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Approve Pay Estimate #1, Pine Bend Trail Reconstruction �- � ��M # �. � � � � ; � � ' CITY OF ROSEMOUNT APPLICATION FOR PAYMENT NO. _� CITY PROJECT N0: ,�9LI SEH FILE NO: g�oZ`7 3 PROJECT: _ P!lYE F„3�M/) T2A-1t- R�CON ST12vG-T7at� CONTRACTOR: �C� $L,��KT'pP� ��/G• CONTRACT DATE: "�f f.Z�'�90 7.250 DIGKiNAN TR�-jG APPLZCATION DATE: $/ g /90 SN✓f.�Ga20VE IG/F/�.�,NTS FOR PERIOD ENDING: $l q / 90 /�/�v�YESax'A SSS'o 7� Total Contract Amount $ 2?S�341. �3 Total Amount Earned $ �4.;�,?3�.¢¢� ,--- Material Suitably Stored on Site, � Not Incorporated into Work . $ ' Contract Change Order No. � Percent Complete $ �Nc.t.u�fD ABav�.� Contract Change Order No. Percent Complete $ Contract Change Order No. Percent Complete $ GROSS AM4UNT DUE . . . . . . . . . . . . . . . . . . . . . . $_ I�EaZ,eZ�,�-*�' LESS S $ RETAINAGE . . . . . . . . . . . . . . . . . . . $ �,/;II • �3 AMOUNT DUE TO DATE . . . . . . . . . . . . . . . . . . . $ I3S I��•SJ LESS PREVIOUS APPLICATIONS . . . . . . . . . . . . $ �"� AMOUNT DUE THZS APPLICATION . . . . . . . . . . . $ 13S�I�0.$I O . .c � ` ` � �� ichard M. , City Enginee ' ector of Public Works � � � � � � �� APPLICATION FOR PAYMENT ------------------------- SHORT EL!{OTT N3wiy�RiCKSOi�J, INi.. (UNIT PRICE CONTRACT) A►1� 1� 1990 NO. 1 ------- �Ty �� JER: ROSEMOUNT, MINNESOTA OWNER' S PROJECT N0. 199 ENGINEER' S PROJECT N�. 89273 --------------- �ATION: PINE BEND TRAIL vTRACTOR ACE BI.�CKTQP INC. CONTRACT DATE '7l�S� q4 ------------------------------- - --------------------- 7280 DICKMAN TRAIL CONTRACT AMOUNT $275,341. 63 --- ---------------------- INVER GROVE HEIGHTS,MN 55076 VTR. FOR PINE BEND TRAIL STREET RECONSTRUCTION - ROSEMOUNT, MINNESOTA ---------------------------------------------------- ?LIC.DATE �� 9 � 9p ---------- 3IOD END. ---$��1-90----------- APPLICATION FOR PAYMENT CONTRACT QUANTITY UNIT DESCRIPTION UNIT QUANTITY TO DATE PRICE TOTAL ---------------L.S. --------------------------------------- z1. 501 MOBILIZATION 1 0.85 10000.00 8500.00 :.01.501 CLEARING ACRE 0. 25 675.00 $ '01. 506 GRUBBING ACRE 0 675.00 $ �4. 501 REMOVE CULVERTS L.F. 40 6.00 $ �4. 509 REMOVE RAILROAD CROSSING EACH 1 1 200.00 200.00 .05. 501 COMMON EXCAVATION C.Y. 60 52 10.30 535. 60 _05.507 SUBGRADE EXCAVATION C.Y. 1125 15 4.45 66.75 05.521 GRANULAR BORROW (CV) C.Y. 590 4. 95 $ 05. 535 SALVAGED TOPSOIL C.Y. 10 3. 50 $ JE l OF 4 SHORT-ELLIOTT-HENDRICKSON, INC. 2118. 501 AGG. SURFACING, CLASS 2 TON 50 10.50 $ *2211. 502 AGG. HASE, CLASS 5 C.Y. 1600 892 6.30 5619. 60 *2231. 501 BIT. PATCHING MIXTURE TON 0 23.80 $ *0231. 606 BIT SURFACE JOINT & CRACK REPAIR L.F. 0 1.27 $ 2331. 508 TYPE 41 WEARING COURSE MIXTURE TON 3460 2686.07 17.70 47543.44 *2331. 512 TYPE 31 LEVELING COURSE MIXTURE TON 0 19. 10 $ 2357. 502 BIT. MATERIAL FOR TACK COAT GAL. 1215 400 1.00 400.00 2501 . 511 35"X24" CS PIPE CULVERT L.F. 38 31.00 $ 2501 . 515 35"X24" CS PIPE APRON EACH 2 150.00 $ 2506. 517 CAST. , TYPE R-2560-EB (GRATE ONLY) EACH 1 150.00 $ 0563. 601 TRAFFIC CONTROL L.S. 1 0:7 7950.00 5565.00 2564. 531 F & I SIGN PANEL, TYPE C S.F. 110 16.75 $ 0564. 532 F & I SPECIAL SIGN, "K" EACH 11 35.00 $ 0564. 532 F & I SPECIAL SIGN, "L" EACH 1 35.00 $ 0564. 602 F & I STREET NAME SIGN EACH 1 200.00 $ 0580. 503 4" SOLID LINE YELLOW - PAINT L.F. 8865 0.18 S 0580. 507 4" BROKEN LINE YELLOW - PAINT L.F. 22fi 0. 18 $ *2573. 501 BALE CHECK EACH 4 6.25 $ 2575. 502 SEED, MIXTURE 700 LB. 50 6.00 $ *2575. 523 WOOD FIBER BLANKETS, S.Y. 50 2.75 $ TYPE HV - *MILL BIT. SURFACE, FIRST COVERAGE S.Y. 21500 20800 D.74 15392.00 *MILL BIT. SURFACE, SECOND COVERAGE S.Y. 21500 0.39 $ ?AGE 2 OF 4 SHORT-ELLIOTT-HENDRICKSON, INC. *BASE PREPARATION AND COMPACTION S.Y. 21500 20$00 0.41 8528.00 *TYPE 31 BINDER COURSE MIXTURE TON 3100 2518.26 17. 50 44069. 55 *SHOULDER PREPARATION R.S. 80 77.5 75.00 5812:50 ENOTES REVISIONS PER CHANGE ORDER NO. 1 �E 3 OF 4 SHORT-ELLIOTT-HENDRICKSON, INC. • � : ' . APPLICATION FOR PAYMENT - Continued � , . Total Contract A�unt $ *199 ,479 . 88 Tota1 Amount Earned $ 142,232 .44 Material Suitably Stored on Site, Not Incoporated into Work $ Contract Change Order No. l �ercent_Complete � %Included Above Contract Change Order No. Percent Complete $ Contract Change Order No. Percent Complete � GROSS AN�UtVT DUE. . .. . . . . . . .. . . . $ 142 ,232 .44 LESS 5 % RETAINAGE. . . . . .. .. $ 7, 111,63 � AMOUNT DUE TO DATE. . . . . .. . . . . . . $ 135 , 120 . 81 LESS PREVIOUS APPLICATIONS. . .. . $ 0 . 0 0 AMOUNT DUE THIS APPLICATION. .. . $ 135 ,120 . 81 CONTRACTOR'S AFFIDAVIT The undersigned Contractor hereby swears under penalty of perjury that (1) all previous progress. payments receiv.ed from the Owner on account of work performed under the contract referred to above have been applied by the undersigned to discharge in full ail obligations of the under- signed incurred in connection with work covered by prior Applications for Payment under said contract, and {2) al] materiai and equipment incorporated in said Praject or otherwise listed in or covered by this Application for Payment are free and clear of all liens, claims, security interests and encumbrances. Dated August 9 , 19 90 , Ace Blacktop , Inc. Contractor � By - (Name and Tit e COUNTY OF �a� SS STATE OF �'I.'.ar,es�_. ) 3efore me on his /G � day of • , 19 1�4 personally appeared $ �e knawn to me, w o bein�g�uTy sworn, did depose �nd say that he is the e r of the Contractor above mentioned; Offi that he executed the above Application for Payment and Affidavit on beh of said Contractor; and that all of the r�in ar true, corr t and mplete. �`�'�� 6f�T.•��EEN M. S�1;E�ENEY My Commission Ex ir ""'"=° P z• �-��raoraRY Pvsuc—rw;ror��soTa DkKQTACOU�VTY otary ubl ic �r commissian.Expi►es 6=1s•sa The undersigned has chec e e on ra or R piication for Payment shown abo�re. A part of this Application is the Contractor's Affidavit stating that all previous payments to him under this Contract have been applied by him to discharge in full all of his obligations in connection with the work covered by all prior Applications for Payment. In accordance with the Contract, the undersigned approves payment to the Contractor of the Amount Due. Q, /`3 /p�„ SHORT EL I NE CKSO I Date CJ[ � /�� By Page 4 of 4