment of said fund shall not be construced in any way to affect or impair any obligation of the undersigned for or in relation to work performed or installed and in specific shall not alter or affect the warranty and guarantees obligations of the undersigned. Executed this 5- day of MA g -c- /4 2012 Witness By PLEASE RETURN YOUR SIGNED LIEN WAIVER BY MAIL TO: DON GARDNER CONSTRUCTION CO. 315 LA PORTE RD. WATERLOO, IA 50702 OR FAX TO: (319) 234-2033 THANKS !!! This amount reflects all payments except Retainage due to you in the amount of: $0.00 L1t1V WA1VLK JOB# 11-500 PROJECT: Waterloo Forestry Building FINAL PARTIAL STATE OF IOWA COUNTY OF BLACK HAWK XXX RECEIVED MAR m 9 2012 The undersigned having the position of President with Overhead Door of Waterloo first being duly sworn, states that he is duly authorized and Appointed as its agent to execute this Lien Waiver. That he does hereby certify that Overhead Door of Waterloo has furnished all materials and labor and has performed all its Don Gardner Construction on the above described project and the contract documents between Don Gardner Construction and the Owner of the project. Amount Seven thousand fifty-six & no/100 Dollars $7,056.00 receipt of which is hereby acknowledged, represents payment in full for labor performed and materials fumished by the undersigned, its subcontractors material vendors, suppliers, agents and employees have been paid in full by undersigned and hereby warrant that alit such subcontractors, material vendors, suppliers, agents and employees have been paid in full by undersigned and hereby waives and releases any and all claims and lien rights for and in connection with the above described project including but not limited to those for labor performed and materials furnished on the project. The undersigned acknowledges that this release and the payment of said fund shall not be construced in any way to affect or impair any obligation of the undersigned for or in relation to work performed or installed and in specific shall not alter or affect the warranty and guarantees obligations of the undersigned. Executed this 28th day of February 2012 By ko-n-re_ PLEASE RETURN YOUR SIGNED LIEN WAIVER BY 03/12/12 MAIL TO: DON GARDNER CONSTRUCTION CO. 315 LA PORTE RD. WATERLOO, IA 50702 OR FAX TO: (319) 234-2033 THANKS !I! This amount reflects all payments except Retainage due to you in the amount of: $784.00 e a,r� ION 19r'/ '. itaw aJojaq i eadde (s)uosiod atq aq W eDuap!Aa Mopeispes T o selq aye u: a Panaud.1a ou)1 AHeu aacr-- 011.1' Aq ZTDZ . J' rr—Jo AEPSlyz aui &piaci a3NJIS GNb 01 N2i0MS �� CG�� jo Aluncro d� ales sox[dxe uo?ssnartuoo .[ T9989 3N `sngwnpo3 69S X09 0 d 'was pRZL 3 SZOi, Ortui 3'bdw :1d30X3 II' Lit pied uaaq anal pau6isJepun art Aq paAoldwe stopa1 uo3gns He pue 'J0j. pied uaaq seg pau6pJapun aul Aq pausiwry leuaaeu t Ile 4egl soups pau6!slepun au1. '(paPPOtp Si Z X08 it uMoys a6euseial Joj 4deoxe pue 'pavotp sl I Xoa 4! Pled lunowe aye .lob Apo) ApadoJd teal pies oo pagsiutnj le!Jaiew Jo ins 'Jowl Joh A1.iadoid tela pies 4.suie6e uall spiuegaaw pio3a i Jo alb o} peu6pJapun au; Aq paatnb3e slg6ia lie sanleM AgaIag paNaow anlen Joj. puY 'SOLOS VI 0O1U J YM �S 113gdwaD Agseiod ocgaeleM •(aweu pa*oid Jo ssaippe pacts'umdpasap le6a1) :hpadcud Rai pagiaasap 6ulMollod atp,o pagsluJnJ eq o4 Jo pausiwnj lepa4ew pue illi 'axle! i!e aoj quawAed leuu pue lint sv xx '£ Olaegploq ao abeule ai $ o wns aux ldaaxa pauslwnn aq a Jo paysiwnJ lepaeetu pue ins'Joqel Ile Joj 4uauued — 'z apionuj e pags!wnj pue pis 'loge! aoJ luawAed lewd sv :3N0 AINO )IZ3HD ZOLOS VI 1001,18-12N1 PII a}1od el STE OD uol naISuo3 Jaup e9 uoa WOJ 9ti'OL6'6L$ o wns aq ao L9T£L i quWnu poatp pue SS9ZL aacpunu vestp isS9ZL aagwnu X3643'SSEEL Jagwnu paw jo ;paw sabpelMouve Apia' pau6lsiapun a ZtOZ'6 tl ieii ;2 ea SI.H911I N3Il S,3INVH33IN Jo'd3AIVM Poe 1d13D31 ZOE z 03AI333 JOB# 11-500 PROJECT: Waterloo Forestry Building FINAL PARTIAL STATE OF IOWA COUNTY OF BLACK HAWK RECEIVED MAR 14 2012 The undersigned having the position of Pc .t 5-1 C� k -1' with Arctic Seal Urethane Insulation first being duly sworn, states that he/she is duly authorized and Appointed as its agent to execute this Lien Waiver. That he/she does hereby certify that Arctic Seal Urethane Insulation has furnished all materials and labor and has performed all its duties on the above described project and the contract documents between Don Gardner Construction and the Owner of the project. Amount Twenty-nine thousand four hundred seven & 50/100 Dollars $29,407.50 receipt of which is hereby acknowledged, represents payment in full for labor performed and materials furnished by the undersigned, its subcontractors material vendors, suppliers, agents and employees have been paid in full by undersigned and hereby warrant that all such subcontractors, material vendors, suppliers, agents and employees have been paid in full by undersigned and hereby waives and releases any and all claims and lien rights for and in connection with the above described project including but not limited to those for labor performed and materials furnished on the project. The undersigned acknowledges that this release and the payment of said fund shall not be construced in any way to affect or impair any obligation of the undersigned for or in relation to work performed or installed and in specific shall not alter or affect the warranty and guarantees obligations of the undersigned. Executed this I,2 day of /QrC h 2012 By i.i. PLEASE RETURN YOUR SIGNED LIEN WAIVER BY ASAP MAIL TO: DON GARDNER CONSTRUCTION CO. 315 LA PORTE RD, WATERLOO, IA 50702 OR FAX TO: (319) 234-2033 THANKS 111 This amount reflects all payments except Retainage due to you in the amount of: yh.js $3,267.50