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Home My WebLink About4.n. Authorize Payment #5 for Shannon Parkway & Connemara Trail, City Project #189 t� . ..� . . . �1�J_�� . � � �.; �.' � �. `�� '_., APPLICATION FOR PAYMENT ;�bRT r!�;�iT ;:�':.'k'G;tS�iJ. IP�f,. (UNIT PRICE CONTRRCT) pi�� ;; ��:'��! NO. 5 � . . . _�_�._.�.� � .. � I r `l�.V� . . � � . . OWNER: ROSEMOUNT, MTNNESOTA OWNER'S PROJECT NO. 1$4 ENGINEER'S PRQJECT NO. $$254 LOCATION: ROSEMOUNT, MINNESOTA -- _____..�______ .�,,.� , , � CZTY OF 1tOSEMOUNT . �PPLICJITZON FOR PAYt�NT r�. _� �c�ti -� ��I�,�--7 . CITY PROJECT NO: ��?J� SEH FILE NO: �1 fS2 S'•¢ PROJECT: Sl�tibv�vo+u p�t�,p.Y � 5�4�'Lo8•/06�04 � Cp�v�r��t,.S�yo�OB-tof-c CONTRACTOR: �t'P KeII�Pw• �,z�-. �'p. �O��CT .DATE: �I �'�g� '�"�a/ ��re, APPLiCATION DATE: _ �� 8'} �fi �I, ��. SSIt7 FOR PERIOD F�tDING: �� j„9 Total Coatract Am�unt $_ '�$4,7�9 °-�'� Total Amount Earned S 3 -¢Z� 7 7Q— Mater3al Suitably Stored on Site, Not Incorporated into Work $ Coc�tract Change Ozder 'No. Percent Complete $ Contract Change Order No. Percent Complete g Contract Char�ge Order No. Perc�nt Complete s GROSS AMOUNT DU� . .. . . . . . . . . . . . . . . . . . . . $ 3`fi"Z, ?7a "� � LESS S$ RET�►IN1lGE . . . . . . . . . . . . .. . . . . . $ I7� �� . RMOUNT DUS T4 QATE . . . . . . . . . . . . . . . . . . . . $_ 32..�5�� 3 ) `�' LESS PREVZOUS APPLZCATIONS . . , . . . . . . . . . $ Z7�� }39 `� ��. � . � . � . . . a�' '� � •. . � .. . . .. . 0256.608 8" DIP, 14' -I6 ' DEEP L.F, 45 45 16.QO $ 7�Q.� 0256.608 8" DIP, 15'-1$' DEEP L.F. 40 40 1b.Q0 $ 64p.00 0256. 608 $" DIP, 18' -20' DEEP L.F. 50 153 16.00 $ 2r448.00 0256.608 8" DIP, 20' -22' DEEP L.F. 65 32$ 16,QO $ 5,248.00 0256.608 g" DIP, 22' -24 ' DEEP L.F. 330 476 i6.00 S 7,616.OQ Q256. 608 8" DIP, 24' -2b' DEEP L.F. 595 �5� 16.00 S g�32$.QQ 0256.608 8" DIP, 26' -28' DEEP I�.F. 3p1 47�_ 16.00 $ Z�6),6�� 0255.?Ol STND MANNOLE, $' DEEP EACH 11 ],2 800.00 $ 9,b0�.OQ 0256.702 EXCESS DEFTH STND MH L.F. 148 143 70.00 S 10,0I0.OQ 0256.706 MANHOLE DROP SECTION L.F. 41 38,33 110.00 S 4,216.30 0256.900 CONNECT TO EX SEWER EACH 5 4 1500.0(? $ 6,000.� 0256.910 8" DIP FORCEMAIN L.F. 1700 1733 12.0� S 2Q,796.04 0256.911 AIR RELIEF MANNOLE EACH 1 1 20�0.�0 S Z,ppQ,pp SECTION II - WATERMAIN 02��.40� �,► nip wrt, cL, s�-------'�.F. �eo �,��. xo.00 s5 3�610.oa 0257.408 8" DIP WM, CL. 52 L.F. 45 3g 12.0(3 S 420.OQ 0257.412 12" DIF WM, CL. 52 L.F. 605 6O�T 15.00 $ g,430,� 0257.416 16" DIP WM, CL. 52 L.F. 2270 T�A 23.QO $ 51��,7.� I, 0257.606 6" RS GATfi VALVE & Ht?X EACH 8 g,__ 3Q0.00 S �,�^� 0257.608 8" RS GATE VALVE & HOX EACH 1 ^� 400.OU $ 4�` 0257.613 12" BTRFLY VALVE & BOX EACH 1 1 650.Q0 $ �5p_00 0257. 617 16" HTRFLY V,�LV£s & HOX EACH 3 4 1300.00 $ 5,2pp.(� 0257. 63Q FITTINGS LESS THAN 12" LB. 490 450 1.00 $ 450.� 025?.631 FITTINGS 12" AND LARGER L8. 7250 J6g4 i.00 $ 7,69�,pp 0257. 640 FIRE HYDRANT EACH 7 �, 925.Q0 $ �,�SQ.� 0257.903 CONNECT TO E:� WM EACH 7 4 500.OU $ 2, .pQ PAGE 2 OF 5 SHORT-�LLIOTT-HENDRICKSON, INC. � ` • • S�CTTON III - STREET, STORM SEWER, AND LIGNTIN� 2021.501 MOBILIZATION L.S. 1 ], 1800Q.00 $ 18�000.00 21Q5.501 C(3MMON EXCAVATION C.Y. 1000 � 2.Q0 $ 2�(�p.Op 2105.521 GRANULAR BORROW (L.V. ) C.Y. 1000 �_ 1.OU $� O.Op 2112. 501 SUHRADE PREPARATION R.S. 44 _,� 1Q0.(JQ S 4,4Ca0_�O 2116,501 CORE EXCAVATION C.Y. 2000 �� 1.00 $ n_� �116.503 AGGREGATE HACKFILL C.Y. 200Q Q 1.00 S 0.� 0211.504 4" AGG BASE FOR SDWALK, CS.F. 33Q60 (Z Q.20 S Q.p4 2211.503 AGG BASE PLACED, CL. 5 C.Y. 6050 50� 7•50 � 37�5Q9.OQ 23�1. 504 BIT MATE:RIAL F(JR MIXTUR� TON I3� �� 128.QO $ Q.QQ 2331. 514 BASE COURSE MIXTURE TQN 2840 � $.�t3 $ p,pp � 2341.504 BIT MATERIAL FOR MIXTURE TON 173 Q 128.QC3 $ ,,�pp_ 2341.50$ WEARING CQURSE MIXTURE TON 2890 � 8.20 S p,� 2357.502 BIT MAT FOR 'PACK COAT GAL. �.310 � 1.00 $ p,pQ 2503.511 12" RCP STORM SEWER, CL. V L.F. 565 5�� I.4.0� S � 7,�196.00 2503.511 15" RCP STORM SEWER, CL. IV L.F. 832 �ga 16.00 $ �2,656.00 2503.511 18" RCP STOR�4 SEWER, GL. IV L.F, 653 714 17.00 $ 12.138.00 2503. 511 21" RCP STORM SEWER, CL. IV L.F. 511 _�� 18.00 S 9,2 6.OQ 2503.511 24" RCP STORM SEWER, CL. III L.F. 24 2,� 2$.OU $ 432.00 2504.602 ADJUST GATE VALVE HOX EACH 21 � 100.00 $ �_� 2506. 506 CONSTRUCT MH, DESIGN B I,.F. 82.5 75 92.QO S 6,900.Q0 2506. 506 CONSTRUCT MN, DESIGN C L.F. 5,6 �.5 190.00 S 2,850.� ' 2506. 506 CONSTRUCT MH, DESIGN Gl L.F. $.6 Z` 17Q.UQ $ ],,ZgQ.Qp 2506.506 CONSTRUCT MH, DESIGN Y L.F. 21 ��.� 175.00 $ 31Qg�,pp 2506.509 CONSTRUCT MH, DESIGN X L.F. 32.1 �6_�d 1Q5.0� $ �,��a PAGE 3 OF 5 $H�RT-ELLIOTT-HENDRICKSC3N, INC. : . . . , � • 2506.511 RECONSTRUCT MANHQLE L.F. 20 p fi5.pp g O.pp 2506.516 CASTING ASSEMHLY, TYPE R-1733 EACH 10 p 150.00 $ p.pp 2506.516 CASTING ASSEMHLY, TYPE R-3067 EACH 16 p 25t3.QO $ O.qp 2506.522 ADJUST FRAME AND RING CASTING EACH 56 _� 100.QQ $ p,00 2521.511 2" HITUMINOUS WALK S.F. 33�60 Q 0.30 $ p,QQ 2531.5A1 CONCRETE CURB & GUTTER, AESIGN D418 L.F. 2920 2,gpp 4.30 $ 12,040.� . 2531.501 CONCRETE CURH fi GUTTER, DESIGN 8618 L.F. 5640 ,��_ 4.3Q S 23,220.00 2545.511 LIGHTING UNITS, TYPE H EACH 5 � 1Q00.00 $ p.pp 2545.511 DIRECT BURIED CABLE L.F. 111Q � 3.00 $ �pp 2545.552 FEED POINT EACH 2 Q 1500.0t? $ �� 2554. 505 PERMANENT BARRICADES L.F. 32 p 25.00 $ �.�Q 2564.531 F&I SIGN PANELS, TYPE C S.F. 193 _� 17.00 $ p pp 0564.602 CROSSWALK PVMENT MESSAGE EACH 2 Q_ gp.pp $ Q pp 2564.603 4" WIDE SOLID LIN�, YELLOW L.F. 6750 � 0•� 0.25 S 2564.603 4" WIDE BROK�N LTNE, WHITE L.F. 980 0 0.25 $ 0.4Q PAGE 4 OF 5 SHORT-ELLIOTT-HENDRICKSON, 223C. . � ` . a�CATION FOR PAYMENT - Continue� Total Contract Amount � 563,760.5o Total Amaunt Earned $ 342,770.00 Material Suitably Stored on Site, Not Incoporated inta Work $ p.pp Contract Ghange Qrder Flo. Percent.Comptete $ Contract Change prder �lo. Percent Complete $ Contract Change Order tJo. Percent Complete $ GROSS AN�UNT DUE. . . . . . . . . . . . . . . $ 342,770.00 IESS �% RETAIPtAGE. . . . . . . . . $ 17_,_�_138,54 AMOUNT DUE TQ DATE. . .. . . . . . . . . . $ 325,63I.50 LESS PREVIQUS APPIICATIONS. . . . . $ 274,939.5Q � � Ah�UNT DUE THIS APPLICATION. . . . $ 50 692.00 CONTRACTOR'S AFFIDAVIT { �' he undersigned Contractor hereby swears under penalty of per�ury that (1} all previous pragress. payments received from the Owner on account of work performed under the contract referred to above have been applied by the undersigned to discharge fn full all obligations of the under- signed incurred in cannection with work covered by priar Applications for Payment under said contract, and (2) ail material and equipment incor�.�orated in said Project ar otherwise listed in or covered by this Application for Payment are free and clear of all liens, ctaims, security interests and encumbrances. , Odt@d _��t,y�- �, �_, ],Q �r, Austin P. Keller Cvnstruction Co. ' Con rac er ..� By .-Gc . � Name and Title �OUNTY OF � $5 �Terry G. Larson, Vice President STATE OF • ) 3efore me this 1g day af , 19 8� personaily appeared nown to me, w o bein� u y swarn, did depose ind say t at he the ' of the Contractor above mentioned; ice that he executed the above Application for Payment and Affidavit on behalf of said Contractor; and that all �of the statements�co � ed therein are�rue�,�correct and omplete. ..,�1 . My Commission Expires: . � . .'i'�'�� I^ .: �;M.,,� Notary Pu c The undersigned has checked the Contractor's Application for Payment shown above. 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 atl of his abligations in . connection with the wark covered by all prior Applications for Payment. In accordance with the Contr,�ct, the undersigned approves payment to the Contractor of the Amount Oue. �� SHORT E T DRIG 0 FRaC. Date _____�� _ gY paae S of S .