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Change Order No 1 & PCA - Wayne St. & Leighton Plaza Parking Structures Repairs 2019 Proj No. 119-048 - DC. Byers Co.
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Change Order No 1 & PCA - Wayne St. & Leighton Plaza Parking Structures Repairs 2019 Proj No. 119-048 - DC. Byers Co.
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4/9/2025 8:29:43 AM
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9/10/2020 9:53:08 AM
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Board of Public Works
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Projects
Document Date
9/8/2020
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SWORN STATEMENT <br />State of Michigan <br />County of Wayne <br />BRENDA NELSON Being Duly sworn, deposes and says, that he makes this sworn <br />statement on behalf of DC Byers Company/Detroit, 5715 Rivard St, Detroit, Mi 48211, <br />313-875-0545 So is the(contractor) (subcontractor) for the following description <br />WAYNE AND LEIGHTON <br />That the following is a statement of each subcontractor and supplier and laborer, for <br />which laborer the payment of wages or fringe benefits and withholding is due but unpaid, <br />with whom the (contractor) (subcontractor) has (contracted) (subcontracted) for <br />performance under the contract with the owner or Lessee thereof, and the amounts due to <br />the persons as of the date thereof are correctly and fully set forth opposite their names, as <br />follows <br />NAME DESCRIPTION EARNED (PAID) OWNING <br />MATERIAL FROM FULLY PAID YARD STOCK <br />ALL LABOR, FRINGES, TAXES, PAYROLL TAXES & OTHER PAYROLL <br />OBLIGATIONS PAID IN FULL THRU JI1LY 2020 <br />NO SUBCONTRACTORS <br />Deponent further says that he/she has not employed, or procured materials from or <br />subcontracted with, any person or persons other -than those above mentioned and owes no <br />moneys for labor or material for this contract other than the sums above set forth. <br />s <br />BRENDA NELSON <br />Subscribed and sworn to before me <br />The 25 Day Of' August 2020 <br />Notary Public", Co my of Macomb <br />My Commissiom'Pxpires 8/8/2026 <br />Acting in the County of Wayne <br />
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