R2009-204 ACCEPTING THE BID AND AUTHORIZING CONTRACT

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' AFFIDAVIT OF CLAIM State of Alabama COU11ty Of �TPffPrGnn j� T.V. Cwynar , the Director Corporate pf U.S. Pipe and Foundrv Co� , LLC Credit located at 3300 First Avenue North , on behalf of said firm, hereby state underoath that: Birmingham, AL 35222 1) Claimant furnished, sold and delivered D �� i 1 Tron Pi ne F� ArrPscnri ac to Atlas Excavating, Inc betweenthe dates of January 5. 2010 and November 24,201�or the COnstruCtiOn Of M.L. Kin� Watermain Replacement in accordance with a Subcontract, Purchase Order or Rental Agreement (hereinafter Contract) dated November 3 L 2009 , a complete copy of which is attached hereto. Verbal change orders are not included. 2) Claimant last furnished labor and/or materials on November 24. 2010 , & credits 3) The agreed price of the contract including approved change orders, vr�as � 1,373,093.18 of which $ 1,192,175.09 has bee� earned. The amount paid to date is $ 946,435.22 , Ieaving an amount due of $ �5,994.46 . 4) Copies of all supporting documentation for the Claim including, but not limited to progress estimates, invoices and signed delivery tickets, as applicable, along with a statement of account supporting the Claims is attached or has been provided. 5) Claimant has delivered notice(s) of said Claim by Registered/Certified Mail, if applicable, to Surety, Contractor, Owner. 6) Copies of all required notices and proof of their receipt are attached hereto or have been previously provided. 7) Claimant certifies that there are no just credits, offsets, assignments, liens or encumbrances against the Claim and that Claimant has fully paid all firms or persons supplying labor, material or equipment to or for the project except 8) Claimant certifies that it is properly licensed •as evidenced by License No. , which was issued by the State of and that said license was in effect for the entire period of Claimant's performance of its Contract. 9) Claimant certifies that it has fully performed its duties under the Contract, including the delivery of all required closeout documents, warranties, as-built drawings and 08cM manuals, with the exception of: , 10) Claimant confirms that all guarantees and warranties required under the terms of the aforesaid Contract pertaining to the work, labor and/or materials furnished by the undersigned shall remain in full force and effect in accordance with their terms which, however, shall not be extended nor enlarged hereby. I IIIIII IIIII III�IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII II III IIIII IIIII IIIII IIIII IIII IIII *00-00031378005079*