Sworn Statement 5 copy.pdf
Jacob Barshaw Petitioner V Township Of Waterford Respondent · 26-002749-TT
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Page 1
RESIDENTIAL NEW CONSTRUCTION PROJECT SWORN STATEMENT FOR CONTR CONTRACTOR OR SUBCONTRACTOR ( CTOR'S NAME: Fresh Start Homes Development PERIOD FROM: 08/20/2025 TO: 08/01/2026 fee il REQUEST NO.:5 STATE OF MICHIGAN ) ) ss COUNTY OF Oakland ) 1, being duly sworn, deposes and says: (1) That Fresh Start Homes Development is the (contractor)(subcontractor) f Oakland : County, Michigan, described as follows: (insert legal description of property) The following is a statement of each subcontractor and supplier, and laborer for whom payment of wages or fringe benefits and withholdings is due but unpaid, wit (subcontracted) for performance under the contract with the owner or lessee of the property, and the amounts due to the persons as of the date of this statement a NAME ADDRESS AND TELEPHONE NUMBER Type of Total Change Adjusted Amount No. |OF SUBCONTRATOR, LABORER OR SUPPLIER Improvement Furnished] ~~ Contract Orders Contract Already Price (+) or (-) Price Paid 1 Permits & Fees 0.00 2| Waterford Township Building Perm 0.00 430.00 430.00 430. 3]Oakland County Soil/Erosion Soil Erosion Permit 0.00] 0.00 4)Oakland County Soil/Erosion Water & Sewer Permit 0.00 0.00 5 Engineering 0.00 6]Oakland County Soil/Erosion Soil Testing 0.00 3 0.00 f 7] : [Surveying ; 0.00 8] Seiber, Keast Lehner Engineering Plot Plans 0.00 : 0.00 9] Seiber, Keast Lehner Engineering __[Stakeout & Pin 0.00] 0.00 : 10) Seiber, Keast Lehner Engineering Preliminary Grade for Backfill 0.00 0.00 11} Seiber, Keast Lehner Engineering Grade Staking 500.00 500.00 12) Seiber, Keast Lehner Engineering Final Grade sas But 1,600.00] 1,600.00 : 13|Seiber, Keast Lehner Engineering Topographic Survey 0.00 0.00 : 14 Soil Erosion 13a aea B 0.00 # 15|Fresh Start Remodeling Silt Fencing 0.00 0.00 : 16] Fresh Start Remodeling [crushed Concrete/Mud Mat 0.00 0.00 ] 17 : [Excavation . 0.00 ; 18|Already In ___|Dig Basement/Water & Sewer Line 0) ERE 0.00) : 19] Fresh Start Remodeling [sump Line 2,000.00 2,000.00
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20]Already In
:
Backfill
0.00
0.00
21|Fresh Start Remodeling
Rough Grade & Cut for concrete
2,500.00
2,500.00
1,000
NAME ADDRESS AND TELEPHONE NUMBER
Total
Change
Adjusted
Amount
No.
|OF SUBCONTRATOR, LABORER OR SUPPLIER
Contract
Orders
Contract
Already
Price
(+) or (-)
Price
Paid
22|Fresh Start Remodeling
Finish Grade
3,000.00
3,000.00]
23|Fresh Start Remodeling
Fill dirt & material (In/Out)
0.00
0.00
24|Rossi Contracting
Sewer line
4,000.00
3,500.00
7,500.00
7,500
25|Rossi Contracting
Water Tap
7,000.00
7,000.00
7,000
26
Temp Utilities
0.00,
0.00
27{J & D
Electrical
PCM
/ Temp electric Meter
750.00)
750.00
750
28|J & D Electrical
600.00
600.00
29
Steel
0.00
EL
0.00
31
0.00
32
Foundation
0.00
33
0.00
34|Fresh Start Remodeling - Messina
Fill Mati-Sand/6A Stone
2,000.00]
-93.59
1,906.41
1,906
35|Already In
Walls
0.00
0.00
oe
0.00
0.00
37|Concrete Turner LLC
Basement slab
9,210.00
1,461.00
7,749.00
7,749
38| Concrete Turner LLC
(Garage Slab
$8.00 Sqft
6,240.00
6,240.00
6,240.
39|Smede Steel
Stab Mats (re-rodimeshetc,
500.00)
590.00
1,090.00
1,090.
40
-
Framing Lumber
y
0.00
41]84 Lumber w/Truss
Framing Material (Base)
49,400.00]
17,130.91
32,269.09
32,269.
42|ABC Supply
Vinyl Siding
8,500.00]
1,025.35
9,525.35
43]|George Thoms Construction
Siding labor
9,000.00
2,607.00]
11,607.00
44] ABC Carpentry
Roughing Framer
18,013.00)
6,894.00]
24,807.00
24,907.
45
Windows/ Doors
0.00
0.00
46|Home Depot
Exterior doors
1,500.00
-500.00)
1,000.00
1,000
47)|MLC
Windows and labor
16,500.00
16,500.00)
16,500.
48
Stairs
0.00
49
Garage Stairs
0.00
0.00
50
|Roofing
:
0.00
51JABC Supply
Material
6,900.00
238.91
6,661.09)
6,661.
52] Antonio Construction
Labor
3,300.00
3,300.00
3,300.
53]
=
0.00
54]Home Depot
Misc Deck Wood
0.00
1,500.00
1,500.00
55
0.00
0.00
56
Brick
0.00
0.00Page 3
57|Fresh Start Remodeling Cleaning 4,500.00 4,500.00 2,500. 58] Fresh Start Remodeling [Mason sand 0.00] 0.00f 59]|DLK Caulking [exterior cau 2,500.00 2,500.00, 60 Estimating Error/Contingency 0.00 0.00 NAME ADDRESS AND TELEPHONE NUMBER Total Change Adjusted Amount No. |OF SUBCONTRATOR, LABORER OR SUPPLIER Contract Orders Contract Already Price (+) or (-) Price Paid 61 Stone 0.00 62 Material 0.00 0.00 63 Labor 0.00] 0.00 64 Limestone : 0.00 65 Address Stone 0.00 0.00 66 Siding/Gutters 0.00 67]George Thoms Construction Gutters 4,000.00f -1,490.00 2,510.00 68] George Thoms Construction Flashing 100.00] 100.00 69 Shutters 0.00 0.00 70 0.00 71 Fireplace 0.00 72 Prefab Fireplace 0.00 0.00 73 Prefab Mantle/ Surround 0.00 0.00 74 |Hvac 0.00 75] Mulligan Heating, Inc [rougn 8,750.00] -95.00 8,655.00 7,155. 76] Mulligan Heating, Inc JFumaceucts 8,750.00 -95.00 8,655.00 7,155. 77|Mulligan Heating, Inc AC Condensers & Final 0.00 0.00 78] Mulligan Heating, Inc Venting to Exterior 350.00 350.00 350. 79 Plumbing 0.00 80] Scott Brendel Plumbing Rough 4,800.00 3,850.00, 8,650.00 8,650. 81] Scott Brendel Plumbing Final 4,800.00 3,850.00 8,650.00 82] Scott Brendel Plumbing |Fixtures -Tub 1,500.00 1,500.00 1,500. 83 |Etectric 0.00 84]J & D Electrical [Rough 7,000.00) 291.00 7,291.00 7,291. 85]J & D Electrical Final 7,000.00] 291.00 7,291.00 86]J & D Electrical Fixtures 0.00 0.00 87 0.00 88 Prewire Low Volt 0.00 89 Phone (Rough) 0.00 0.00 90 Cable Rough 0.00 0.00 91 Alarm 0.00 0.00 92 Insulation 0.00 93] Gale Insultation Batt/Blanket /Blown 5,000.00 726.00 5,726.00 5,726.
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94 Gale Insultation Energy Seal 1,000.00 1,000.00] 1,000 95|Gale Insultation Energy Testing 275.00 275.00 96|Accurate Insulation Basement Wall Insulation 0.00 0.00 97|Accurate Insulation Winter Package 0.00] 0.00 98 Drywall 0.00 99| Clinton Interiors [Hang and Finish 14,000.00 2,450.00 16,450.00 16,450 NAME ADDRESS AND TELEPHONE NUMBER Total Change Adjusted Amount No. |OF SUBCONTRATOR, LABORER OR SUPPLIER Contract Orders Contract Already Price (+) or (-) Price Paid 100 Garage Doors 0.00 107 Superior Garage Door Doors each a1 §2200 4,400.00 4,400.00 4,400 102] Superior Garage Door Openers 1@9$550 550.00 550.00 103 Ceramic Tile 0.00 104]Fresh Start Remodeling - Floor & Décor Master Bath tle & Labor 5,000.00 2,370.14 2,629.86, 629 105] Mater Bath 0.00 106 Interior Trim 0.00] 10784 Lumber finish trim Doors and Millwork 6,500.00 ~1,552.00 4,948.00 4,948 708 0.00 0.00 109 0.00 0.00 110 Trim Carpentry 0.00 111] Dominic Badalaenti Trimmer Final Draw 6,000.00 6,000.00 6,000 112] Dominic Badalaenti Trimmer Stairs 1,500.00 1,500.00 1,500 113] Series Extras 0.00 0.00 114 Cab. & Vanities 0.00 115] Dominic Badalaenti Trimmer Instaling Cabinets 1,500.00 ~1,500.00 0.00 116|LaF ata Cabinets Cabinets STD 10,500.00 10,500.00 70,500 117 0.00 118] Countertops 0.00 719 Granite 0.00 0.00 120|PMG Lamina tops 3,000.00 247.00 3,247.00 121 Painting 0.00 122] Exterior Paint/Stain 0.00] 0.00 123] Painter [interior Paintstain-tst draw 0.00 0.00 124] A&V Painting Interior Pain/Stin 2nd Draw 33.50sqt 9,000.00| 9,000.00 9,000. 125] Paint - John Paterson Series Extras 0.00 0.00 126 0.00 127] ~ |Hardwood 0.00 128] Fresh Start Remodeling Material 8,500.00 -3,449.11 5,050.89 125] Fresh Start Remodeling Labor 0.00 0.00 131 Accessories 0.00
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132] Golden Glass Mirrors 0.00] 0.00 133] Golden Glass Shower Doors 0.00 0.00 134] Golden Glass Wire Shelving 0.00 ; 0.00 135|Smede Steel Door Hardware 600.00] -600.00 0.00 137) Appliances SS 0.00 140] Sergeant Appliances [Appliances Package 0.00 0.00 138 7 Carpet 0.00 139] Carpet Center Carpet 4,000.00( 4,000.00 NAME ADDRESS AND TELEPHONE NUMBER Total Change Adjusted Amount No. |OF SUBCONTRATOR, LABORER OR SUPPLIER Contract Orders Contract Already Price (+) or (-) Price Paid 139 Ext Flatwork 0.00 140] Fresh Start Remodeling Fill Matl-Sand/6A Stone/21 AA Stone} 4,500.00 4,500.00 141] Turner Concrete (Concrete - Driveway 0.00 0.00 142 Turner Concrete Concrete - Porches & Walks 4,500.00 -340.00 4,160.00 143| Fresh Start Remodeling Interior Cleaning Finish ~~ 1.00/ft 0.00 0.00 144] Fresh Start Remodeling |Extra footings for balcony 0.00 3,000.00 3,000.00 3,000 148] Fresh Start Remodeling Toumpster 2,500.00; 2,500.00 1,000 149] Fresh Start Remodeling Clean up labor 3,000.00 3,000.00 1,000 150 Winterizing 0.00 151]Consumers Energy gas - Hook up 1,500.00 196.86 1,696.86 1,696 152] DTE Energy Hook up power 3,000.00 -2,337.00 663.00 663. 153] Fresh Start Remodeling Punch out list 4,000.00 4,000.00 154] Fresh Start Remodeling Office paperwork 4,000.00 4,000.00 3,000 155] Fresh Start Remodeling Supervision 50,000.00 50,000.00 32,950. 156 Core Insurance Group LLC (General liability Insurance 3,500.00 3,500.00 3,500. 157| Fresh Start Remodeling [Heater rental for basement 326.39 326.39 326. 158] Fresh Start Remodeling [pians for inspector & bluebprints 85.38 85.38 85 159] Fresh Start Remodeling Jumper Supplies 153.00! 153.00 153. 160] Fresh Start Remodeling/ SRM Concrete [extra footings in basement 1,500.00 1,500.00 1,500. 161|Smede-Son Steel [Extra steel for second floor 1,847.00 1,847.00 1,847. 162 Fresh Start Remodeling cutting footing in garage 2,250.00 2,250.00 2,250. 163] Smede-Son Steel [Extra steel 21.00 21.00 21. 164 Fresh Start Remodeling [Window tape for flashing 274.06] 274.06 274. 165] Fresh Start Remodeling |Reinspection Fee 140.00 140.00 140. 166] Consumers Energy gas usage 618.82 618.82 618. 167|DTE Energy energy usage 89.97 89.97] 89. 168 TOTAL COST 368,888.00 5,501 374,389] 267,172. 169 170
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171 172) 173] TOTALS 368,888.00] 5501.17 374.389.17| 267,172. The contractor has not procured material from, or subcontracted with, any person other than those set forth and owes no money for the improvement other than th | make this statement as the (contractor) (subcontractor) or as of the (contractor) (subcontractor) to represent to the owner or lessee of the property and his or her except as specifically set forth in this statement and except for claims of constructions liens by laborers that may be provided under section 109 of the Construction Lien Act, 1980 PA 497, above-described premises and his or her agents that the above-described property is free from claims of construction liens, or the possibility of construction liens, except asspecifically set construction liens by laborers which may be provided pursuant to section 109 of the construction lien act, Act No. 497 of the Public Acts of 1980,as amended, being section 570.1109 of t WARNING TO OWNER: AN OWNER OR LESSEE OF THE ABOVE-DESCRIBED PROPERTY MAY NOT RELY ON THIS SWORN STATEMENT TO AVOID THE CLAIM OF SUBCONTRACTOR, SUPPLIER, OR LABORER WHO HAS PROVIDED A NOTICE OF FURNISHING OR A LABORER WHO MAY PROVIDE A NOTICE OF FURNISHING PURSUANT TO SECTION 109 OF THE CONSTRUCTION LIEN ACT, 1980 PA 497, MCL 570.1109 TO THE OWNER OR LESSEE IF THE DESIGNEE IS NOT NAMEDOR HAS DIED. ON RECEIPT OF THIS SWORN STATEMENT, THE OWNER OR LESSEE, OR THE OWNER'S OR LESSEE'S DESIGNEE, MUST GIVE NOTICE OF ITS RECEIPT, EITHER IN WRITING, BY TELEPHONE, OR PERSONALLY, TO EACH SUBCONTRACTOR, SUPPLIER, AND LABORER WHO HAS PROVIDED A NOTICE OF FURNISHING UNDER SECTION 109 OR, IF ANOTICE OF FURNISHING IS EXCUSED UNDER SECTION 108 OR 108A, TO EACH SUBCONTRACTOR, SUPPLIER, AND LABORER NAMED IN THE SWORN STATEMENT, IF A SUBCONTRACTOR, SUPPLIER, OR LABORER WHO HAS PROVIDED A NOTICE OF FURNISHING OR WHO IS NAMED IN THE SWORN STATEMENT MAKES A REQUEST, THE OWNER, LESSEE, OR DESIGNEE SHALL PROVIDE THE REQUESTER A COPY OF THE SWORN STATEMENT WITHIN 10 BUSINESS DAYS AFTER RECEVING THE REQUEST. WARNING TO DEPONENT: A person who gives a false sworn statement with intent to defraud is subject to criminal penalties as provided