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18-0829_PALP INC., DBA EXCEL PAVING COMPANY_Preliminary NoticeFile #: 5096 [CAI[PUBLICI[COPY:EST] I Customer: Excel Paving Company Recording Requested by and Return to: I P.O. #: Hill Crane Service, Inc Project: 32221 Del Obispo Street Project Rec ID: 18A71C74-CEBO-4F51-A3EB-084916374191 3333 Cherry Ave Job #: Long Beach, CA 90807 Cert No.: CALIFORNIA PRELIMINARY NOTICE - PUBLIC WORKS (=Z0 1=ZCZ Z8 OIVZN MODAW 70 CLLZFGXNZA CIVIL C=Jr 15 8034(8), 6102, 8106-6110, 8700 at seq., 0612, 9300 at Seq.) >> TO THE PUBLIC ENTITY OR REPUTED 1. The following is a general description of City of San Juan Capistrano the labor, service, equipment or materials 32400 Paseo Adelanto furnished or to be furnished by the undersigned: SAN JUAN CAPISTRANO, CA 92675 Crane Rental USA 2. The estimated amount of the work provided or to be provided is $6,000.00 3. The name of the person or entity who furnished TO DIRECT OR REPUTED CONTRACTOR that labor, service, equipment or Excel Paving Company materials is: 2230 Lemon Ave Hill Crane Service, Inc LONG BEACH, CA 90806 3333 Cherry Ave USA Long Beach, CA 90807 USA Relationship to Parties: Equipment Supplier >> TO LENDER, SURETY OR BONDING CO. OR 4. The name of the person or entity who contracted for >> REPUTED LENDER, SURETY, BONDING CO. purchase of that labor, service, equipment or material is: Excel Paving Company T r-� Z 2230 Lemon Ave <L LONG BEACH, CA 90806 =�= USA S. The description of the jobsite is: C3 yi UJ 32221 Del Obispo Street Project UJ Ln y 32221 Del Obispo St UJ H .� SAN JUAN CAPISTRANO, CA 92675 .�+ 0— V =3 USA LL J c 00 County of ORANGE �w REQUEST FOR COPY OF PAYMENT BOND AND NAME OF SURETY COMPANY TO CONTRACTING BODY. City of San Juan Capistrano 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 Long Beach, California on 08/29/2018 for H SERVICE, INC. Prepared by: Kelly Ittner, Accounting Phone: (562) 595-6031 Fax: (562) 595-1771 PROOF OF SERVICE BY NAIL 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 above, on 08 declare under penalty of perjury that the foregoing is t e anrect. ong Beach, California on 08/29/2018. Prepared by: Kelly Ittner, Accounting USPS CERTIFIED MAIL Hill Crane Service Inc 3333 Cherry Ave Long Beach CA 90807 9214 8901 7795 9300 0000 0372 73 CITY OF SAN JUAN CAPISTRANO 32400 PASEO ADELANTO SAN JUAN CAPISTRANO CA 92675 Postage: 5102800