Gib-son Construction 01-23-2019File #: 79 [CA][PUBLIC][OWNER] 1 Customer: GIB -SON CONSTRUCTION
Notice Requested by and Return to: j ID #: 222459
Allied Building Products DBA: AMS Project; MENIFEE CITY HALL
I Rec ID: 23CC973E-C1AF-4AOB-BD54-095569568048
8840 Columbia 100 Parkway Job #: 244594,MENIFEE
Columbia, MD 21045 1 Cert No.: 9214-8901-3515-6502-4000-32
CALIFORNIA PRELIMINARY NOTICE — PUBLIC WORKS
(THIS NOTICE IS GIVEN PURSUANT TO CALIFORNIA CIVIL CODE §§ 8034(B), 8102, 8106-8118, 8200 et seg., 8612, 9300 et Seg.)
>> TO THE PUBLIC ENTITY OR REPUTED
CITY OF MENIFEE
29714 HAUN RD
MENIFEE, CA 92584
USA
>> TO DIRECT OR REPUTED CONTRACTOR
GIB -SON CONSTRUCTION
29826 HAUN RD STE 305
MENIFEE, CA 92586
USA
>> TO ORIGINAL OR REPUTED PUBLIC ENTITY OR
City of MenifeP
City Clerk
►JAN 2 3 2019
Received
1. The following is a general description of
the labor, service, equipment or materials
furnished or to be furnished by the undersigned:
Building material
2. The estimated amount of the work provided or
to be provided is $37,000.00
3. The name of the person or entity who furnished
that labor, service, equipment or
materials is:
Allied Building Products DBA: AMS
15 East Union Avenue
EAST RUTHERFORD, NJ 07073
USA
Relationship to Parties: Material Supplier
4. The name of the person or entity who contracted for
purchase of that labor, service, equipment
or material is:
GIB -SON CONSTRUCTION
29826 HAUN RD STE 305
MENIFEE, CA 92586
USA
5. The description of the jobsite is:
MENIFEE CITY HALL
29844 HAUN RD
MENIFEE, CA 92586
USA
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 am authorized to file this claim on behalf of the Claimant. I have read the
foregoing document and know the contents thereof; the same is true of my own knowledge. I declare
under penalty of perjury that the foregoing is true and correct. Executed at Columbia, Maryland on
01/07/2019 for ALLIED BUILDING PRODUCTS DBA: AMS.
Prepared by:f
Kimberly Dunham, CFS Manage Phone: (877) 636-6652 Fax: ( )
PROOF OF SERVICE BY MAIL AFFIDAVIT
I declare that I served the Preliminary Notice, and any related documents, by certified or
registered mail, postage prepaid, or other certified delivery, addressed to the above named
parties, at the addresses listed above, on 01/07/2019. I declare under penalty of perjury that the
foregoing is true and correct. Executed at Columbia, Maryland on 01/07/2019.
Prepared by:�?�`_
Louis Warren, NACM MLBS Re sentative
California Owner and Lender request per CA Statute 8208
California Law provides that the General Contractor must make available to any person seeking to give a
preliminary notice the Owner and Lender information per the following section:
8208. A direct contractor shall make available to any person seeking to give preliminary notice the
following information:
(a) The name and address of the owner.
(b) The name and address of the construction lender, if any.
Please enter any corrections to the information listed within the notice provided.
Owner or Public Entity:
Lender, Surety or Bonding Company:
Return completed form:
NACM's STS — MLBS
8840 Columbia 100 Parkway
Columbia, MD 21045
Email:
mlbsre uest nacm.ar
MLBS Project #: 222459 Iw
NACM STS Iw
8840 Columbia 100 Pkwy
Ste 100
Columbia, MD 21045-0000
CITY OF MENIFEE
29714 HAUN RD
MENIFEE, CA 92584
USPS CERMED MAIL
111111111111111111111111111111111111111111111
222459
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