Art3_SanBernardino_FY19_Transit_Accessibility_Inv Supporting DocsINVOICE#
457
PROJECT
BILL TO
City of San Bernardino PW
Attn: Donna Puentes
290 North D St.
San Bernardino, CA 92401
DATE
08/19/2020
Citywide Bus Stop Improvements
DATE ACTIVITY
02Site Work
02 Site Work
02Site Work
02Site Work
02Site Work
02 Site Work
02 Site Work
02Site Work
Retention
Thank you!
TOTAL DUE
$55,936.00
DESCRIPTION
Mobilization
Traffic Control
DUE DATE
09/18/2020
Clearing & Grubbing, Unclassified
Excavation & Unclassified Fill
SWPPP
Construct Sidewalk, Per City
Standard No. 202
Construct ADA Driveway Bypass
Per City Standard No. 204
Construct Bus Door Landing Area
Per Standard Plans for Public
Works Construction
Construct PCC Bus pad per
Standard Plans for Public Works
Construction 131 -2
Amount of Retainage 5%
BALANCE DUE
TERMS
Net 30
QTY
1
1,300
150
105
960
Invoice
ENCLOSED
RATE AMOUNT
6,200.00 6,200.00
1,600.00 1,600.00
5,800.00 5,800.00
1,400.00 1,400.00
8.00 10,400.00
40.00 6,000.00
88.00 9,240.00
19.00 18,240.00
-2,944.00 -2,944.00
$55,936.00
CONDITIONAL WAIVER AND RELEASE ON PROGRESS PAYMENT
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 SATISFIED THAT
THE CLAIMANT HAS RECEIVED PAYMENT.
Identifying Information
Name of Claimant: Tryco General Engineering
Name of Customer: City of San Bernardino
Job Location: Citywide Bus Stop Improvements Project 13375
Owner: City of San Bernardino
Through Date: 08/19/2020
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: City of San Bernardino
Amount of Check: $ 55,936.00
Check Payable to: Tryco General Engineering
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: IJ It"
Amount( s) of unpaid progress -p-ay_m_e_n_t_( s-) :-$-=--=--=-���-:At::-:_-:_-:_-:_-:_-:_-:_-:_-:_-:_-:_-:_-:_-=_-=_-= (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:
Date of Signature: 08/19/2020
7 /1 /12
en City G>f San Bernardino ::,-City' Hall -5· · 290 ND St d SAN BERNARDINO, CA 92401
VENDOR6136 -TRYCO GENERAL ENGINEERING
TRYCO GENERAL ENGINEERING PO BOX 391 RIM FOREST, CA 92378
REFERENCE # 2020-98
QUANTITY DESCRIPTION
1.0000 Each CONSTRUCTION
CIJ
-I0
City of San Bernardino City Hall Purchase Order
No. 2021-00000362 290 ND St SAN BERNARDINO, CA 92401 DATE 09/21/2020
PURCHASE ORDER NUMBER MUST APPEAR ON ALL INVOICES,
SHIPPERS, BILL OF LADING AND CORRESPONDENCE
DELIVER BY SHIP VIA FREIGHT TERMS PAGE 1 of1 ORIGINATOR: Kaarla Selva
BUYER: Vanessa Slouka EMAIL: PURCHASING@SBCITY.ORG PHONE: 909-384-5086
UNIT COST TOTAL COST
26,936.0000 $26,936.00 123-160-8778*5504 -Construction 26,936.00
1.0000 Each CONSTRUCTION 35,994.1200 $35,994.12 129-160-8778*5504-Construction 35,994.12
TOTAL DUE $62,930.12
THIS P.O. IS SUBJECT TO TERMS AND CONDITIONS @ WWW.SBCITY.ORG/TCS
Special Instructions
VENDOR ACKNOWLEDGEMENT PURCHASING MANAGER
5691 Baseline @ Sepulveda
54 9th St @ Medical Center