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ANR HOMES, INC. -2011
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ANR HOMES, INC. -2011
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Last modified
1/3/2012 3:24:56 PM
Creation date
9/15/2011 9:20:54 AM
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Contracts
Company Name
ANR HOMES, INC.
Contract #
A-2011-170
Agency
COMMUNITY DEVELOPMENT
Council Approval Date
6/20/2011
Insurance Exp Date
5/19/2012
Destruction Year
0
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EXHIBIT F <br /> <br />CITY OF SANTA ANA <br />Housing & Neighborhood Development <br />20 Civic Center Plaza / 3rd Floor / P.O. Box 1988 / M-26 / Santa Ana, CA 92702 <br />(714) 667-2250 <br /> <br />AUTHORIZATION FOR RELEASE OF RETENTION FUNDS <br />Date: <br />Project Number: <br />Homeowner: <br />Address: <br />Santa Ana, CA <br />Telephone #: <br />PROGRESS PAYMENT #: <br />AMOUNT APPROVED: <br />AMOUNT RETAINED (-10%) <br />AMOUNT TO BE DISBURSED: <br />PAYABLE T0: <br />V OFFICE USE ONLY V <br />SOURCE OF FUNDS AMOUNT <br />HOME <br />CALHOME <br />TAX INCREMENT <br />CDBG <br />TOTAL DISBURSEMENT <br />IDS NUMBER: <br />ESCROW NUMBER: <br />ACCOUNT NUMBER / W.O.#: <br />CONTRACTOR <br />The undersigned CONTRACTOR certifies that to the best of their knowledge, information and belief, all charges for labor <br />and material incurred by CONTRACTOR and used in construction pursuant to the Housing Rehabilitation Work Contract <br />have been paid in full, and that no liens and/or legitimate claims have been reported. <br />Date Contractor (Signature) <br />HOMEOWNER <br />The undersigned HOMEOWNER: (1) Certifies that to the best of their knowledge, information and belief, the <br />CONTRACTOR has complied with the Housing Rehabilitation Work Contract and that no liens and/or legitimate claims have <br />been reported; (2) Authorizes the release of the retention funds to the CONTRACTOR. <br />Date Homeowner (Signature) <br />CITY OF SANTA ANA <br />The undersigned Residential Construction Specialist (RCS) certifies that to the best of their knowledge, information and <br />belief, the CONTRACTOR has complied with the Housing Rehabilitation Work Contract and is entitled to receive the <br />retention funds withheld during construction. <br />Date Residential Construction Specialist (Signature) <br />The undersigned certify that to the best of their knowledge, information and belief, this Request For Retention Funds has <br />been properly prepared and documented and authorize the disbursement of funds in the amount requested. <br />Date Senior Residential Construction Specialist (Signature) <br />Date Housing Programs Coordinator (Signature) <br />Required Attachments: <br />02/2004
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