2. CONTRACTOR AND ADDRESS
Document 24-3
Filed 07/30/2008
Page 1 of 20
ALL STAR IRON WORKS,
~ D~'SCRIPTI~)"N OF WORK
1
PROM Zll/0~
QUAN}ITYAND ' d~lT: ' UNIT
4'~ DISTI~ICTIsHEET ~--°[ z
7. REQUIRED COMPLETION DATE 10. JOB ORDER NO.
GA[Ek~AY OUTBOUND CANOPY-DESIGN
B': LOCATI~N .........
BROWNSVIL,LE~ TX
IIEM
THRU 4/30/00
CDNTRACT PRICE d AMOUNT e
11. E~_..~ATE NO.
TOTAL TO DATE ........ Q'GANI~ITY AND UNIT AMOUNT I
i
DESIGN WORK (BASE CANOPY) (REFER TO PLANS & SPECS.) !ALTERNATE BOOTH DESIGN ALTERNATE MISTIN6 SYSTEM
-
100%
17,668.80
65%
11,497.72
100% lO0%
6,400. O0 1,650.00
.4,160.00
1o%
165.0D
4
TECHNICAL LINES & SPARE ELECTRICAL LINES DESIGN (PENDING)
TOTAL EARNINGS |CLUDES MODIFICATION THRU: 12. PRESENTED FOR PAYMENT PAYEE PER
TOTAL CONTRACT ~ $ ...... ~4.A"
25,718.80 TO DATE
PREVIOUS DEDUCTIONS OTHER THAN RETAINED PERCENTAGE"" PREVIOUS RETAINED PERCENTAGE PREV IOUS PAYMENTS PREVIOUS EARNINGS (A+B-~C) ¯
...5-26-0Q
. PRES !DEN..T. ... ......
13. APPROVED FOR PAYMENT E. EARNIN'~B THIS PERIOD {TOTAL EARNINGS T.O DATE MINUS DI F. LESS RETAINED PERCENTAGE GI LESSDEDUCTION OTHER THAN RETAINED PERCENTAGE FOR
I CERTIFY that I have checked "the quantities covered by this bill or estimate; that the work ~vas actually perlormed; that the quantities are co:rect and consistent wilh all previous computations as actually checked; 1hat lhe quanf.ilies end amounts are wholly consldent with th~ requirements of the contract or other instrument involved.
SIGNATURE
TITLE
DATE
,.. RETA',N G ' REFUNDED
"= J. OTHER REFUNDS K~ TOTAL REFUNd; ~HIS PER L. AMOUNT DUE CON'[RACTOR (E-H+K| 1S. RECAP |TULATION: ..... TOTAL RETAINED PCTG. (B+F-I) S TOTAL PAID (C÷L) S
CO~C~IN~ OFFICER APPROVA_L_(Signai.ure| ENG i FORM 78 MAR 93
DATE
PREVIOUS EDITION OF TI4IS FORM IS O6SOLE~E
"(use REVERS--- S.~E FO~ DETAILED EXFL~I~TI©~ AND.O.-q ~EM~..~:'; .
Case 1:07-cv-00355-NBF
Document 24-3
Filed 07/30/2008
Page 2 of 20
APP 022
Case 1:07-cv-00355-NBF
Document 24-3
Filed 07/30/2008
Page 3 of 20
4.1DISTRICT
3. {;ONTR ACT
"83 , MERCEDES, TX7 8570 LOS TOMATES OUTBOUND
B. LDCAT# O~'4
TC-I-96-013
CANOPU DESIGN
BROWNSVILLE ,
ITEM
TEXAS
,#y ~~-<~ ~,,, .......u.,-r .......
U N IT ¯ PRICE
OONTR ACT
TOTAL TO DATE AMOUNT B UNI~T ~UNT
c
d
100% (REFER TO PLANS & SPECS.) ~TEBNATE BOOTH DESIGN (DESIGN) 3 4 5
19,900.00
100%
i;9. 900. O0
1oo%
6,B00,00
Ioo%
10o%
6,B00.00
~O~DWAY & DRAINAGE MODIFICATIONS
ALTERNATE MISTING SYSTEM(DESIGN)
zoo%
lOO% lOO%
TQTAL CONTRACT ~
~ ,~oo ,oo
1,650.0"0 7,240.00
!~37~390. 00
,ooo..oo
1,650.00 "~. 7~240.00 ~
¯
100%
TO DATE
PAYmeNT & PE~F0~ANCE BONDS
INCLUDES MODIFICATION THRU:
~. P~E~NTEO ~Oa P~YMENT
PREV1OUS DEDUCTIONS OTHER THAN RETAINED PERCENTAO~"" PREVrOUS RE/A IlN,E O,,, PERCENTAGE C. PREVIOUS PAYMENTS
- 0 28,642:~ 00 2B,641.00
OATEIEI- 0
7- 0 0
PRESIDENT
APPROVED TOR FAYN~ENT
D. PREVIOOS EARNINGS [A+B÷C] " E. EARNINGS THIS PERIOD IToTAL EAFININGFI TO DATE MINUS D' F. LE~ RE~AI~'EO PERCENTAGE ~. L{~ DEDUCTION ~EB THAN ..... RETAINED PER~EN~AGE FO~ I. RETAINAGE REFUNDED J, O~ER REFUNDS L. ~OUNT DUE C~T~ACTOR [E-~+K) TOTAL RETAINED PCTG. |B÷F-I| S TOTAL PAID IC+LI' $
8,748.00
SIGNATURE
TITLE
DATE
''[USE REVERS~ SIDE FOR DETAIL~ED EXFL ~,N,-~.TION .ANP"OR REMa.F~F'.
Case 1:07-cv-00355-NBF
Document 24-3
Filed 07/30/2008
Page 4 of 20
b
DESIGN WORK (BASE CANOPY}
{REFXR TO PLANS & SPECS.) 6.0BO.00 1.567.50
2 3
ALTERNATE BOOTH DESIGN ~LTERNATE MISTING SYSTEM (DESIGN)
NCLUD~S MODIFICATION THRU: 12. PRESENTED FOR PAYMENT PER PREVIOUS PAYMENTS
TOTAL EP~RN TO DATE
00 8 - O 7 -0 0 PRES IDE~.T
13. ~PROVED FOR PAYMENT D. PREV IO -~IS EARNINGS E;EARNINGS THIS PERIOD iToTAL EARN;NG5 TO DATE-MINUS F. LESS ftETA.INEDPERCENTAGI~ .G. LESS DEDUCTION OTHER THAN RETAINED PERCENTAGE FOR con*ist~ with the r~!u;r~entt of the ~tr~t ~ other ins;rUment H. TOTAL DEDUCTIONS THIS PERIOD SIGNATURE
15,822-72
;-:-:-:-:,:<<<-.'..;.;-;<.:-.'<.;-; .>:-:<-:-:-.'-i ¯ :- :':':-:-: <-.'<- 5::::~:-:':-:-:-:-.'-:':~-.'-:->:i ::::::::::::::::::::::::::::::::::::::::::::::: , ~
TITLE
I. RETAINAGE REFUNDED J. OTHER .REFUNDS K. TOTAL REFUNDS THIs PERIOD L. AMOUNT DUE CONTRACTOR 15. R EC AP ITULAT IONTOTAL RETAINED PGTG. {B+~:-I| $
Case 1:07-cv-00355-NBF
Document 24-3
Filed 07/30/2008
Page 5 of 20
ii
APP 025
Case 1:07-cv-00355-NBF
Document 24-3
Filed 07/30/2008
J I. DATE
Page 6 of 20
PAYMENT ESTN%JATE -. CONI'R:ACTPERFORMANCE
~~o A~PR~S~
i. OESC
CONTRACT, NO.
~
TAR IR0~ ~0RKS,ZMC.P.0.BOXB3,~RCEDES,TX 78570
¯
TC-I-g6-013 "
TH IS F_~TII%{ .~ T~ TFi~U 09--[~--00
LOS ~NDIOS
.... :" ":;..~ .,.~--, "Z~, ~ ~,,~" ['[G" .~.~ ' "~ ,~ ~.~ " - ":'-.":,~'~.: ~.::,'q~'~ ,OUqBOUND CANOPY DESIGN ,_
L Lo~.T, ON
NO. ~ ~ DESCR IPTtON b
ZOOl]2.~o~e -to ~'b o S.EP
QUANTITY AND UNIT
¯ COaTRAC~ "
Toi~L TO O~TE "' ....
AMOUNT QUANTITY ANO UNIT !
Pm~C.E
u~If "
DESIGN WORE RASE (.BASE CANOPY) (~EFER TO PLANS & SP.EC-S.)
ALTERNATE BOOTH DESIGN (DESIGN)
ROADWAY & DRAINAGE MODIFICATIONS ,ALTERNATE MISTING SYSTEM (DESIGN)
FPAYMENT & PEI
1oo%
100%
19,900~00
6,800..00
100%
1oo% 10o%
100%
19,900.00
~oo~ ~oo~ ~oo~
~oo%
I,B00.00
1,800.00
,650.0o
7,~40.00
5,100.00
79.,500.00
:STRUCTURAL STEEL
¯
~.-,
lOO% 95% : 7~%
1,650.00 7,~40~00 4,545.00 57,240.00
I ,._, (t
~NCLUOE$ Moo)F~ATION L'I"~. RU: 12. PReSeNTED FOR PAYME~'T' ,
....
TOTA!. CONTRACT
S121,990.00
TO O ATE
; 1~
' , ' ,
s 99,475.00
14"A. PREVIOUS DEDUCTIONS OTHER THAN RETAINE0 PERCENTAGE ' "
pREVIOUS ;t ETA INED PERCENTAG E
PREVIOUS PAY&,I ~" NTS OAT E
37,3g0.00 ;
:::::::::::::::::::::::::::::::::::::::::
37.r390,00
-0-
09-15-00
?RESIDENT
13. APgJ:IOV£O FOR PAYM.=NT
O. PREVIOUS EARriINGS E. EARNII~GS THI.~ Fi~RIOD iTOTA'L E.ARNIN~S I'0 0AT'-~ %fliP, US 0]
z ~.~-:.':.'.:'-'.'.'.';:'I.Z-Z.'.T::,'.'.'.'::'~
{
" 0. -
,085.00
F, LE55 RETAIN==D PERCENTAGE
vi~J~ ~m~t~ion~ ~ ~tu~ ~ecked: that ~he ~uaadtles and amount~ are wholly ' ~'i L~$$ DEDUCTIO;~ 0T'H~a THA3I .......... RETAINED ~ERCENTAGE FOR
3,104.25~
H. TOTAL 0 :DUCTIOI~IS -r'.A iS P E~IOO !F ~G': ~:~:ii~:]~i~'~:~[."~:i~i:!:i:i[i:ili:i . 3, I 0 4. Z5 "" ..... B!,'.L'~! , ¯ . .'.','.,.,.,,-.;-., ~'.;'-'.'~-¢,, ,. . ,,. ,,:, TITLE DATE
..... ~_. '~.vIO'u~T 'D'U£ COt~TR &C~'OR [E-H-K.', ..... ~'-'~:-~-~K~'---~9>;--.~¢~!~:~.~--~`~`~-:~ :':':'-""':::':'"':'~ 58 r 980, 75' "
Case 1:07-cv-00355-NBF
Document 24-3
Filed 07/30/2008
Page 7 of 20
!9. PERIOD COVERED BY ~'H~ EST~&,IATE CO N TR
TOTAL TO DATE
A MOUN T UNIT ! AMOU N r
NO.
b
QUANTIFY AND UNIT ,.
UNIT PR IC.E '..
].oo%
100%
~iRO~WAY & DRAINAGE ~0DIFICATIONS
19,900.00
ioo%
lOO% 10o% 10o% 100% B5%
19,900.00
6,800.00"
ioo%
10o% 100%
STRUCTURAL STEEL
lOO% 1oo%
6 , B00 I,B00~00 1,650.00 7,240.00 5,400 ¯ 00 7fl,800.00
l, 800. O0
1,650.00 "
7,240.00
4,590.00 56,7~6.00
q~_N_CLUD~ MOOIFICATION THRU: i:Z. PRESENTED FOR f~AY/MEN~ ..........
TOTAL CONTRACT ~ i14-A. PR EV1OUS DEOUCTION~ OTHER THAN R.=TAIN ED PERICEN'I'AGE" ' B. PREVIOUS RETAINEO PERCENTAGE C. PREVIOUSPAYMENTS D. PRE.V IO~S EARN IDIG3
i'121. 670.00
TOTAL EARN iN~ TO DATE
98,716.00
13, APPROVED FOR PAYMENT
E. EARNINGS THIS PERIOD {TOTAL EARNINGS TO DATE MINUS OI
F. LESS R-ETAII,~ED PERCENTAGE G.LE~S O~9UCTION OTHER THA.~ R=.TAINED PERCENTAGE FOR
SIGNATUR~
TITLE
DATE
~-IUSE ~EV~RS~ S10£ ---OR DET,.%[LEO 'EAP,'L;~N aT|O,',I &NO 0"~" R~'&Ax'
Case 1:07-cv-00355-NBF
Document 24-3
Filed 07/30/2008
I t. DATE
Page 8 of 20 10/25/00 SHEET l___o~ l_!---
PAYMENT~ ESTIM;~T.E°U¯ C'ON:~RACT" PERFORMANCE For use of this form, see ER 37-2~10 and ER 37-345-10. CONTRACTOR AND ADDRESS
.~l.l 8tar Iron Works, Inc. PO Box83, Mercedes,TX ?85[70 ~ESCRIPT~ON OF WOR<
I
3. CONTRACT NO.
I
' I6. APPROPR~ATIbN AND PROJECT
I .CS-T-99-24749-6
CONTRACT UNIT PRICE d"e"
TC-T-96-013
Los Indios Outbound Canopy Design "
LOCATION ITEM NO. a
REOuIRE coMPLE 'oN. . .
10. JOB ORDER NO. [I 1. ESTIMATE NO. ~TOTAL TO DATE
9. PERIOD COVERED BY THIS ESTIMATE
FROM 09--16--00 THRU 10--15--00
DESCRIPTION QUANTITY AND UNIT o AMOUNTQUANTITY AND f AMOUNT
g
Design Work Base (Base Canopy) (Refer to Plans & Specs.) Alternate Booth Design (Design) Roadway & Drainage Modification~ Alternate Misting System(Design Bonds
19,900.'00
6,800.00 1,800.00 1,650.00 7,240.00
9,.20"0.00
1oo% lOO% lOO% zoo% lOO% lOO%
19r900.00
6,800.06 1,800.00 1,650.00 7~240,00 9,200.00
,I00.00 240.00 500.00 S151'430"00
OTHER THAN "AGE" B. PREVIOUS RETAINED PERCENTAGE " C. PREVIOUS PAYMENTS
100%
5, i00.00
20,240.00 6z~, 600. O0
100% 81% "
CLUDES ,YEE
TOTAL EARNINGS )-S 136,530.00 TO DATE
10/25/00
Presidez
D. PREVI~IUS EARNINGS (A+B+C) EARNINGS THIS PERIOD {TOTAL EARNINGS TO DATE MINUS D|
99,475.00
13. APPROVED FOR PAYMENT ;ERTIFY that I have Checked the quantities covered by this bill or estimate; that the was actually performed; that the quantities ~re co,'rect and consistent wi=h all procomputations as actually checked; that the quantities and amounts a~'e wholly nsistent with the requirements of the contract or other instrument involved.
,37,055.00
F. LESS RETAINED PERCENTAGE G. LESS DEDUCTION OTHER THAN RETAINED PERCENTAGE FOR " H. TOTAL DEDUCTIONS THIS PERIOD (F+G)
GNATURE
TITLE
DATE
I. RETAINAGE REFUNDED .
J. OTHER REFUNDS K. TOTAL REFUNDS THIS PERIOD
~
G oFFICER APPROVAL (_S.!.gnature) .~ FORM 93 1 MAR 78
DATE
L. AMOUNT DUE CONTRACTOR (E-H+K) 1,5. RECAPITULATION; TOTAL RETAINED PCTG. {B+I=-I) S TOTAL PAID {C+L} S
0 35,2U2.25
PREVIOUS EDITION OF TI41S FORM IS OBSOLETE
¯ "(USE REVERSE SIDE FOR OETAtLED EXPiLANAT|O'N AND-OR REMAR~ "
Case 1:07-cv-00355-NBF
Document 24-3
Filed 07/30/2008
1. DATE
Page 9 of 20
PAYMENT ESTIMATE CONTRACT PERFORMANCE For use of Ihis. lorrn. ~ee ER 37-2-10 and ER 37-345-i0. TRACTOR AND ADDRESS 3, CONTRACT NO.
0/25/00
14" DISTRICT
SHEET lo[ ~
~ Tron Wor~s, Trim- l~O BO~
3RIPTION OF WORK ATION
8.3 Mercedes, TX
....... TO-',,, 1-96-013
6. APPROPRIATION AND PR. OJECT
CS-I-00-23988-9
PERIOD COVERED BY THIS ESTIMATE
[7. REQUIRED COMPEETION DAT'~ t I 10. JOB ORDER NOr tII. ESrIMATENO" TOTAL TO DATE AMOUNT
¯
hts
FR0,,M ,,, i0-I-00 THRU I0--i~.--00
tON .
QUaNTiTY At~O Ur~IT CONTI=IACT UNIT PRICE d
~
Mobilization
Kitchen Cabinets
o Paint Repairs
OUANT'TY AND
. AMOUNTe UNIT
100%
4,8Q0.00 66,020.05 2,200.00 4,8.00.00
10o%
4,800.00
lOO%
100%
~emou~. i i z at i on
lO0%
DES M~DIFIC~ION THRU: -"=< "~" 12. PRESENTED FOR PAYM'ENT I PER TOTAL CONTRACT
j
s 77,.820.05
TOTALEARNINGS~ TO DATE,,
4,800.00
14"A. PREVIOUS DEDUCTIONS OTHER THAN R ~:TAINED P,ERCEf~TAGE ~" B. PREVIOUS RETAINED PERCENTAGE C. PREVIOUS PAYMENTS
0 o
10/25/qo
13. APPROVED FOR PAYMENT "IFY that I have i::heckLL'd the quantitie~ covere"J by this bill or estimate; that the actually perlormed; that the quantitle$ are co:feet and c;3nsi$tent with all preomguta~ion$ as actually" checked; that the cIuanti:|~ and amounts are wholly with lhe r~!uir.".men:.~ DE the contract or other instrument'involv~d.
D. PREVI~3~S EARNINGs {A+B~-CI E.EARNINGS THIS PERIOD EARNINGS TO DATE MINUS F. LESS RETAINED PERCENTAGE " G. LESS DEDUCTION OTHER THAN RETAINED PERCENTAGE FOR H. TOTAL DEDUCTIONS THIS PERIOD IF+G) TITLE DATE I. RETAINAGE REFUNDED J. OTHER REFUNDS K. TOTAL REFUNDS THIS PERIOD L. AMouNT DUE CONTRACTOR {E-H-;-K) ! 5. RECAPITULATION: LrOTAL RETAINEDPCTG. {B4-F-I} S TOTAL PAID IC~-LI
4,800.00
DATE
FORM '93 1 MAR 78
pREVIOUS EDITION OF TI41S FORM IS OBSOLETE
.
..:{.U$~;R~.y.ER$I=.SIDE FOR DETAILED EXPLAN~ATION AND-DR REMAR~ ¯ .
Case 1:07-cv-00355-NBF
Document 24-3
Filed 07/30/2008
Page 10 of 20
PAYMENT ESTIMATE - CONTRACT PER'FORMANCE
For use oI this form, ~e ER 37-2-1{] and ER'37-345-I0. ¯ coNTRACTOR AND ADDRESS
Lll Star Iron Works Inc. P0 Box 83 Mercedes, TX
. DEScRIP.TION OF WORK
'elcom Dam Admin. Bldg. Roof Repairs
LOCATION 9. PERIOD COVERED Bh; THIS ESTIMATE
'aic6n Heights, TX
ITEM
FROM i0-I-00 THRU 10-15-00
QUANTITY AND UNIT c CONTRACT UNIT PB IC.E d AMOUNT e QUANTITY AND UNI'~ f AMOUNT
4,800o00
27,900,00 4,800.00
4,800.'00
27,900.00 4,800.00
100%
4,800.00
CLUDES MODIFICATION THRU: 12. PRESENTED FOR PAYMENT ,YEE PER
TOTAL CONTRACT ~ $
37,500.00
TOTAL EARNIN, GS TO DATE ~-
4, 800 - 00
14"A. PREVIOUS DEDUCTIONS OTHER THAN RETAINED PERCENTAGE." ~ B. PREVIOUS RETAINED PERCENTAGE C. PREVIOUS PAYMENTS
TITLE
10/25/00
Presi
13. APPROVED FOR PAYMENT
D. PREVIbUS EARNINGS {A+B~-C) E.EARNINGS THIS PERIOD (TOTAL EARNINGS TO DATE MINUS D) F. LESS RETAINED PERCENTAGE G. LESS DEDUCTION OTHER THAN RETAINED PERCENTAGE FOR , H~.TOTAL DEDUCTIONS THIS PERIOD {F+G}
.ERTIFY that I have checked the quantities covered by this bill or estimate; that the ,rk was actually performed; that the quantities are co.'rect and consistent with all pre~us computations as actually checked; that the quantities and amounts are wholly lsi~tent wlth lhe r~'.lUJ[ements of the contract or other instrument involved.
TITLE DATE
0
3NATURE
I. RETAINAGE REFUNDED J. OTHER REFUNDS K.TOTAL REFUNDS THIS PERIOD L. AMOUNT.DUE CONTRACTOR (E-H+K) 5. RECAPITULATION: TOTAL RETAINED PCTG. (B+F-I] $ TOTAL PAID (C'tLI S
0 4,560.00
IN.TR,~CTING oFFICER APPROVAL {Signature)
FORM 1 MAR 78
DATE
7
93
FAEVIOUS EDITION OF THIS FORM IS OBSOLETE
¯ "(USE REVERSE sIDE FOR DETAILED E×PI~AN,~TIQN AND-OR RE~,~F~
Case 1:07-cv-00355-NBF
Document 24-3
Filed 07/30/2008
Page 11 of 20
LOS Tomates Outbound Canopy Design
8. LOCATION
:., ,~
|
! CS~I~99--2~7~-0 ."
CONTRACT PRIDE d
iI" 7. REQUIRED COMPLETION DA'T ~ ' "TO. JOB ORDER NO.
'9. PERIOD COVERED BY
I
I l. ESI'IMATE NO
Brownsvil i e, .Texas
NO.
a
ouA~TrrY ~o .....
'UNIT ~=
UN~
' AMOUNT , e ...... .
TOTAL TO DATE QUANTITY AN'D
UNIT AMOUNT g
i
Design Work (Base Canopy)
(Refer to plans & specs.) Alternate Booth Design Roadway & Drainage. Design Alternate Misting System (Design. Payment & Performance Bonds Mobilization
~9,900.0C
100
100%
19,900.00~
lbO~
lOO% lOO%
100%
6,800..0C
.~1,800.0C
11,650.0C
~o~
6,800.00
1,800.00
1,650.00
7,240.0C
i00%. 100%
7,240,00
Rebar
Structural Steel
"9,650.0[
5,400.0[
78,800=0[
100%
85%
TOTAL EAFININGS ,T,O,,,DAT,~,,~ . _ ~ s
9,050.00
g~90.O0
63.,040.0~
.......... ...... THRU:
130,.640,Q.['
~OTALCONTRACT--------}~
$ RETAINED PERCENTAGE
114,070.00
PRESENTED FOR PAYMENT
0/25100
~,~ --
'
¯~ ~
/ /
, ....... . ........
O. PREVIOUS EARNINGS {A~B~CI E. EAFININGS T~I~";EBtOD 'TOTAL EARNINGS TO DATE MINUS D, F. L-=SS RETAINED PERCENTAGE G. LE~S DEDUC'~ION OT~a THAN ~ETAINED PERCENTAGE FOR Ho TOTAL DEDUCTIONS THIS P-=RII:3~
13. APPROVED FOR PAYMENT CERTIFY that I have checked -~Se quantities covered by this bill ot estimaP; that the
SIGNATURE
TITLE
DATE
I. FIr'TAINAGE FI=~FUNDED ' " ~'.ToTAL REFUNDS T~'IS PERIOO L, AMOUNT OU£ CONTRACTOR I"3. R~.CAPiTuL'ATION : ............
'.. 7/2 RET 'I E +-,, ......
TOTAl PAID (C*Li S
Case 1:07-cv-00355-NBF
Document 24-3
Filed 07/30/2008
Page 12 of 20
LOCATION
9. PERIOD COVERED BY THIS ESTIMATE
. JOB ORDER NO,
11 ESTIMATE NO.
Fal6on
FROM .] n!1 6!nn THRU
¯ DUANTi'TY AND UN IT l:: CONTRACT " UNIT PR ICE d" TOTAL TO DATE AMOUNT
oU'kNTiTY AND UNIT f
AMOUNT g
Mobilization
Roof Repairs 2.1 Materials
100% 100% 100% .100%
4,800.00 16,140.00 11,760.00
,100%
4,800;00 12,912.00
2.2 Labor
~SO%
3
Demobilization.
4,800.00
TOTAL EARNINGS
JiNCLUDES MODIFICATION THRU: ' 12. PRESENTED FOR' PA'YMENT PAYEE
PER
TOTAL CONTRACT 14"A. PREVIOUS DEDUCTIONS OTHER THAN ' RETAINED PERCENTAGE"" B. PREVIOUS RETAINED PERCENTAGE
PREVIOUS PAYMENTS
TODATE :
~ ~
17,_712.00...
-
:::::::::::::::::::::::::::::::::
DATE
D. PREVIOUS EARNINGS
1~I/30/00
.................... President
APPROVED FOR PAYMENT
E. EARNINGS THIS PERIOD (TOTAL EARNINGS TO DATE MINUS DI
il ERTIFY that I I~ave che=:ked the quantities covered by =his bill or es:im~e- that th4 work Was actually peHormed; that the ~antltles are ~:r~£ and consistent wi~h all pre'vlous :om~utati~n~ ~ ~ually :hacked; Ihar Ihe quantities and amounts are wholly constant with ~he r~uff~ents of the :ont~c~ or o~her inst~ment involved.
G. RETAINED PERCENTAGE .OR L=.~s DEDUCT,ON OT.ER
H. TOT~,L DEDUCTIONS THIS PERIOD (F 1." REV;I~AG'~ ..... R£FUND£D J. OTHER REFUNDS K. TOTAL REFUNDS THIS PER lOO L. AMOUNT DUE CONTBACTOB RECAPITULATION: '
sIGNATURE
TITLE
.DATE
CONTACTING OF ICER APPROVAL
,TO:FAL RET_AIN.E_D__P~CT_G. (B~+F-') S~
TOTAL ,PAID {C÷LI S
ENG I FORM 93 MAR 7S
Case 1:07-cv-00355-NBF All"Star Iron W6#ks,
Document 24-3
Filed 07/30/2008
Page 13 of 20
" 7. REQUIRED COMPLEi'ION DAT : ">._': ....... ::~...-,:. .,: -. .... : -, : ..'. 2_'3:~. 10. JOB ORDER NO.'' "!', ESTIMATE NO. TOTAL TO DAT~
e. APPHOPRIATION AND PROJECT .--.." ~-~;
B & M Out,bound
Can~p.y Design ..:. ,-::---~
¯ :.'.~'..-~ ; ~, ..
~.. LbCA.TION-- '
- ITEM
~. e~'~iO~,.COVEREO"~ T.,S EST,MA'~E
FRO,. 9/,~0/,,00
QUANTITY AND UN IT CONTRACT UNiT PR i.C.~
CS-I-'99'- 24748- 8
Brownsv~l-le, Texas
THRU 1 I/.15/00
AMOUNT e
NO:
...... 6UA~TITY AND ..........
UNIT !
d
AMOUNT g
100%
2
DESIGN WORK(Traffic Study)
lOO%
9 ii,000.00 8,568.00
65%
100%
12,935.00.
8,568.00.
..... ,==-MOOIlf= ICATION THRU: 12. PRESENTED FOR PAYMENT" 'AYEE
TOTAL CONTRACT
S27,568.00
" TOTAIL EARNINGs TO DATE , ~,
$21.,503.00 _
1 i 980, .'00
,ATE
"~/30/00
. Presiden~
13. APPROVED FOR PAYMENT
O. PREVIOUS EARNINGS (A+EI~C) E. EARNINGS, THIS PERIOD |TOTAL EARNINGS TQ DATE MINUS D] F. LESS RETAINED PERCENTAGE G. LESS DEDUCTION OTHER T~"AN RETAINED PERCENTAGE FOR H. TOTAL DEDUCTIONS THIS ~ERIOD {F+Gi
::::::::::>:-:.';.'.'.'.::-.v.-.:::- ¯.....,-, ~ :::;;;-" ........
98o.,oo
!9,523.00
CERTIFY that ! have checked the quantities cove~ed by this bill or es¢imate; that the fork was actually Flerf°rme¢l; that the quantities are I;;o:re~t and ¢ons|stent wlth all preious corriputa~ion~ as actually c~eck~l; that the quantities and amounts are wholly ~nsi~tent with the ¢equirement~ o! Ihe contract or other instrument involved. TITLE
"
IGNATURE
DA %=
!. R-=TAINAGE REFUNDED .... K. TOTAL REFUNDS THIS PERIOD
~FICER APPROVAL {Signature}
DATE
L. AMOUNT DUE CONTRACTOR 15. RECAPITULATION: TOTAL RETAINED PCTG.'{B+F-I}" S TOTAL PAID (C+LI S
FoRM 93 ENG ~ .MAR 7s
Case 1:07-cv-00355-NBF
Document 24-3
Filed 07/30/2008
Page 14 of 20
'' ....
."
3. CONTRACT NO.
4. DISTRICT -¯ 7. REQUIRED COMPL~_T, ION DA'f
Mercedes, TX78570
TC-I-96-013
' 6. ~PPROPRIAT|ON AND i=ROJ~CT -
"C8-I.99.2474:q~0
PERIOD C0VERED"~' THIS ESTIMATE "
"" "" : . ".i ":.'.;'~:':.-', .":
10. JOB ORDER NO. ' 1 I, ESTIMATE NO. TOTAL TO DAT~ QUANTITy AND AMouNT UNIT
~SOM ~0i16/00 ..... THOU 1!/!5/00.
CO~RACT UNIT ¯c PRIqE d AMOUNT e
19,900-00
IO'ON .... I~", 900. O0 100% 100% o-~
2
(Refer to plans & specs.) Alternate Booth Design
100%
Roadway & Drainage .Design
Al~ernate Misting System (Design] Paymen.t & Performance Bonds
lO0% lOO%
100% 100%
6,BO0.O0 1,800.00 1,650.00
7,240.00
6,800.00
I.,800.00
1,650.00
7,240-00
100% rm
100% ~
Mobilization
9,0~0.00
~7 8 9 ~0
Refer Structural Steel .Mech~n~c~l-~V/AC (Booth Only)
I Inspection Booth
i,
PER
~oo% zoo% 1o0% ~oo%
TOTAL CONTRACT
5,400.00 78,800.00
3,602.00 12,607.00
B5~
~0,%
9,050.00
4,590.00
25% ¯ ~
~ ~
63,040.00
90Q.00 10,806.00
....... T6TAL EiRN IN~S
~CLUOES MOD~IFICATigN THRU:
$ 146,84.9-9~
TOO,,ATE,,,,- ~ ,,,,
~;s125,776.50~
14"A. PREVIOUS DEDUCTIONS OTHER THAN RETAINED PERCENTAGE""
REV'Ous PA ' NTS , ,,
ATE / D. PREVIO~S EARNINGS {A+B+CI
~.~'3o/oo .... os~aen~ ..
13. APPROVED FOR PAYMENT
~I I[
ll4,OTO.nn
E. EARNINGS THI$'PEBIOD |TOTi~ ¯ EARNINGS TO DATE MINUS D) F. LESS RETAINED PERCENTAGE RETAINED FERCENTAGE FOR H. TOTAL DEDUCTIONS THIS PERIOD (F+G|
CERTIFY =hat I have checked lhe quantities covere~ by this bill or estimate: that the o~k w~s ~:tually performed; that the quantities are ~o;re~t and consistent with ~11 ous ~mputallanS ~ ~:ually checked; that the qu~nti~ies and amounts are wholly ,mlsten~ ~th Ihe requlr~ents of the contract or other inR~ument DATE
S GNATURE
~rlTLE
L RETAINAGE REFUNDED ..... K:ToTAL REFUNDS I'HIS FER 16'0 15. RECAF~ULATION: TOTAL RETAINED PCTG. JR+F-I)
NTR/
Case 1:07-cv-00355-NBF
Document 24-3
Filed 07/30/2008
Page 15 of 20
-" - : ::-'- ~i--~.~:t~Z.~". :::-:. ¯ ..,.-.,°: ¯ ¯ .. ..... : " ¯ ¯ 6. APPROPRIATION AND PROJECT : " ,"~ ¯ , 7. REQUIRED COMPLE'~I6N'{ g. PERIOD COVERED BY THIS ESTIMATE FROM!O,/1 6/00
~R-T,-9~,,--25600-1 - :. "
JOB ORDER NO.
LOCA.TiON ITEM NO.
THRU 11/15/00
CONTRACT UN IT AMOUNT
h I.
ESTIMATE N(
DESCR IPTION b
~NYi ~Y
UNc,T
TOTAL TO DATE QUANTITY AND UNIT AMOUNT ~ g
1
DESIGN WORK (BASE CANOPY)
lOO%
I00~
!?~668-80
100~
17,668.8
6,400,0 "1,650.0 8,586.0
2 3 4
(REFER TO PLANS & SPECS,) ALTERNATE BOOTH DESIGN
ALTERNATE MISTING SYSTEM DESIGN woEK (traffic study)
6,400 /1#650.00 8,568.00
lOO%
100% 100%
TOTAL EARNINGS FICATION THRU: 12. PRESENTED FOR PAYMENT
TOTAL CONTRACT
~ S 34.,..286°80 TO DATE
~ S34,286.80
14"A- . PREVIOUS. DEDUCTIONS OTHER THAN RETAINED PERCENTAGE"" B, PREVIOUS RETAINED PERCENTAGE " C. PREVIOUS PAYMENTS
24,432.86 '432,86 853-94
)ATE
11/30_]/00
O. PREVIOI~$ EARNINGS {A+B÷C|. E. EARNINGS THIS PERIOD {TOTAL EARNINGS TO DATE MINUS D| F. L=.SS RETAINED PERCENTAGE G. LESS DEDUCTION OTHER THAN . RETAINED PERCENTAGE FOR H. TOTAL DEDUCTIONS THIS PERIOD (F+G)
IGNATURE
I. R.=TAINAGE REFUNDED J. OTHER REFUNDS " K. TOTAL REFUNDS THIS PER IOD APPROVAL {Signature} L. AMOUNT DUE CONTRACTOR IE-H+KI RECAPITULATION: TOTAL RETAINED PCTG. (B+F-I) S TOTAL PArD {C~LI S
Case 1:07-cv-00355-NBF
¯
Document 24-3
;
Filed 07/30/2008
Page 16 of 20 12/26/00
I
PAYMENT ESI'IMAtE -. CONTRAC] PERFORMANCE
For use o! this lotto, se~ ER :37-~.lO,and ER 37-345-10.
t
TC-1-96-013
{!: DA]'E
1
¯
!SHEET .. _o[ 1
Mercedes TX 785~0
~CAT;ON
"
1 3.'CONTRACT NO. " .
/'8. APPROPRI,~TION AND PROJECT 7. REQUIRED COMPLETION DARE
|, CS'I-98-25600-I
.... [9. PEI~IOD' COVERED ]ElY ~HIS ESTIMATE FROM ~1/16/00 THRU i2/15/00 DESCRIPTION b. QUANTI~Y AND UNIT CONTRAC+ UNIT PRiqE d
!~
IO. JOB ORDER NO;
.,o
IT.l,
I
ESTIMATE NO.
5
AMOUNT e
TOTAL TO DATE QUANTITY AND UNIT AMOUNT f. g
DESIGN WORK (BASE CANOPY)
(REFER TO PLANS & SPECS.) ALTERNATE BOOTH DESIGN
ALTERNATE MIS~ING SYSTEM (DESIGN DESIGN WORK (TRAFFIC STUDY
lOO%
100%
17,668-80 6,400.00
lOO%
lOO% 100% ~oo% 100% 100%
17~668.80
6,400.00
lOO%
PAYMENT & PERFORMANCE BONDS
10o% 100%
1,650.00 8,568.00 7,680.00
650 ¯ 00 b
MOBILIZATION
lOO%
9,500°00
6B¢.. oo
o5oo
,'
~
TOTALEARNING~
;LUDES MODIFICATION THRU: 12. PRESENTED FOR PAYMENT
TOTAL CONTRAC1~ ~
>
S52,006.80
-0286. BO '
r,,,,,,~ . ..~
14"A. PREVIOUS DEDUCTIONS OTHER THAN RETAINED PERCENTAGE"" B. PREVIous RETAINED PERCENTAGE C. PREVIOUS PAYMENTS¯
:::::::::::::::::::::::::::::::::::::::: ¯ -;'-::,;:-:-:-'. : : .:;'.':~',',v
12/26/00
13: APPROVED FOR PAYMENT
ERTIFY tha~ I have checked the quantities covered IW this bill or" estimate; that the rk w-as ectually perlormed: that the quantities are co.'trust and consistent wish all pre,u~ computations as ~tually check~d; that the qUanlilies and'amounls are wholly ~sistent with the requi~on=s of the c0n~ract o[ o~her in, tureen{ involved. TITLE I~ATE
D. PREVIOUS EARNINGS E. EARNINGS THIS PERIOD {TOTAL EARNINGS TO DATE MINUS F. LESS RETAI~ED PERCENTAGE G. LESS DEDUCTION OTHER THAN RETAINED PERCENTAGE FOR H. TOTAL DEDUCTIONS THIS PERIOD (.F +G} RRF, _ n~
34,286.80
. 17,720.00
886.00
3NATURE
I. RETAINAGE REFUNDED J. OTHER REFUNDS K.TOTAL REFUNDS THIS PERIOD L. AMOUNT DUE CONTRACTOR {E-H+K.} RECAPITULATI.ON : TOTAL RETAINED
~°00
)NTRACTING oFFICER APPROVAL {S~gna{Ur~}
Case 1:07-cv-00355-NBF
'"
i~, cO~NTRACTOR AND ADDRESS
Document 24-3
Filed 07/30/2008
Page 17 of 20
I~/26/00
PAYMENT ESTIMATE - CONTRACT PERFORMANCE
Fr~r use of Ihls form, see ER 37-2-10 ~nd ER 37-345-10, " " S.'CONTRACT NO.
I
~. DATE
1 1 SHEET __a[
~ AlL. Star Iron Works, Inc.-P.0. Box 83 Mercedes, TX TC-I~96-013 6. APPROPRIATION AND PROJECT s. DESCRIPTIO~ OF We~k'. .......... 0S-I-00-2398B-9 Falcon heights HOusing Repalrs&
9. PERIOD COVERED B~"THlS ESTIMATE .......
...... i 7. REQUIRED Co~'PL'~TiO{4 D~T E 10. JOB ORDEi~ NO. 11. ~IMAT'E NO';
FROMI0/I 6/00 THRU 12/15/00
ITEM
2
TOTAL ~O DATE ..... QUANTIT~ AND ' ........ UNIT AMOUNT g
NO.
DESCRIPTION b
'
CONTRAC'~ OOANTI~f'""~ND .... " UNIT UNIT PRIC.E c
AMOUNT
100%.
4,800.00
66,020-05
4~B00.00
2
Kitchen Cabinets
} int Repairs
Demobilization
>3
lOO% lOO% 100%
29,709.00.
~'"' .: 3. "?
2,2oo.oo
o
.......................~ ~,~ ~ ~ ~.[~~
.,o
-
4, BOO" O0
.
t'-3
;~ ~ ' '3"'~:/~.
~:~ ' t.~-.~ ~ "~-~,~';~ ~ ~, ~ ~: INCLUDES MODI =ICATION THRU: 12. PRESENTED FORpER PAYMENT 14rA" TOTAL EARNINGS ~ TOTAl. CONTRACT ~ S77 t 820 - 05 TO DATE °OTHER" THAN RETAINEDPREVIOUS DEDUCTIONSp~RCENTAGE
~s34,509. DO
Ti~L~ 7~/-. v -- /
D. PREVIOUS EARNINGS IA~'B÷C}
work w~ actually ; )erformed; that the ~an{ities ~re co. r~l and consistent wl{h'all provioUS c~mputat~ons as ~:lu~lly checked; that lhe qua~litJee and amounts are wholly :onsisten{ wlth the ~equi{ements ol the contract or other instrument involved. DATE
" F. LESS RSTAINED PERCENTAGE
sIGNATURE
TITLE
CONTiR.~CTING OFFICER APPROVAL (SignatureI
1:5. RECAPITULATION: TOTAL RETAINED PCT~:.
-'",,.,./4--"
Case 1:07-cv-00355-NBF
Document 24-3
" "
Filed 07/30/2008
Page 18 of 20
I
[4, DISTRICT i ~. REQUIRED COMPLETION bATh
PAYMENT ESIIMATE -- CONTRACT PERFORMANCE
For usa of th~s Iornl. see ER 37-2-1D and ER 37-345-10.
Iron Works, Inc~-P~O. BOx 83
5. DESCFIlPTION OF WO'~K ..... ;'' "
Mercedes, TX
¯ ~ C~NTRACT NO.
, II:DATE 12/27/00'
I
1
1
TC-I-96-013 CS-I-00-23554-9
B~' APPR0'I;'hlATION AND PROJECT
Falcom am Admin. Bldg. FaleDn eights, Texas
Roof Repairs
~ LdcAT'ON
9. PERIOD O~ERED BY THIS ESTIMATE
11./16/0.0 THRU 12/15/00
CONTRACT QUANTITY AND UN IT
OESGR IPTION b
.... bNiT
PRIC.E
AMOUNT
d
TOTAL TO DATE OU~N~ITY AND UNI~ AMOUNT ~f -g .:.
¯Mobilization of Repairs
2.1 Materials 2.2 Labor mobilization
100%
4,800.00
16,140.00 IL~760.00
I00~
4,800.00
O0 oo
10o%
90%
lOO%
100%
90%
~.;.800.00
INCLUDES MObil :_ICATION THRU: .......... 1,,.~. PRESENTED FOR PAYMENT ......14"AI PREVIOUS DEDucTioNS OTHER THAN ~AYEE PER B.'PREVIOUS RETAINED PERCENTAGE
TOTAL CONTRACT ~ S37" 500. O0
~29 ,"~I 0. O0
R TA,NED ERCENTAGE'"
~',:,-":O:.7-: ' "":"~>;':-:-3: ; Z ;
C, PREV:iOUS PAYMENTS
12~ Z7/00
President
~3. APPROVED FOR PAYMENT
¯ D. PREVIOUS EARNINGS (A+B~CI E.EARNINGS THiS PERIOD (TOTAL EARNINGS TO DATE MINUS D} F. LESS RETAINED PERCENTAGE G. LESS DEDUCTION OTHER THAN RETAINED PERCENTAGE FOR H. TOTAL DEDUCTION~J THIS'PERIOD (F+G!
17,712.00
12,198.00
I cERTIFY that ! I" ave check.=d the quantities covered by this bill or estim,ate; that the work was actually I: erlormed; that the quantities a~a {:~;rL, ct and consistent with all previous ~,omputatlona as actually checked; that the quantities and amounts are wholly conslsIent whh the requirements o# the contracl or ozher instrument involved. TITLE DATE
;IGNATURE
. I. ,RETA1NAG. E REFUNDED J. OTHER REFUNDS K. TOTAL RE~'UNDS THIS PERIOD " -- 0-:::::::::::::::::::::::::::::::::::::::::::::::::::::: .......... TOTAL P~ID {C-~LI -~ L. AMOUNT DUE CQNTRACTOR 15. R ~CAPh'ULA~IpN : ~ TOTAL RETAINED PCTG. (B .'-F-I}
CO~A CTi N~6--6 FI~ ICE R'"APPRO V A L {Signa,ure}
Case 1:07-cv-00355-NBF
2. coMTF~ACTOF1 AND ADDRESS ~N OF WORK
Document 24-3
Filed 07/30/2008
3. ~ONTRACT NO,
Page 19 of 20
DISTRICT REQUIRED COMPLETION DA 10. JO'B ORDER NO. [ 1 I. ES IIMAz~E NO. TOTAL TO DATE QUANTITY AND UN IT ANiOUNT [ g
For use o! ~,hi~ form. see ER 37-2.10 and ER 37-34S-I0.
ALL STAR IRON WORKS, INC. P.O. BOX 83 MERCEDES , TX 78570
TC-I-96-01 3
6. APPROPRIATION AND PROJECT
~ALCON D___~M AD,MIN.
8". LocATION
BLD~-. RoqF REPAIRS
_.
CS~I-00-23554-9
9. PERIOD COVERED BY THIS ESTIMATE FROM THRU01/15/01
. FALC,,ON~T_~m.q ..
ITEM NO.
a
m~A~
I~/16/00
CONTRACT DESCRIPTION b
QUANTIT~ AND
UNIT c
UNI~
PRIGE d AMOUNT
2
MOBILIZATION ROOF REPAIRS 2.1 MATERIALS 2.2 LABOR. DEMOBILIZATION
100% 100% 100%
4,800.00
lOO%
.4,800 .00,
lO0%
16,14000 11,760.00 4,800.00
100%
100%
16,140 .0o
11,760 .oo 4,800 .00
100%
IN.__CLUDES MODIFICATION THRU: 12. PRESENTED FOR PAYMENT =AYEE PER . .
TOTAL CONTRACT --'---'---)" S 37,500.0
14"A. PREVIOUS DEDUCTIONS OTHER THAN RETAINED P.ERCENTAGE" " S. PREVIOUS RETAINED PERCENTAGE "C/PREVIOUS PAYMENTS
TOTA:L EARN INGS TO DATE
> s37,500 .00
)ATE 01/24/01
~{TITLE//"
I"
.
D. PREVIOUS EARNINGS (A+B÷C} E. EARNINGS THIS PERIOD ,{TOTAL EARNINGS TO DATE MINUS D} F. LESS RETAINED PERCENTAGE G. LESS DEDUCTION OTHER THAN RETAINED PERCENTAGE FOR H. TOTAL DEDUCTIONS THIS PERIOD IF+G}
I PRESIDENT
13. APPROVED FOR PAYMENT t CERTIFY that I have checked the quantities covered by this bill or estimate; that [he. work was actually partormed; [hat the'quantities are ~o;rec[ and consistent v~kh al! previous computations as ~[ually checked; thin the quandde%and amoums ~re wholly consistent with ~he requirements ol the contract or o~her ms~fu~en6 mvoLved. ¯ .. .¯
29,300.10
SIGNATURE
TITLE
"~'"-'
DATE
I.r'RETAINAGE REFUNDED J. OTNER REFUNDS K. TOTAL REFUNDS THIS PERIOD
CONTFIACTING OFFICER APPROVAL {Signature)
DATE
'1 L. AMOUNT DUE CONTRACTOR 15. RECAPITULATION: TOTAL RETAINED PCTG.'(B÷F-I} S
FOR~J ENG ~ MAR 78 ~3
PRE,VIOUS ED T ON OF: THIS FORM IS OBSOLETE
¯ "{USE REVERSE SIDE FOR DET~,ILED EXPL.~,N~'TION AND-OR REMA~:
Case 1:07-cv-00355-NBF
Document 24-3
Filed 07/30/2008
3. CONTRACT NO. -
Page 20 of 20
01/24/01 . tSHEET ~..L_o, ~ 4. a~SiRiCT
For use o! this IotaL ~ea ER 37-2-10 and ER 3"/.345-10.
2. CONTm~CTO~ A~D ADDRESS ALL STAR IRON WORKS, .]'NO.
P.O. BOX 83
MERCEDES, TX78570
~C-I-96-013
6. APPROPRIATION AND PROJECT
5. OESCR'~PT~O-~-OF WOR~< ..............
, 7. REQUIRED COMPLETION' Oi',,
FALCON ~_TGHT~. HOU.S_TNG REPAIRS
#~ LOCATION
CS'I-00'23988-9
9. PERI'0D ~OVER~D ~Y THIS ESTIIVlATE ....... ' 10."'JO8 ORDER NO. ! l |.' ES'rlMA]~E' NO.
FALCON HEI.GHTS, TEXAS .......
ITEM NO. DESCRIPTION b
3 ~ROMI 2/,I 6/0 0 ....... T~,'~,, 01 / 15/01
QUANTITY AND UNIT CONTRACT UNIT PRICE d AMOUNT TOTAL TO DATE QUANTITY AND ;UNIT AMOUNT
a
1 2 3 4
i MOBILIZAT.ION IKITCHEN CABINETS PAINT REPAIRS DEMOBILIZATION
10o%
100%
~o0%
.100%
4~800~;00 66,020.05 2,200.00 4,800.00
100%
55%
4,800.00
36,311 -00
500.00
TOTAL EARNINGS INCLUDES MODIF:ICATION THRU: 12. PRESENTEC)FOR PAYMENT PER ~AYEE TOTAL CONTRACT ~ $ "7 ?, 8
20¯05
TO DA~E ..... .
>- s
41,611.00
i 14"A. PREVIOUS DEDUCTIONS OTHER THAN RETAINED PERCENTAGE" B. PREVIOUS RETAINED PERCENTAGE
:., .v.-.v,..-.........r.:-'-v.',"
c. PREV,OUS PAYMEN'~ .......
01/24/01
............
PW ~..q TDENT
13. APPROVED FOR PAYMENT
,,
D. PREVIOUS EARNINGS {A+B÷C) E. EARNINGS THIS PERIOD (TOTAL EARNINGS TO DATE MINUS D} LESS RE[AINED PERCENTAGE G. LESS DEDUCTION OTHER THAN RETAINED PERCENTAGE FOR H. TOTAL DEDUCTIONS THIS PERIOD - ,.-.~.-,~,,,.......-...-.-...-..,.,-,~
CERTIFY tl~a~ I have checked the quantities covered by this bill or estimate; lhat Work was actually t~erforrned; that ~he quanti~ies are ¢o.'rect and consistent whh all p~avious computatlon~ as actually checked; that lhe quantities and amounts are wholly consistenl wi~h Iha requite.ments of the contract or other instrument involved.
¯ ,'.'.-. ......."-',v,',,.'.~.-..'-:.'.'-'.'.v
7, I 01 . 5
SIGNATURE
TITLE
DATE
I. RETAINAGE REFUNDED J. OTHER REFUNDS K. TOTAL REFUNDS THIS PERIOD L. AMOUNT DUE coNTRAcTOR
CON,2-;~ACTI NG: O--~ F I~ 1/ ISigna][ura}
DATE TOTAL RETAINEDPCTG. IB~-F-I) S TOTA~LPAID IC÷L}S
FORM MAR 78
PREVIOUS EDITION OF TIllS FORM IS.OBSOLETE
"'[USE REVERSE SIDE FOR DETAILED EXPL-~NATION