Silver Rock - UF - Archuleta Concrete - SignedRELEASE OF PAYMENT STOP NOTICE — PUBLIC WORKS
Civil Code §§ 8100, et seq., and 9350, et seq.
Claimant:
Name: Archuleta Concrete Construction Com
Address:79-301 Country Club Drive #100
city: Bermuda Dunes state: CA Zip:92203
To Public Entity:
Name: City of La Quinta
Address: 78-495 Calle Tampico
city: La Quinta
To Direct Contractor or Reputed Direct Contractor:
Name: Urban Habitat
Address: PO BOX 1177
city: La Quinta state: CA Zip92253
To Construction Lender or Reputed Construction Lender:
(or Agency responsible for disbursing construction funds)
Name:
Address:
State: CA Zip:92253 City:
The name of the person or firm to whom labor, materials
and equipment are provided:
Name: Urban Habitat
Address: PO BOX 1177
City: La Quinta State: CA Zip;92253
State: Zip:
General description of the labor, service, equipment, or
materials furnished or to be furnished and an estimate of
the total price thereof:
Project Name: La Quinta SilverRock Park Venue
Address: 52nd and Jefferson, La Quinta, CA 92253
Site Description:
RELEASE
The undersigned Claimant does hereby partially release from the effect of that certain Stop Payment Notice served on
08/15/2021 (date) against the Public Entity, Direct Contractor, and/or Construction Lender
as described above which at the time was in the amount of $61,905.69
Dated: By: l�
Name/Title
ACKNOWLEDGEMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed
the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
STATE OF CALI IA i )
COUNTY OF
On No\[(��
Notary Public, personally appeared U I r`vp L (wt- U W-- lQ--y— , who proved
to me on the basis of satisfactory evidence to be the pers n(s) whose name(s) is/are subscribed to the within instrument and
acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s)
on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under penalty of perjury under the laws of the State of California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal. 11 IC EL HO e1
CC11m. "332285
NOTARY PUBLIC a CALIFORNIA
law RIVERSIDE COUNTY
Comn inion bOmsAUGUST 24, 2D24
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Name: , Notary Public
0 2012 Law Office of John L. Boze