Cherry Hills Facilities lmprovements-Ph 1
ctP 23-13
APPENDlX 4
CLOSE-OUT DOCUMENTS
4-l
Cherry Hills Facilities lmprovements-Ph 1
ctP 23-13
CONTRACTOR'S AFFIDAVIT OF PAYMENT
To All Whom lt May Concern:
WHEREAS, the undersigned has been contracted by the City of Menifee to furnish labor and materials for Cherry Hills Facilities lmprovements-Ph 1 , CIP No. 23-13, under a contract dated the 28 day q1 July 2025, in the City of Menifee, County of Riverside, State of California, of which City of Menifee is the Owner.
NOW, THEREFORE, th iS day 61 July 202q the
undersigned, as the Contractor for the above-named Contract pursuant to the Conditions of the Contract hereby certifies that, except as listed below, he has paid in full or has otherwise satisfied all obligations for all materials and equipment furnished, for all work, labor, and services performed, and for all known indebtedness an d claims aga inst the Contractor for damages a rising in any manner in connection with the performance of the Contract referenced above for which the Owner or his property might in anyway be held responsible.
EXCEPTIONS: (lf none, write "None". lf required by the Owner, the Contractor shallfurnish bond satisfactory to the Owner for each exception.)
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t 7-28 S Us< s.-- 7-28
Signature of Prime Contractor
Shrenik Vora / President
Date Signature of Prime Contractor
Siddharth Vora / Secretary
Date
Print name and title Print name and title
(lf the Prime Controctor is a corporotion two signotures of corporote officers ore requircd.) 4-5
Cherry H ills Facilities lm provements-Ph L
crP 23-13
CONTRACTOR'S CERTIFICATION OF COMPLETION
np17. 712812025
TO: City of Menifee
29844 Ha un Rd
Menifee, Ca liforn ia 92586
pg6y. lntegrated Demolition and Remediation lncoporated (Firm or Corporation )
PROJECT: Cherry Hills Facilities lmprovements-Ph1 - CIP No.23-13 This is to certify that l, acting as an authorized official of the above stated firm or corporation, have been properly authorized by said firm or corporation to sign the following statements pertaining to the subject contract:
1. I know, of my own personal knowledge, and do hereby certify, that the work of the contract described above has been performed, and materials used and installed in every particular, in accordance with, and in conformity to, the contract drawings and specifications.
2. The contract work is now complete in all parts and requirements, and ready for your final inspection.
3. I understand and agree that neither the determination by the Owner that the work is complete, nor the acceptance thereof by the Owner, shall operate as a bar to claim against the Contractor under the terms of the guarantee provisions of the contract documents.
I U*qt^-
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C
Signature of Prime Contractor
Siddharth Vora / Secretary
Signature of Prime Contractor
Shrenik Vora / President
4-2
Print name and title Print name and title
(lf the Prime Controctor is o corporotion two signotures of corporote officers ore required.) Cherry Hills Facilities lm provements-Ph 1
ctP 23-13
CONTRACTOR'S AFFIDAVIT OF DISPOSAL
WHEREAS, on the 28 day o1 J uly 2025 , the undersigned entered into and executed a contract with City of Menifee for Cherry Hills Facilities lmprovements-Phl as partlcularly described in said contract and identified as CIP No.23-13, and WHEREAS, the specifications of said contract requires the Contractor to affirm that "all brush, trash, debris, and surplus materials resulting from this project have been disposed of in a legal manner" and that all designated recyclable materials are properly recycled in compliance with the City of Menifee Ord ina nces.
WHEREAS, said contract has been completed, all surplus materials disposed of, and proof of compliance with the City of Menifee Municipal Code has been furnished.
NOW, THEREFORE, in consideration of the final payment by the City of Menifee to said Contractorunderthetermsofsaidcontract,theundersignedContractor,herebycertifiesandaffirms under penalty of perjury that all surplus materials as described in said contract have been disposed of at the following location(s):
I!]q'us lsEes\os
Type of material disposed of
\Nas\c Mo,..l.l rr<-,| [-Cl\rcua^ ]\lrt<
Name of d isposal sHe
3FLr 6t5 6$r"a fl}, lcrxl*aa^Q.[_ q3251
Address of disposal site
Name of disposal site
Type of materialdisposed of Type of material disposed of Name of disposalsite Name of disposal site
Address of disposal site Address of disposal site
By signing and submitting this form to the City of Menifee on this !l day o1 July zo 2I t (we) ed information is true and coraforementg rect without omissiolr, error or misrepresentation. a1 1
7-28 )'v s-gc^-- 7-28
Signature of Prime Contractor
Shrenik Vora / President
Date Signature of Prime Contractor
Siddharth Vora / Secretary
4-3
Date
Print name and title Print name and title
(lf the Prime Controctor is o corporation two signotures of corporate officers ore required.) Type of materialdisposed of
Address of disposal site
hereby certified and swear under penalty of perjury under the laws of the State of California that the