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Home My WebLink About4.i. Approve Pay Estimate #6, West Ridge 3rd Addition . . iT�� , , ' , CITY OF ROSEMOUNT � APPLICATION FOR PAYMENT NO. _� CITY PROJECT NO: I�5 SEH FILE NO: S�II3 7 PROJECT: WESTR i��E 3�'D ADD STR�ET F� i1?lL 17Y GDN STR UG7�ON CONTRACTOR: /�/pp�p ('�NSi, � ,�NG, CONTRACT DATE: ��j� �pjq �,cU. (�X 33$ APPLICATION DATE: 'T�oZ4 l q(� f}�-EXA-ND P-I A , M l� ��308 FOR PERIOD ENDING: �f a2�-,�9 p Total Contract Amount $ 31�,O�S,ov Total Amount Earned $ 31 b�4-00..2'� Material Suitably Stored on Site, Not Incorporated inta Work � $ --�-- Contract Change Order No. �_ Percent Complete /oo s /a� �'g 4.�i3 / Contract Change Order No. Percent Complete $ Contract Change Order No. Percent Complete $ GROSS AMOUNT DUE . . . . . . . . . . . . . . . . . . $ 3�'7� 39 5.O$ LESS � $ RETAINAGE . . . . . . . . . . . . . . . . s /b,369-7S AMOiJNT DUE TO DATE . . . . . . . . . . . . . . . . . . . . $�I I.025'. 33 LESS PREVIOUS APPLICATIONS . . . . . . . . . . . . $ eZ$3� �,Oe�Z,. S I � AMOUNT DUE THIS APPLICATION . . . . . . . . . . . $ a �I, $aa,$oZ. � � , � � . _ ' z � 3t�� ichard Hef�a. City Engineer/D'� ctor of Public Works / r . a . . �� .� � �..�� .� . � APPLICATION FOR PAYMENT � � �`.�-•� .� .. SHORT E!.!1E;7 ti�ii�4ICKS0i'�. ItJC. (UNIT PRICE CONTRACT) IL41 �� 1 !„q� NO. 6 •��- . 1ER: ROSEMOUNT MINNESOTA OWNER'S PROJECT NO. ------------------------------------ -_----1-95--------- � ENGINEER'S PROJECT NO. 89137 �ATION: ROSEMOUNT, MINNESOTA .1TRACTOR NODLAND CONSTRUCTION CO. , INC. CONTRACT DATE g�ll/89 ---- ------------------------- P.O. BOX 338 CONTRACT AMOUNT $316,025.00 ---- ----------------------- ALEXANDRIA, MINNESOTA 56308 ------------------ VTR. FOR WEST RIDGE 3RD ADD. ST. & UTILITY CONST. - ROSEMOUNT, MINNESOTA ---------------------------------------------------- ?LIC.DATE 7-24-90 --------- RIOD END. 7-24-9p ------------------------- APPLICATION FOR PAYMENT CONTRACT QUANTITY UNZT DESCRIPTION UNIT QUANTITY TO DATE PRICE TOTAL �6.408 8" PVC, 10' -12' DEEP L.F. 968 868 10.00 $ 8680.00 �6.408 8" PVC, 12' -14' DEEP L.F. 100 192 10.00 $ 1920.00 �6.408 8" PVC, 18 ' -20' DEEP L.F. 80 80 12.00 $ 960.00 �6. 610 10" DIP, 16'-18' DEEP L.F. 130 236 24.00 $ 5664.00 i6. 610 10" DIP, 18 ' -20' DEEP L.F. 262 499 25.00 $ 12475.00 j6.b10 10" DIP, 20' -22' DEEP L.F. 443 227 26.00 $ 5902.00 >6. 610 10" DIP, 22'-24' DEEP L.F. 131 197 27.D0 $ 5319.00 �6. 610 1Q" DIP, 24' -26' DEEP L.F. 276 81 28.00 $ 2268.00 :E 1 OF 5 SHORT-ELLIOTT-HENDRICKSON, INC. G.5E.701 STANDARD MANHOLE, 8' DEEP EACH 8 8 700.00 $ 5600.00 0256.702 EXCESS DEPTH STANDARD MH L.F. 69 67.6 '60.00 $ 4056.00 0256.705 8" PVC CLEAN OUT L.F. 13 17. 3 25.00 $ 432. 50 0256.706 MANHOLE DROP SECTION L.F. 32 19. 88 80.00 $ 1590.40 0256.801 8" BY 4" PVC WYE EACH 25 25 100.00 $ 25Q0.00 0256.801 10" BY 4" DIP TEE EACH 17 17 160.00 $ 2720.00 J256.803 4" PVC SERVICE L.F. 1995 1989 6.00 $11934.00 0256.805 4" DIP RISER L.F. 225 1�5 12.00 $ 2100.00 025b.900 CONNECT TO EXISTING SEWER EACH 1 � 100.00 $ 100.00 0256.900 CUT INTO EXISTING MANHOLE EACH 2 2 100.00 $ 200.00 0257.406 6" DIP WM, CL 52 L.F. 1450 1427.5 10.00 $14275.00 0257.408 8" DIP WM, CL 52 L.F. 1280 1279 12.00 $15348.00 0257. 606 6" RS GATE VALVE AND BOX EACH 2 2 350.00 $ 700.00 �257. 608 8" RS GATE VALVE AND BOX EACH 4 2 450.00 $ 900.00 0257. 630 FITTINGS LESS THAN 12" LB. 1300 1143 1.40 $ 1600.20 0257. 640 FIRE HYDRANT EACH 6 6 1000.00 $ 6000.00 0257.710 1" COPPER SERVICE L.F. 2085 2117 3.00 S 6351.00 �257.730 1" CORPORATION EACH 42 42 20.00 $ 840.00 0257.740 1" CURB STOP & BOX EACH 42 42 60.00 $ 2520.00 0257.$O1 8" ON 12" PRESSURE TAP EACH 2 2 1600.00 $ 3200.00 �257.806 INSULATION BD. FT 200 0 1.00 $ 0 �257.903 CONNECT TO EXISTING WM EACH 2 2 100.00 $ 200.00 �258.401 12" RCP CB LEADS, CL. IV L.F. 368 348. 2 17.00 $ 5919.40 �258.4Q2 15" RCP CB LEADS, CL. III L.F. 139 150 18.00 $ 27D0.00 ]258.415 15" RCP STORM SEWER CLIIZ L.F. 346 184 19.00 $ 3496.00 )258.418 18" RCP STORM SEWER CLIII L.F. 663 210 20.00 $ 4200.00 )258.421 21" RCP STORM SEWER CLIIT L.F. 55 207.5 22.00 $ 4565.00 )258.424 24" RCP STORM SEWER CLIII L.F. 60 544. 5 23.00 $ 12523.50 'AGE 2 OF 5 SHORT-ELLIOTT-HENDRICKSON, INC. �8.427 27" RCP STORM SEWER CLIII L.F. 497 493 ,25.00 512325.00 58.436 33" RCP STORM SEWER CLIII L.F. 1104 1011 32.00 532352.00 58.536 33" RCP APR W/TRASH GUARD EACH 1 1 750.00 $ 750.00 , 58.603 MANHOLE, TYPE B L.F. 27 �� 60.00 $ 1 8.00 �8. 604 MANHOLE, TYPE C L.F. 99 91 .0 100.00 $ 9100.00 �8. 605 MANHOLE, TYPE D L.F. 24 30.7 150.00 $ 4605.00 58.?04 CATCH BASIN, TYPE X L.F. 35 �� _ � 50.00 $ 175 .00 �8.705 CATCH HASIN, TYPE Y L.F. 39 an ti b0.00 $ �4�6_ 00 �8. 801 R 1733 MH CASTING EACH 15 15 130.00 $ 1950.00 �8.808 R 3067 CB CASTING EACH 18 1g 180.00 $ 3240.00 �8.809 R2561A CB CASTING EACH 2 � 180.00 $ 360.00 58.920 GROUTED RIPRAP CL. III C.Y. 15 15 50.00 $ 750.00 �8.921 GRANULAR FILTER MATERiAL C.Y. 7 '7 20.00 $ 140.00 73. 501 STRAW BALES EACH 20 gp 5.00 $ 400.00 �5. 501 COMMON EXCAVATION C.Y. 1000 4350 0.50 $ 2175.00 �5. 521 GRANULAR BORROW (LV) C.Y. 1000 p 1.00 $ 0 11.501 TEST ROLLING R.S. 24 24 35.00 $ 840_00 12.501 SUBGRADE PREPARATION R.S. 24 24 65.00 $ 1560.00 11.503 AGG. BASE PLACED, CL. 5 C.Y. 1780 1780.00 8.50 515130.00 31. 504 BIT. MATERIAL FOR MIXTURE TON 35 47 . 26 125.00 $ 5907.50 31. 514 BASE COURSE MIXTURE TON 770 843.88 9.30 $ 7848.08 �1. 504 BIT. MATERIAL FOR MIXTURE TON 50 49. 25 125.00 $ ��5�°'�aS OG: � �,� _ .- �1. 508 WEARING COURSE MIXTURE TON 770 857. 77 10.30 $ 8$35.03 i7. 502 BIT. MAT FOR TACK COAT GAL. 450 400 1.30 $ 520.00 )4. 602 ADJUST GATE VALVES ' EACH 6 � 50.00 $ 350.00 )6.522 ADJUST FRAME/RING CASTING EACH 14 16 75.00 $ 1200.00 ;1.501 4° CONCRETE WALK S.F. 9600 c�7c�� _Q 1.15 $ 11260. 11 �E 3 OF 5 SHORT-ELLIOTT-HENDRICKSON, INC. APPLICATION FOR PAYMENT - Continued � � � � . $ 31 Ca,u�o�.�� s T�tal Contract Amount $ 316,025 .00 Total Amount Earned Material Suitably Stored on Site, Not Incoporated into Work $ � Contract Change Order No. 1 Percent_Compt ete 100� � $ 10,994.81 Contract Change Order ��o. percent Complete $ Contract Change Order �do. Percent Complete g 3�'1, 3q�'•O$ n�s GROSS AMOUNT DUE. . . . . . . . . . . . . . � , . LESS 5 � RETAINAGE. .. . . .. .. $ -i��3 �'�� DF� AMOUNT DUE TO DATE. . . . . . . . . . . . . $��--��" LESS PREVIOUS APPLICATIONS. . . . . $283, 202.51 +� AMOUNT DUf THIS APPLICATION. .. . $ ��.�,��-'�'F' GONTRACTOR'S AFFIDAVIT The undersigned Contractor hereby swears under penalty of perjury that (1) all previous progress. payments received from the Owner on account of work performed under the contract referred to above have been applied by tfie undersigned to discharge in full all obligations of the under- signed incurred in connection with work covered by prior Applications for Payment under said contract, and (2� all material and equipment incorporated� .in said project or otherwise listed in or covered by this Application for Payment are free and clear of all liens, claims, security interests and encumbrances. Dated 7 - Z 4 � lg qp . NODLAND CONSTRUCTION CO. , INC . Con actor BY - -tv�a S. Name and Title �OUNTY OF _) SS �TATE OF �inie�' ) 3efore me on this day of , 19 9� persona9ly appeared known to me, w�io being�TcuTy swarn, did depose 3nd say that he is the of the Contractor above mentioned; Office that he executed the above Application for Payment and Affidavit on behalf of said Contractor; and that all of the statements contained therein are true, correct and complete. . 2teala,�.lac,�,G��7��annn.a,ar�.a�,�;t,..�. � JJ • C�./�e.�/G.�'L`'l/�? < � �,t•,r.nc.� �� My Corn�i��?�n B��sc , �,�1;'�9y� e� �'�' � h'0 Art'r P(;3;!� . M?IN SGTA � NOtd1'�l PUb 1 C '! j� ANQKA COUNTY '�� My Commiss�on Exp�res P�ta 11 1gQ � rhe urt�d�r�x��e�•:-b�a.s•,�;k�ecJ��t��;��tractor's Application for Payment shown above. A part of :his Appl�cation is the �Contractor's Affidavit stating that all previous payments to him �nder this Contract have been applied by him to discharge in full all of his obligations in �onnection with the work covered by all prior Applications for Payment. `n accordance with the Contract, the undersigned approves payment to the Contractor of the �mount Due. )ate �` Z�l �O SHORT E T HEN CKSON I N . By age 5 af 5