Parking Lot Third & Main FinalMEMORANDUM
November 1, 2001
TO:
FROM:
SUBJECT:
The Honorable Mayor and City Council Members
Michael C. Van Milligen, City Manager
Parking Lot at Third and Main Streets
Economic Development Director Bill Baum is recommending acceptance of the
construction contract for the parking lot at Third and Main Streets, as completed by
Conlon Construction, in the final contract amount of $89,242.43.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
Michael C. Van Milligen
MCVM/jh
Attachment
cc: Barry Lindahl, Corporation Counsel
Cindy Steinhauser, Assistant City Manager
Bill Baum, Economic Development Director
CITY OF DUBUQUE, IOWA
MEMORANDUM
October 24, 2001
To: Michael C. Van Milligen, City Manager
From: Bill Baum, Economic Development Director
Re: Parking lot at Third and Main Streets
Introduction
The attached resolutions provide for the acceptance of the construction contract
for the parking lot at Third and Main Streets.
Discussion
In September, 2000, a contract was awarded to Conlon Construction for the
parking lot at Third and Main Streets. The construction included 17 metered
parking spaces to support development in the Old Main Distdct and to provide
parking for the new Welcome Center. Construction of this new surface lot
involved the replacing the existing curb, gutter and sidewalk with new material,
installing additional stone base and brick pavers than originally estimated. This
additional work resulted in a higher final project cost. A summary of the budget
cost is as follows:
Construction costs
Estimate Final
$71,042 $89,242.43
This project is funded from the following funds:
Parking Construction Fund $71,042.00
FY '01 Street Improvements $18,200.43
Recommendation
I recommend that the City Council accept the improvement and the final contract
price be established at $89,242.43
Action
The requested action is for City Council to adopt the attached resolutions
accepting the improvement and establishing the final construction cost.
Cc:
Tim Horsfield, Parking System Supervisor
Pauline Joyce, Administrative Services Manager
Mike Koch, Public Works Director
RESOLUTION NO. 469-01
ACCEPTINGIMPROVEMENT
Whereas, the contract for the Parking Lot Project at Third and Main
Streets has been completed and the City Manager has examined the work and
filed his certificate stating that the same has been completed according to the
terms of the contracts, plans and specifications and recommends its acceptance.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF
THE CITY OF DUBUQUE, IOWA:
Section 1. That the recommendation of the City Manager be approved
and that said improvement be and the same is hereby accepted.
BE IT FURTHER RESOLVED that the City Treasurer be and he is hereby
directed to pay to the contractor from the Fiscal Year 2001 Parking Construction
Fund and Street Improvement Fund in amounts equal to the amount of this
contract, less any retained percentage provided for therein.
Passed, approved and adopted this 5th
Attest:
day of November 2001.
Terrance M. Duggan, Mayor
Attest:
Jeanne F. Schneider, City Clerk
RESOLUTION NO, 470-01
FINAL ESTIMATE
VVhereas, the contract for the Parking Lot Project at Third and Main
Streets has been completed and the Economic Development Director has
submitted a final estimate showing the cost thereof including the cost of
estimates, notices and inspection and all miscellaneous costs.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF
THE CITY OF DUBUQUE, IOWA:
Section 1. That the cost of said improvement is hereby determined to
be $89,242.43 and the said amount shall be paid from the Fiscal Year 2001
Parking Construction Fund and Street Improvement Fund.
Attest:
Passed, approved and adopted this 5th day of November, 2001.
/s/ Terrance M Dugga, Mayor
Attest:
Jeanne F. Schneider, City Clerk
CONLON CONSTRUCTION CO. · RO. BOX 3400 · DUBUQUE, IOWA 52004-3400 ·
r- Cindy Steinhauser
City of Dubuque Parking Division
IN ACCOUNT 830 Bluff Street
WITH
Dubuque, IA 52001
L
583-1724 · FAX (563) 583~2890
Date
Our Job No. 3071
Your Order No.
Invoice No, 3071-4
Terms: Net Upon Receipt
11/2% after 30 days
PARKING LOT CONSTRUCTION PROJECT
THIRD & MAIN STREETS
5% RETAINAGE
$4,462.12
WAIVER OF LIEN
F~ATERIAL OR LABOR
State of IA January 25
County of DUBUQUE
2001
To Ail W~om It May Concern:
Whereas the undersigned WINTER,S GAP. AGE & WELDING,
has been employed by CONLON CONSTRUCTION CO.
General Contractor/Owner
to furnish labor and/or material for IRON RAILING
Nature of the Work
for the Building and Premises known as CITY OF DUB 3RD & ~AIN PKG LOT
At In DUBUQUE, DUBUQUE IA 61036
Address City, County, State
NOW, Therefore, Know Ye, That WINTER,S GARAGE & WELDING, INO the undersigned
for and in consideration of the sum of:
$ Six thousand two hundred ninety-two dollars and 80 cents { $****6,292.80 )
and other good and valuable considerations, the receipt whereof is hereby acknowledged, do hereby
waive and release any and all lien, or claim or right to lien on said above described building and
pre~L~ses un the Statutes of the State of IA relating to Mechanics, Liens, on account of labor or
materials, or both, furnished or which may be furnished, by the undersigned to or on account of the
said firm or individual therein named for said building or premises.
Given under hand and seal this -- day of A.D. 19
Witness: (Seal)
Witness: (Seal)
Subscribed and sworn to before me this
WAIVER OF LIEN
F~ATERIAL OR LA~OR
State of IA February 15
County of DUBUQUE
2001
To All Whom It May Concern:
Whereas the undersigned CDI EXCAVATINg, INC.
has been employed by CONLON CONSTRUCTION CO.
General Contractor/Owner
to furnish labor and/or material for EXCAVATION/DEMOLITION
Nature of the Work
for the Building and Premises known as CITY OF DUB 3RD & MAIN PEG LOW
At In DUBUQUE, DUBUQUE IA 52003
Address City, County, State
Mow, Therefore, Know Ye, That CDI EXCAVATING, INC. the undersigned
for and in consideration of the sum of:
$ Twelve thousand eiqht hundred nine dollars and 08 cen~ ( $**'12,809.08 )
and other good and valuable considerations, the receipt whereof is hereby acknowledged, do hereby
waive and release any and all lien, or claim or right to lien on said above described building and
premises un the Statutes of the State of I__A relating to Mechanics' Liens, on account of Labor or
materials, or both, furnished or which may be furnished, by the undersigned to or on account of the
said firm or individual therein named for said building or premises.
Given under hand
Witness:
(Seal)
(Seal)
Subscribed and sworn to before me this
My Commission Expires
WAIVER OF LIEN
F~ATERIAL OR LABOR
State of lA
County of DUBUQUE January 25
2001
To All W/%om it May Concer~:
Wllereas the undersigned WINTER,S ~AI~AGE & ~rELDiNG,
has been ea~loyed by CONLON CONSTRUCTION CO.
General Contractor/Owner
to furnish labor and/or material for IRON RAILING
Nature of the Work
for the Building and Premises known as CITY OF DUE 3RD & ~AIN PKG LOT
At In DUBUQUE, DUBUQUE IA 61036
Address City, County, State
NOW, Therefore, Know Ye, That WINTER'S GARAGE & WELDING, INC the undersigned
for and in consideration of the sum of:
$ Six thousand two h~ed ninet~-tw~ dollars and 80 cent... ( $****6,292.80 )
and other good and valuable considerations, the receipt whereof is hereby acknowledged, do hereby
waive and release any and all lien, or claim or right to lien on said above described building and
premises un the Statutes of the State of I_~A relating to Mechanics, Liens, on account of labor or
materials, or both, furnished or which may be furnished, by the undersigned to or on account of the
said firm or individual therein named for said buildin9 or premises.
Given under
Witness:
Witness:
hand and seal this __ day of A.D. 19
Subscribed and sworn to before me this
My Commission Expires
(Seal)
(Seal)
WAIVER OF LIEN
~ATERIAL OR LABOR
State of IA April $
County of D~UQUE
2001
To All Whom It May Concern:
Whereas the undersigned NAUHANNURSERY, INC.
has been employed by CONLON CONSTRUCTION CO.
~eneral Contractor/Owner
to furnish labor and/or material for LANDSCAPE
Nature of the Work
for the Building and Premises known as CITY OF DUB 3RD & ~AIN PKG LOT
At In DUBUQUE, DUBUQU~ IA 52002
Address City, County, State
NOW, Therefore, Know Ye, That NAIIMAN NURSERY~ INC. the undersigned
for and in consideration of the sum of:
$ Twelve thousand nine h~,~ved fifty-six dollars and 10 centc ( $**'12,956.10 )
and other good and valuable considerations, the receipt whereof is hereby acknowledged, do hereby
waive and release any and all lien, or claim or right to lien on said above described building and
premises un the Statutes of the State of I__A relating to Mechanics. Liens, on account of labor or
materials, or both, furnished or which n~ay be furnished, by the undersigned to or on account of the
said firm or individual therein named for said building or premises.
Given under ha~d and seal this /~day of ,/~/~' A.D. ~
Witness~ (Seal)
Witness: (Seal)
Subscribed and sworn to before me this
My Comm/ssion Expires
WAIVER OF LIEN
~ATERIAL OR LA~OR
State of IA April 5
County of DUBUQUE
2001
To Ail Whom It May Concern:
W~lereas the undersigned NAUi~AN NURSERY, INC.
has been employed by CONLOW CONSTRUCTION CO.
General Contractor/Owner
to furnish labor and/or material for LA/~DSCAPE
Nature of the Work
for the Building and Premises known as CITY OF D~B 3RD & F=%IN PKG LOT
At In DUBUQUE, DUBUQUE IA 52002
Address City, County, State
Now, Therefore, Know Ye, That NAUMANNURSERY, INC. the undersigned
for and in consideration of the sum of:
$ Twelve thousand nine hundred fifty-six dollars and 10 cents ( $**'12,956.10 )
and other good and valuable considerations, the receipt whereof is hereby acknowledged, do hereby
waive and release any and all lien, or claim or right to lien on said above described building and
premises un the Statutes of the State of I__A relating to Mechanics' Liens, on account of labor or
materials, or both, furnished or which may be furnished, by the undersigned to or on account of the
said firm or individual therein named for said building or premises.
Witness: (Seal)
Witness:
Subscribed and sworn to before me this
(Seal)
My Commission Ex~ires
WAIVER OF LIEN
MATERIAL OR LABOR
State of IA Deceafoer 7 2000
County of DUBUQUE
To Ail W/lom It May Concern:
Whereas the undersigned O'DO~D~ PAT CONC~ET~
has been employed by CONLON CONSTRUCTION CO.
General Contractor/Owner
to furnish l~bor and/or material for CONCRETE
for the Building and Premises known as CITY OF DUB 3RD & MAIN PKG LOT
At In
DUBUQUE, DUBUQUE IA 52001
City, County, State
Now, Therefore, Know Ye, That O'DOWD, PAT CONCRET~ the undersigned
for and in consideration of the sum of:
$ Six thousand one hundred dollars and 14 centc ( $***'6,100.14 )
and other good and valuable considerations, the receipt whereof is hereby acknowledged, do hereby
waive and release any and all lien, or claim or right to lien on said above described building and
premises un the Statutes of the State of I~A relating to Mechanics. Liens, on account of labor or
materials, or both, furnished or which may be furnished, by the undersigned to or on account of the
said firm or individual therein named for said building or premises.
Given under
Witness:
hand
Witness:
Subscribed and sworn to before me this
Day Of )~;~/~ ~'
Notary Publi~
and seal this ~ l~ day of ':~-'~ . A.D. 1~3- ~a9-90~ ~
(Se l)
(Seal)
WAI%rER OF LIEN
16ATERIAL OR LABOR
State of lA December 7
County of DU~UQU~
2OOO
TO Ail Whom It May Concern:
Whereas the undersigned O'DOWD, PAT CONCRETE
has been employed by CONLOM CONSTRUCTION CO.
General Contractor/Owner
to furnish labor and/or material for CONCRETE
Nature of the Work
for the Buildin9 and Premises known as CITY OF DUB SRD & ~AIN PKG LOT
At
Address
Now, Therefore, Know Ye, That 0'DOWD PAT CONCRET~
for and in consideration of the sum of:
$ Six thousand one hundred dollars and 14 cent~
DUBUQUE, DUBUQUE IA 52001
City, County, State
the undersigned
( $***'6,100.14 )
and other good and valuable considerations, the receipt whereof is hereby acknowledged, do hereby
waive and release any and all lien, or claim or right to lien on said above described building and
preanises un the Statutes of the State of I__A relating to Mechanics' Liens, on account of labor or
materials, or both, furnished or which n~y he furnished, by the undersigned to or on account of the
said firm or individual therein named for said building or premises.
hand and seal this
Witness:
Subscribed and sworn to before me this
(Seal)
Title ~J;~ ~' ~ ~
WAIVER 0E LIEN
MATERIAL OR LABOR
State of IA Nove~ber 9
County of DUBUQUE
2000
TO All Whom It May Co=cern:
Whereas the undersigned O'DOWD, EAT CONCRETE
has been employed by CONLON CONSTRUCTION CO.
General Contractor/Owner
to furnish labor and/or material for CONCRETE
Nature of the Work
for the Building and Prennises known as CITY OF DUB 3RD & MAIN PKG LOT
At In DUBUQUE, DLrBUQUE IA 52001
Now, Therefore, Know Ye, That O'DOWD, PAT CONCRETE the undersigned
for and in consideration of the sum of:
$ Seven thousand six h~ed eleven dollars and 40 cent.~ ( $***'7,611.40 )
and other good and valuable considerations, the receipt whereof is hereby acknowledged, do hereby
waive and release any and all lien, or claim or right to lien on said above described building and
premises un the Statutes of the State of I__A relating to Mechanics, Liens, on account of labor or
materials, or both, furnished or which may be furnished, by the undersigned to or on account of the
said firm or individual therein na~ed for said building or premises.
Witness:
(Seal)
Witness:
(Seal)
Subscribed and sworn to before me this
WAIVER OF LIEN
~ATERIAL OR LA~OR
State of IA Noven~ber S 2000
County of DUBUQUE
To Ail Wtlom It May Concern:
Whereas the undersigned O'DO~TD, PAT CONCRETE
has been employed by ~OATLON CONSTRUCTION CO.
General Contractor/Owner
to furnish labor and/or ~aterial for CONCRETE
Nature of the Work
for the Building and Premises known as CITY OF DUB 3RD & MAIN PEG LOT
At In DUBUQUE, DUBUQUE IA 52001
Address City, County, State
Now, Therefore, Know Ye, That O'DOWD, PAT CONCEETM the undersigned
for and in consideration of the sum of:
$ Seven thousand six ~red eleven dollars and 40 cent ( $***'7,611.40 )
and other good and valuable considerations, the receipt whereof is hereby acknowledged, do hereby
waive and release any and all lien, or claim or right to lien on said above described building and
premises un the Statutes of the State of I__A relating to Mechanic~. Liens, on account of labor or
materials, or both, furnished or which may he furnished, by the undersigned to or on account of the
said firm or individual therein named for said building or premises.
Witness:
and seal this /5-- day of
Z
(Seal)
(Seal)
Title ~
Subscribed and sworn to before me this
WAIVER OF LIEN
~ATERIAL OR LABOR
State of IA Novem%ber 9
County of DUBUQUE
2000
To Ail Whom It May Concern:
Whereas the undersigned RIVER CITY PAVING, INC.
has been employed by CONLON CONSTRUCTION CO.
General Contractor/0w~er
to furnish labor and/ormateria! for PAVING
Wature of the Work
for the Building and Premises known as CITY OF DUB 3RD & ~AIN PKG LOT
At In DUBUQUE, DUBUQUE IA 52004-1430
Address City, County, State
NOW, Therefore, Know Ye, That RIIrER CITY PAVINGr INC. the undersigned
for and in consideration of the sum of:
$ Eiqht thousand seven hundred three dollars and 08 centn ( $****8,703.08 )
and other good and valuable considerations, the receipt whereof is hereby acknowledged, do hereby
waive and release any and all lien, or claim or right to lien on said above described building and
premises un the Statutes of the State of I__A relating to Mechanics, Liens, on account of labor or
materials, or both, furnished or which may be furnished, by the undersigned to or on account of the
said firm or individual therein na~ed for said building or premises.
Witness: (Seal)
Witness: (Seal)
Subscribed and sworn to before me this
My Commission Expires
WAIVER OF LiEN
~{ATERIAL OR LA~0R
State of IA November 9
County of DUBUQUE
2000
To Ail Wqlom It May Concern:
~fhereas the undersigned RIVER CITY PAVING, !NC.
has been employed by CO~LON CONSTRUCTION CO.
General Contractor/o~er
to furnish labor and/or material for PAVING
Nature of the Work
for the Building and Premises known as CITY OF DI/B 3RD & MAiN PKG LOT
At
Address
In DUBUQUE, DUBUQUE iA 52004-1430
City, County, State
Now, Therefore, Know Ye, That RIVER CITY PAVING, INC. the undersigned
for and in consideration of the su~ of:
$ Eiqht thousand seven hundred three dollars and 08 cents ( $****8,703.08 )
and other good and valuable considerations, the receipt whereof is hereby acknowledged, do hereby
waive and release any and all lien, or claim or right to lien on said above described building and
premises un the Statutes of the State of I_~A relating to Mechanics, Liens, on account of labor or
materials, or both, furnished or which may he furnished, by the undersigned to or on account of the
said firm or individual therein na~ed for said building or premises.
~iven ~=der hand and s~al this ;~day of ~J~ A.~. ~. ~0
Witness: (Seal)
Witness:
Subscribed and sworn to before me this
My Co~unission Expires
(Seal)
IOWA
department of Revenue and Finance
Construction Contract
Claim for Refund
NA~E OF GOVERNMENTAL BODY, PRIVATE NONPROFIT EDUCATIONAL INSTITUTION OR NONPROFIT MUSEUM
C1~¢¢ OR TOWN I sTATE I ZiP CODE COUNTY NO.
1. Federal identification number:
2. Description of project: Third & Hain St Parking ~ot
Claim must be filed within six
3. Final settlement date of contract: ___ months of final settlement.
COLrNTY NO.
FOR OFFICE USE ONLY
~CCOUNT NUMBER
NTROLNU BER 30__04
TAX AMOUNT
INTEREST AMOUNT
TOTAL REFUND
NAME 500# DUP
~Sa, M DATE INTEREST DATE
COMMENTS
4. Was contract in writing?
If so, date signed:
5. Have you previously filed a claim for this project?
Items 1 - 5 and the local option tax summary on the reverse side
must be completed before your claim can be processed.
LIST CONTRACTORS AND SUBCONTRACTORS ONLY.
ATTACH ADDITIONAL SHEETS IF NEEDED.
NAME OF CONTRACTOR MATER[AL PURCHASES TAX TO BE REFUNDED
AND/OR SUBCONTRACTORS AMOUNT Iowa Sales/Use Regular Local Option School Local Option
Apel Par~ing/Paving 30.00 1.50 .30
Becker & Beok~ Stone 9,589.00 479.45 95.89
Nauman Nursery 2,726.96 136.35 27.27
Patrick O' Dowd 4~117.82 205.89 41.18
River City Paving 2,664.36 133.32 26.64
Winters Garage 1,071.06 66.94
$20,199.20 $1,023.35 $191.28
TOTAL REFUND DUE: Add Iowa and both local option taxes paid columns ,
SUBMIT ORIGINAL ONLY OF THIS FORM WITH ORIGINAL CONTRACTORS STATEMENTS TO:
COMPLIANCE DIVISION Questions? Call.2
IOWA DEPARTMENT OF REVENUE AND FINANCE 515/281-6177 or
PO BOX 10456 1-800-367-3388 (Iowa, Omaha, Rock Island/Molme only)
DES MOINES[A 50306-0456
I, the undersigned, declare under penalty of perjury that I have examined this claim, including all attached contractors statements, and, to
the best of my knowledge and belief, it is a true, correct and complete claim. This claim is filed pursuant to Section 422.45(7) Code of Iowa.
Signature:
Title: Telephone Number:
Print Name:
Date:
35-003 (4/99)
d=...,,,=,,,.r =~ ........ .',,~ ~ ........ Iowa Contractor's Statement
Address _L.. ~"'" ' '~/ ¥ ~.~ Address
City, State, ZIP ~e _ ~ City, State, ZIP Coda
Iowa Sales or Use Tax Permlt~. Federal ID No, ; If contract Is not directly wllh above name, Who is your contrast directly with?
2. Is your contract written? If so, date signed:
INCLUDE ONLY BUILDING MATERIALS THAT BECOME PART OF REAL PROPERT% See Instructions on reverse side.
A. B. C, D, E. F,
Name, City, and State of Malerial Supplier Type of Building Material Purchase Pdce Amount of Iowa Did auppller collect IA salesl
..........
3,
4.
5.
6.
?,
Subscribed and sworn to by
before me Ihls~ day of ,20 ....
I, "Con rac or,". oath depose and state that this statement is
made .~ectlon 422.45(7), ls made herein are true and accurate as I verily believe; that all
of lhe tangible personal property described herein became an inlegral part of Ihe project herein descdbsd, and sales or use tax
Name __~~ ............ Title ..... ~r...j,_E- ................. 35-002a (01/00)
Iowa Contractor's Statement
_ BECKER & BECKER STONE CO., INC. ....CI~Y OF DUBUQUE
..... 14659 DEKBY GRANGE RO~ 50
D~UQUE, IO~A 52002 ~ City, Stale. ZIP Code
o~uq~, ~ 52001
1. Project 0escHpUon: 3~ S~RRT PAR~1NG
.~, ~s y~0r conlract written? ff so. date signed:
INCLUDE ONLY BUILDING MATERIALS THAT BECOME[ PART OF R'EAL PROPERTY. See InstrucUons on reverse ~lde.
~' RE~KER R BE~ER STOp. CO...I_~ L~S~O~ ~9589.00 $479.45 ~~- $95.89
2.
4.
6~
8,
TOTALS
day of
Count), el Iowa.
macle pursu&nt to Secll~ 422.45(7), Code of Iowa, Ihat all statemer~ts made herein are true told aco~lale as I vedly believe; [hat all
or,he tangible pe{$on~ property described herein became art Inlegrel part et' II~e project herein described, emJ ~qles or use ta~
REC'D JUN 0 6 2001
I
~.~..,,,.~,,, ,,r ..w, ....... , r, ....... Iowa Contractor's Statement
Contractor's Name I Name of government uniLprivate nonprofit education institution, nonprofit musuem
Address - . _ ./ Address · ~ ~
~:lty, Sta~e, ZIP Code ~' ' /~ City, State, ZIP Code
I"~w~, Sales rd~se Tax Permit No, ] Federal ID No. If c~ntract ts n~ directly wlt~ above name, who is your contract direct¥ wilh?
2. Is your contracl wril[en? If so, date s~gned: ~ ~ ~ ~ ~ ~
INCLUDE ONLY BUILDING M~T~LS TH~ BECOME PART OF REAL PROPERTY. See Instructions on reverse side.
A. B. C, D. E. F G, H.
Name, City, and State of Malarial Supplier Type of Building Material Purchase Price Amount of Iowa Did ~uppl~er ~lecl~Asale~
/
5.
6,
?,
8,
Subscribed and sworn to by,~¢'~//~._~2'/~~ _, I, "Contractor," __.,Z~'~._~ /'[~./'.'"~"%-- ..... being duly sworn upon oalh depose and state that this ,late~en[ is
before me this ' ~ day ol ~ 20 ~ / made pursuant Io Secllon 422.45(7), Code of Iowa, thai all statements made herein are Irue and accurale as I verily believe; Ihal all
- ' ~ ............. of the t~gible personal pmpe~y described herein be~me an Integral pad of the proJecl herein described, and sates or use t~
NotnryPubli~lnnnd[or ____~_~oun~yoflown, ~_ ~ ~,~l~nassorted.
U -' .... ~ ~
Iowa Contractor's Statement
Contractor's Name Name of government unil..private nonprofit educalion institution, nonprofit musuem
Address "~ · Address ' ~'~ ~
(~ity, Sta,~e, ZIP Code "' ~ ~ City, State, ZIP Code
I~w~ Sales d~se Tax Permit No. Federal ID No. If contract Is not directly wdh above name, wh~ ~s your con~rac~ direclly with?
2. Is your contract written? If so, date signed: ~ ~ /- ~ '
INCLUDE ONL~ BU~NG MAT~R~LS TH~ BECOME PART OF REAL PROPERTY. See instructions on reverse side.
A. B. C. D. E. .R G. H.
Name, City, and State of Material Supplier Type of Building Material Purchase Price Amoun[ of Iowa Dl~s~pllet c~lecllA~ale~ Amount of regular Amount of IA school
4.
5,
6,
?,
8,
Subscribed and sworn to by _~'~,'~ /~.~'Z_~.--~'C.~, I, "Contractor," ___~,~.--' ~ ./[--/~ u,'¥-.,.~-~_ ..... being duly sworn upon oath depose and state that this stalement le
before me Ihls.~'~- day of _~ ..... 20 _O~/. made pursuant Io Section 422,45(7), Code of Iowa, that ell ststements made herein are true and acourale as I verily believe; Ihat all
Notnry Puhll~, in nmi for __~unly of Iown, of the tangible personal property described herein became an integral pall of the project herein described, and sales or use tax
Contractor's Name.~.,.l~..[_/~[~.[c__ "~ ~)~) ~ f,4~/~/ , Name of government~/~y unit,o~private~nonp~ofit~ ~ ~.~ ~educati°n inslitution, nonprofit musuem
Address
' Address /
City, State, ZIP~ode ~ ¢ City, State, ZiP Code
Iowa 8ales or Use T~ Permit N~.' Federal ID ~, ff contract Is not d'rec~ wdh a~ove name, who is your contract directly with?
1, Project Description:
2, Is your contract written? If so, date signed;
INCLUDE ONLY BUILDING MATERIALS THAT BECOME PART OF REAL PROPERTY. See Instructions on reverse side.
A. B. C. D. E. F G. H.
Name, City, and State of Material Supplier Type of Building Material Purchase Price Amount of Iowa Did supplier collect IA sales/
safes/uselax usetax?(yes/no)lfno, who Amount of regular Amount of lA school ~h~¢
paid Ihe ta~en? ~owa local optlo~ taxlocal option tax
~_~___~ ~ ~ ...........
2, ¢ / ' ¢ '
4,
......... _ ...........
7,
__~ ..... _ ........
ad and sworn to by
pon oath depose and state that this statement is
Notar~ ~'ub,o ~n a,d fo~...j~__~ 0_~..~ County of
made pursuant to Section 422.45(7), Code of Iowa, that all statements made herein are true and accurate as I verily believe; that all
oi' the tangible personal property described herein became an integral part of the project herein described, and sales or use tax
was paid toJ~we/there_circ..as.see.CA . ,
Nama _~'~_~¢~__..~.,_.~¢ ~ Title_ ~ ............ 35~002a (01/00)
IOWA Page 1 of 1
,. department of Revenue and Finance ~OWa Contractor's Statement
CONTRACTOR'S NAME & ADDRESS NAME AND ADDRESS - GOVERNMENT UNIT, PRIVATE NONPROFIT, ETC,
RIVER CiTY PAVING - DIVISION OF IVIATHY CONSTRUCTION COMPANY CITY OF DUBUQUE
P.O. BOX 1430 DUBUQUE, IOWA
~Nfll
DUBBQUE,,O A =004- 4 0 I I','D IVlAY 0 Y DIRECTLY WI[H ABOVE, WHO IS YOUR CONTRACT WITH?
2-00-119833 3g-0752519 CONLON CONSTRUCTION
I PROJECT DESCRIPTION: CITY OF DUBUQUE - 3RD STREET PARKING RAMP
2, IS CONTRACTWRITTEN? IF SO, DATE SIGNED:
INCLUDE ONLY BUILDING ~,~ATERIALS THAT BECOME PART OF REAL PROPERTY
A. B. C. D. E. F. G. H.
NAME, CITY, & St~E OF TYPE OF BUILDING PURCHASE AMOUNT OF IOWA DID SUPPLIER COLLECT IOWA SALES ~MOUNT OF REGULAR AMOUNT OF IA SCHOOL CO. ¢
MATERIAL SUPPLIER MATERIAL PRICE SALES/USE TAX TAX? IF NOT, WNO DID AND WHEN !A LOCAL OPTION TAX LOCAL OPTION TAX WHERE PAID
1. MIDWEST INDUSTRIAL FUELS ASPHALT
LA CROSSE, WISCONSIN CEMENT $1,762.80 $88.14 YES $17.63 $0.00 31
2. AGGREGATE MATERIAL8
DUBUQUE, IOWA SAND $293.02 $14.65 YES $2.g3 $0.00 31
3, RIVER CI~ STONE
DUBUQUE, IOWA STONE $608.54 $30.43 YES $6.0g $0.00 31
$0.00 YES $0.00 $0.00
$0.00 YES $0.00 $0.00
$0.00 YES $0.00 $0.00
$0.00 YES $0.00 $0.00
$0.00 YES $0.00 $0.00
TOTALS $2,664.36 $~33.22 $26.64 $0,00
NOTARY PUBLIC IN AND FOR DUBUQUE DOUNTY OF IOWA
NOTARY PUBLIC:
I, "CONTRACTOR~', CURT PALMER BEING DULY SWORN UPON OATtl DEPOSE AND STATE TIIAT THIS STATEMENT IS MADE
PURSUANT TO SECTION 422.45(7), CODE OF IOWA, TftAT ALL STATEMENTS MADE HEREIN ARE TRUE AND ACCURATE AS I
VERILY BELIEVE; THAT ALL OF THE FANGIBLE PERSONAL PROPERTY DESCRIBED HEREIN BECAME AN INTEGRAL PART OF
NAME: ~L'~/-''~''-''*'~ TITLE: OFFICE MANAGER
, .~ IOWA Page 1 of 1
department of Revenue and Finance
· '- Iowa Contractor's Statement
CONTRACTOR'S NAME & ADDRESS NAME AND ADDRESS - GOVERNMENT UNIT, PRIVATE NONPROFIT, ETC,
RIVER CITY PAVING ~ DIVISION OF MATHY CONSTRUCTION COMPANY CITY OF DUBUQUE
P,O. BOX 1430 DUBUQUE, IOWA
DUBUQUE, IOWA 52004-1430
IOWA SALES TAX PERiVIlT NO. I FEDERAL ID. NO. IF CONTRACT IS NOT DIRECTLY WITH ABOVE, WHO IS YOUR CONTRACT WITH?
2-00-I 19833I 39-0752519 CONLON CONSTRUCTION
I. PROJECT DESCRIPTION: CITY OF DUBUQUE - 3RD STREET PARKING RAMP
2. IS CONTRACT WRITTEN? IF SO, DATE SIGNED:
INCLUDE ONLY BUILDING MATERIALS THAT BECOME PART OF REAL PROPERTY
A, B, C, D. E. F. G. H.
NAME, CITY, & STATE OF TYPE OF BUILDING PURCHASE AMOUNT OF IOWA DID SUPPLIER COLLECT IOWA SALES ~,MOUNT OF REGULAR AMOUNT OF IA SCHOOL CO. #
MATERIAL SUPPLIER MATERIAL PRICE SALES/USE TAX TAX? IF NOT, WHO DID AND WHEN A LOCAL OPTION TAX LOCAL OPTION TAX WHERE PAID
1. MIDWEST INDUSTRIAL FUELS ASPHALT
LA CROSSE, WISCONSIN CEMENT $t,762.80 $88.t4 YES $17,63 $0.00 3t
2. AGGREGATE MATERIALS
DUBUQUE, IOWA SAND $293,02 $14,65 YES $2.93 $0.00 31
3. RIVER CITY STONE
DUBUQUE, IOWA STONE $608.54 $30.43 YES $6,09 $0.00 31
$0.00 YES $0.66 $6.00
$0,00 YES $0.00 $0.00
$0.00 YES $0.00 $0.00
$0.00 YES $0,00 $0,00
$0.00 YES $0.60 $6.00
TOTALS $2,664.36 $133.22 $26.64
SUBSCRIBED AND SWORN TO BY CURT PALMER
BEFORE ME THIS 7th DAY OF MAY, 2001
NOTARY PUBLIC iN AND FOR DUBUQUE COUNTY OF IOWA
NOTARY PUBLIC:
I, "CONTRACTOR", CURT PALMER BEING DULY SWORN UPON OATH DEPOSE AND STATE THAT THIS STATEMENT IS MADE
PURSUANT TO SECTION 422 45(7), CODE OF 10WA, THAT ALL S~I'EMENTS MADE HEREIN ARE TRUE AND ACCURATE AS I
VERILY BELIEVE; THAT ALL OF THE TANGIBLE PERSONAL PROPERTY DESCRIBED HEREIN BECAME AN INTEGRAL PART OF
35-0028 (1198)
Iowa Contractor's
ONLY I~IILDtN~ I~/~T[RIAL~ THAI BECOME PAINT O~ RE, AL PIIOp~IIITy, ~ I~fmcllo. I oil r evw,"~
5,