American Asphalt South, Inc.File #: 343 [CA][PUBLIC][COPY:NOEST) I Customer: American Pavement Systems Inc
Recording Requested by and Return to: I P.O. #:
Chandler Aggregates Inc I Project: Zone 3-2015 Street Resurfacing
I Rae ID: 198A3C98-3439-488A-AF3F-360593596623
P 0 Box 78450 1 Job #: 15-150
Corona, CA 92877-0148 1 Cert No.:
CALIFORNIA PRELIMINARY NOTICE — PUBLIC WORKS
(THIS NOTICE IS GIVEN PURSUANT TO CALIFORNIA C= CODE §§ 8034(B), 8102, 8106-811B, 8200 et seq., 8612, 9300 et Seq.)
>> TO THE PUBLIC ENTITY OR REPUTED
City Of Menifee
29714 Haun Road
Menifee, CA 92586
>> TO DIRECT OR REPUTED CONTRACTOR
American Asphalt South, Inc.
P O Box 310036
FONTANA, CA 92331
USA
>> TO LENDER, SURETY OR BONDING CO. OR
>> REPUTED LENDER, SURETY, BONDING CO.
None
The following is a general description of
the labor, service, equipment or materials
furnished or to be furnished by the undersigned:
Aggregate Materials
2. The estimated amount of the work provl®'d'e !JozO
to be provided is $##########
3. The name of the person who furnished JUL that labor, service, equipment or 12015
materials is:
Chandler Aggregates Inc
P O Box 78450 Vie('O'Jvecj
Corona, CA 92877-0148
Relationship to Parties:
4. The name of the person who contracted for
purchase of that labor, service, equipment
or material is:
American Pavement Systems Inc
1012 filth Street, Ste 1000
MODESTO, CA 95354
5. The description of the jobsite is:
Zone 3-2015 Street Resurfacing
Various Streets Menifee
Menifee, CA
County of Riverside
REQUEST FOR COPY OF PAYMENT BOND AND NAME OF SURETY COMPANY
TO CONTRACTING BODY: City Of Menifee or State Comptroller
The undersigned Claimant hereby declares that he has supplied or will supply labor or materials as
described above, that payment has not yet been made therefore; and that he hereby requests that the
contracting body furnish a certified copy of the Payment Bond, if any, to the Claimant, at the
address listed above, and the current address of the contracting public entity.
I declare that I VLEAGGREGAT
zed to file this claim on behalf of the Claimant. I have read the
foregoing documenthe contents thereof; the same is true of my own knowledge. I declare
under penalty of at the foregoing is true and correct. Executed at Corona, California on
07/15/2015 for CHPrepared by:
: (951) 77-3900 (951) 277-3339
PROOF OF SERVICE BY MAIL AFFIDAVIT
I declare that I served he Preliminary Notice, and any related documents, by certified or
registered mail, postag repaid, or other certified delivery, addressed to the above named
parties, at the addresivs listed above, on 07/15/2015. I declare under penalty of perjury that the
foregoing is true d orrect.. Exec t at Corona, California on 07/15/2015.
Prepared by:
Sandi Lawson, Credi