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HomeMy WebLinkAbout4.j. Approval Final Payment, Shannon Parkway Street Improvements , Contract #1987-4 i � _. k . . . � . . . � . � � . � � . � � . • � � . . � � � . •� � � . � � � . . . ....�-���, �y ' .� • *�*�**********�*******�****�*******��r**�MEMQ*�r*�******���*�***��********�**�**** nATE: FEBRUARY 2, 1989 TO c rlAYOR & COUNCILriEMBERS C/0 ADMINISTRATQR JILK FROM: GfTY ENGINE�RJPUBLIC WOt2KS DIRECT4R HEFTI RE: iTEMS F4R 'TliE �EBRUARY 7, 1989 COUNCIL MEETING GOAISENT AGE�IDA . Approve Final Payment, Cantraet 19$7-4 Shannon Parkwa Str�et Im rovements Tt�is item is for consideration o€ final payment for the constructian of Shannon P�rkway between 160th Street and Dearbarn Path. A11 Ghe work has been 'completed and our �onsultants and Public Works S�taf€ have inspected it and found it to be in complianc� with Contract Documents and City Standards. There wi1Z be a one year warranty period for this work. Recammended action for Cc�uncil to cansider is to aPPrave the eighth at�d final payment for City Contract I9$7-4,_ Shannon Parkway� Street Improvements to Areon Construction in the amount of $75,275,p2 and accept the improvements far cnntireual maintenance. " , • . • • 2116. 503 AGGREGATCs HACKFILL C.Y. 1500 3�46.U0 2.5Q $ '7865.00 2211, 593 AGG. BASE PLACED, CL 5 C.Y. 3390 3190.00 7��� $ 24722.50 �211. 594 4�� AGG HASE FOR SID�WALK,S.F 21760 24336.Oa Q. 16 $ 3893.76 ` 234i.504 BIT. MAT. FOR MIXTVRE TON 13? 1:0� S.gQ_ 14p.p0 $ 14812.04 2341.508 WEARING COURSE MIXTURE TON 1530 �,t�17.93 9.9f) $ 14037.50 2341. 519 BINOER CC?URSE MTXTURE TON 900 At►S,,f,6 �.$� $`5596.t4 2357.502 B IT.. MAT. FflR TACK �OAT GAL. 4�0 325.00 1.25 $ 406.25 -.�____,_._ 25fl�.,511 15�� RC PIPE CULVERT CL 5 L.F 225 1'�0.0� 18.O1'? $ 234Q.00 2541. 515 15" AC PIPE APROM W/TRASH GUARI3 EACH 4 2.00 200.00 S 400.p4 2511.501 RANDOM R�PRAP, CL III C.Y. 12 � . s.oo so.oa s �oo.o0 2511.515 GEOT�X�'ILE FILTER S.Y. 2g • )4,,D� 2.a0 $_ 2B AO 2521. 511 2" HITUMINOUS WALK S.F. 21760 21632.00 0.�$ $ 6056.g6 --�.�.. 2554.5Q1 PERMANENT BARRICADES L.F, 26 16.U0 31.25 $ 50b.0U 2564.531 F & I SIGN PANELS, . TYP� C S.F: 45 �l2.45 I4.75 $ 626.1� 05b4.603 4" WZDE SOLIb LINE, . YELLC�W PAINT L.F. 54d0 53G0.UO 0.19 S 1018.��0 : 05b4.603 4" WIDE SOLIb LINE, WHI�� F�AINT L.F. 115 115,pp Q.19 $ 21.Q5 2575.501 R4A�SIDE SEEDING ` ACRE 4.� 295.00 $ 2575.5C12 SEED MIXTURE 5 � LHS. 200 3.�0 $ 2575.511 MULCH MATERIAL, TYPE 1 TON 8 200.f30 $ 2575.519 bISC ANCHORING ACRE 4.0 55.00 $ PA�E � OF 3 SHCIRT-ELLIOTT-HENDRICKSON , INC. . ., : APP�ICAl�ION FOR PAYMENz - Continued . ,-. . . - . :utdl Gontract Amount �_136 1 .50 Total Amount Ea�ed is5 �s5�..�r, ----�- � � ' hlaterial Suit�biy 5tored on Site, Not Incopflrated into llork' � ': Contract Change Order No. 1 Percent.Complete 100$ � 9,338.21 � Contract Change �rder Na. _� Percen�C Gomplete � : Contract Change Order No. Pereent Complete - $ � GROSS Ah�'UNT DUE. . .. . . .. . . .... . $ 1s5,2��.9� LESS � � RETAINA�E.:. .. .. .. $ 8,2s�.5o • AF�UNT t3UE TO DATE. . . . . .. .. .. .. � 357,025.46 tESS PREVIOUS AP�LICATIONS. .., . �'i 147s08�i.33 C4PITRACTOR'S AFfIDAVIT Ah�UNT DUE THIS ApPLiCATION. .. . $ 9,�41.1� : he under�igned Contractor hereby swears under penaltY af Per3ury that fl) all rey � payments received from the (hvner on account of work performed under the contract r,�����gd��oess. ` above have been appli�d by the undersigned to dlscharge in full alI obligations of th ' s�gned incurred ip connectian with work covered b e under- contract, Y prior Appllcati�ons for P�yment under said �terial and �quipment incorporated in said Pro�ect or otherwise ilsted in ar covered�ba�t y his � APP1�cation for Payment are free and ctear af all iiens, claims, security�,interests and encumbrances. Ddted �anuary 23, 1989 , t9 �r. Bituminous Roadwa s Znc. Con a tor By , ,,,,.,_,�._._. Name and Tit1e � C�UNl`Y OF Dakota SS Nozqnan C. Hagen Vice President � S7ATE Of �Sinnesc�ta � Before me an this 2�� day of Jar�uar rr n C, Ha en ' • 19 89 person�lly �PPeared � and say that e is the vice Presiaent n�wn to me, w o being'�1'y sworn, did depose of the Contractar above mentloned; that he executed tlte above Applieattoncfor Payment and Afftd and that all of the statements contair�ed therein are true�t�dndhcom lf g�id C°ntractor; P as.�aee�n,••�,�,,,a��_,,,� My Commission Expires: Afarch 29, 1993 _ ,� �� �r:,:'.� K11TtlY 1. p;ztle�� ��t��t , : . ,: Pl�i�'.:s1 h� +- : ` ,, ..-, TA , �� otary Pu c . , �, � ` �Y Cammissfan t:Tn�es�t.:ai.'�.+i�3 The undersigned has checked the Contractor's Apptication for Pa ment ��r�����'Y thts App}icat1on is th� Gontractar's Affidavit stating tt�at all�previous�payments tQ himt � • under this Cantract have been applted by him to discharge 1n fult a11 of h1s obligations in connection with the work covered by al1 prior Applicatians for Payment. In accordance with the Contract, the undersigned approves payment to the Cantractar af the Amount Due. Da te ____�__���f�� SHORT EL NE�fl KSt?N, N . BY ��ijs Page 3 p� 3 .. - . i � . . . � . . � . . . . . . . . � . �. � . . . � � � . . . . . . . . .•� . . .. .. � � � . � � . ci�r aF Rvs�ovrrT 11PPLICATI�N FOR Pl�iy!M�' AK}. $� CITY gROJECT NO: �tS� '� I�� SEH FIbE NOt �'j�IZ2 PROJECT: ��u.�..�.a� �aw-�eva - CONTRACTOR: trico�,,._ �,�S�vuc,'T�ow.. CON�RACT DATE: T� Z. P3?.�.._... � ��'x s� _ APPLICATItjN DATE: ( � I 89 — l►�oru, 1�7�1. S�'t�Si FOR PERIOD ENDING: I ` l �S9 Tatal Cantract Amount S ��1 t� lS �--3-�60--Total Amount Earned $_��ZZ6.7SZ-- Material Suitably Stored on Site, Not Incarporated inta Work $ -.... Cnntract Change Order Na. I`�'Z Percent Complete f00 S - Q - Contract Change 4rder Na. � Percent Cocnplete dO $` �4� �y '" t �c�ntrac� Change Order No. 4y Perc�nt Complete /00 � �j�'7�. QZ GROSS AMOUNT aUE . . . . . . . . . . . . . . . . . . . . . . $ t. 2-Sd.C�}b. �� L�SS C� $ RETAINAGE . . . . . . . . . . . . . . . . . . . $ "" AMOUNT DUE TO DATE . . . . . . . . . . . . . . . . . . $ �� ZS O, 076 '� LESS PREVYOUS APPLICATIC?NS . . . � . . . . . . . . $ ,� �?4, S[5/ 1S AM4tJNT DUE THIS APPLiCATION . . . . . $ �S� 2.75 d2 `.;��y' A 4 ; ichard . He , c>ity Enginee rectar of Pub11c Works ' , . , . • . -� '�--ti �' i ^ ;�_, '� APPI.�ICATICIN �'(3R PAYMENT �� � r� A!� � �,% �.� ;�..:� . . � � �` SX;�„?{ L��..:1�t ��1 t�.tl,1 ��:�11�. ��41i. . �. . (UNIT PRICE`CONTRACT) NO. ti��T1 •J�% ��,�` � Final -------- NC?TE: QUANTI7'IES RItID UNIT PR�CES HAVE HEEN REVISED IN ACGO • � ' zTH CHANGE QRDER NO. 1 ��� �� d����.-----ROSEMOUNT__MINNESOTA�`-------��pW�ER'S PROJECT NO. 16$ & 171 ENGINEER'S PROJECT NO.-- �87i22� T LOCATION: ROSEMOUNT, MINNESOTA ---_.._- ---_---- CONTRACTQR ARC4I+�I C�NSTRTICTION CO. , INC. CONTRACT DATE 9C.13_E-_FORESTfAVE. _BOX_57 ____CCJNTRACT AMtJUNT��SI,t�?3,560.22 ^ + _ _� - ----------------------- M�PiA, MINNESOTA 55d51 CONTR. Ft7R SHANNON`PARKWA`Y STREETWAND�UTILiTY CONSTRUCTION - ----- -------------�- S.A.P. 2C!$-1t36-Q2 APPLIC.DRTE �_1_8� _`..'..- ------ -------,._-____--------- ----- -- -- PERI�D END. �-1-89----------------- 1�►FPLICATION FOR PAYMENT DESCRIPTION CONTRACT QUANTITY U1�1IT UNIT QUANTITY TO DATE FRICE Tt�TAL --------------------------------- ---_..----------------------------- 2�21. 5Q1 MOBILIZATION L.S. � 1 14322.00 $ 1�,322.00 ; 2101.5�3 C�,EARING TREE 21 20 61.38 $ 1,288.98 210I. 5CI6 GRUHBING TREE 21 20 6i.3$ $_ 1 ,2f38.98 2104.5�71 R£MOVE C�NCRETE CURH AND GUTTER L.F. " 1 ,44? ' 1�50 2.04 5 2,951.88 2104.521 SALVAGE CM PIFE CULVERT L.F. 44 20 5.11 $ 224.84 2104.5�1 REMOVE PIPE CULVERTS L.F. 70 58 5.11 $ ��7.�U 2104.509 REMOVE MANHOLES OR CATCH HASINS �ACH 4 3 204,6Q $ 81�3.40 PAGE 1 OF ? SHORT BLLIOTT-HENDRICKSON, INC. • • 2105.501 CaMMON EXCAVATICIN (P� C.Y. 56,798 4�833 1.30 3 73,83?.�0 2205.511 eOMMON CHANNEL EXCAVATION C.Y. ?60' 43$ 1.3$ $ 1,fl48.80 21�5. 535 SALVAGED TOPSCIIL (�..1T. } C.Y. 5,825 5825 1.22 $ 7,1D6.50 2111.501 TEST ROLLING RD.STA 96 96 102.30 $ 9,$20.80 21I2.501 SU$GRADE PREPARATION R.S. 96 96 153.45 $ 14,731 ,20 2�7.6. 501 CaRE BXCAVATION C.Y. -- 1,350.6 12Q0 1.22 $ 1,647.73 221i.503 AGG HASE PbACED CL 5 (P) C.Y. 8,858 8786 $.1$ $ ?2,458.44 2211.504 AGG. HASE PLRCED FOR WAY.K, CLASS 5 {P) C.Y. 1 ,52? 99f 10.23 $ 15,621:Z1 222i.5Q3 AGGREGRTE SN4ULDERING PLACED, GL. 2 C.X. 16.3 30 33.?5 S 550.13 2331.5�4 H�TUMINOUS MATERIAL FOR MIXTURE TON 299.64 229 163.68 � 49,045.0$ 2331. 514 BASE C�URSE MIXTURE T�N 5.548.97 50'7� 6.64 $ 36.$45.16 2341.504 HITUMIN�US MATERIAL FdR - MIXTURE TflN 326.9$ 33Q 1$4.14 $�60,21�.10 2341.5C18 WEARING Ct?URSE MIXTURE TON 5,375.10 5tJ73 7.67 $ 41,22?.02 2357.502 HITUMINQUS MATERZAL F(JR TACK COAT GAL. _ 2,605 2635 I.02 S 2,657.10 25t31.515 15" RC PIPE APRON W/TRASH GUARD EACH 8 9 423.52 $ 3,3$8.16 2541.515 1$" RC PIPE APRON WJTRASH GUARD SACH 1 1 478.?6 $ 478.76 25C11. 5i5 21" RC PIpE APRON W/TRASH GUARD EACH 1 2 556.51 $ 556.51 2501.515 24" RC PIPE APRON WJTRASH GUA�tQ EACH 1 i b30.26 S 63p.16 2501.515 ' 23�' RC PIPE APRON Wj'�'RASM GUARD EACH 1 1 ?60.08 $ 76p,t7$ 25Ct2.515 42" RC PiPE APRON W/TRASH GUARD � � EACN 1 2 2265.45 $_�, .�*� 25C13.511 12" RCP STORM SEWER, DES. 3006, CL. V L.F. 1,169.0 129$ 19.14 $ 22,3?4.66 PAGE 2 CJF 7 SHflRT-ELLIOTT-HENDRICKSONt, TNC. ' � ;, - � ;_ � ' ' � � 2503.Si1 15" RCP STORM SEWER, DE5. 3006, CL. V L.F. 1,281.0 1143 19. 14 S 24,51$.34 2503.511 1$" RCP STURM SEWER, - DES. 300f, CL. V L.F. 1;365.0 850 21.33 $ 29,115.45 2503.5�1 21" RCP STORM SEWER, DES. 3�06, CL. V L.F. 689.0 1489 , 23.1�1 $ 15,943.46 . 2503.51I 24" RCP STdRM SEWER, DES. 3a06, CL. IV L.F. 129.5 104� 26.30 $ 3,405.85 25�3. 511 27" RC PIPE SEWER, �ES. 30d6, CL. IV L-F• 18.0 18 47.21 S $49.?$- 25tJ3. 511 3Q" RC P�PE SEWER, DES. 3006, Cb. IV L.F. 994.0 13$1 34.31 $ 34:104.24 2543.51I 36" RC PIPE SEW�R, DES. 3006, CL. IV L.F. 1 ,968.Q I972 69.99 $ 137,'T4t�.32 2503.511 42" RC PIPE SEW£R, nEs, 3006, c�. �v L.F. ���. .o �6� �s.�s s �o,��a.�s d543.60$ 15" RCP STORM SEWER, JACKED L.F. ?8 113.55 S 0503.608 36" RCP ST(�RM SEWER, JACKED L.F. 128.0 1.2C} 360.42 $ 46,Q82 .56 2504.602 ADJUST GATE VALVE eOX EACH 11 6 98.20 $ 1 ,480.20 2506.506 CtJNSTRUCT MANHOLE, DESIGN B L.F. 202.8 142 122.35 S 24,$12.58 2506.506 CONSTRUCT MANH�LE, DESIGN C L.F. 110.2 73 174.11 S 19,186,92 2505.507 CQNSTRUCT CATCH HASIN, � D�SIGN Y L.F. $2.0 50 123,98 $_ i a �•-66. �6 2506.509 CONSTRUCT CATCH BASZ`N, D�SIGN X L.F. ' 106.6 132 139.53 $_ 14,873.89 25d6.511 REC�NSTRUCT MANFiOLE L.F. 19,a 20 95.13 $_ 1,$Q?.47 25Q6.516 CASTING Jm1SSEMHLY, TYPE R-1733 EACH 39 28 113..50 S . 4,348.5t� 2506.516 CASTING �►SSEMHLY, TYPE R-3067 ERCH 45 45 1�6.9� $ ?,963.65 2506. 522 ADJUST FRAME AND RING : C1�►5TING EACH 6 3 122.?6 S ?36.56 - PAGE 3 OF 7 SH4RT-ELLIQTT-HENDRICKSON, INC. (. � � � ! 251I. 5i71 RANDOM RIPRAP CL TI C.Y. 29.9 44 4b.t33 $ 1,376.3p 2511 . 516 GEOTEXTiLE FILTER F�IBRIC, TYPE IV S.Y. 57.8 1?b 3.17 $ 1$3.23 2531.501 CONCRETE CURB & GUTTER, DESIGN Dfi18 L.F. 19,983 19550 4.17 $ $3,329.11 252i.511 2" HITUMINOUS WALK S.F. ?3,3,04 7�550 . 0.2$ $ 24,525.12 2531. 5Q? g" C�NCRETE DRIVEWAY PAVEMENT S.Y. 82.5 ?5 2Z.99 S 1;$14.1$ 2545.511 LIGNTING UNIT3, TYPE 8 EACH �7 27 1115.07 $ 30,106.89 2545.521 3° RIGID STEEL CONDUST L.F. _ 55? 4t1� 9.20 $ 5�124.40 2545.532 13IRECT HURIED CABLE L.F. R�A78 90Q0 1.82 $_1�.�50.1$ 2545.552 FEED P�INT EACH < 3 � 1457.77 $ 4,373.31 05fi3.601 TRAFFIC CONTROL L.S. 1 1 2557.50 $ 2,55?.50 2564. 532 SIGN PANELS - TYPE C S.F. 513.65 280 . 18.$2 $ 9,.666.$9 0564.b02 TU�N LANE PAVEMENT MESSAGE L.S. 6 S 35.${3 $ 21�.$4 0564.602 CROSS WALK PAVEMENT MES5I�GE L.S. 1 i 76.72 $ 76.72 2564.603 4" WID� SOL�D L�NE, WHITE L.F. 1,344 645 0.20 $ 268.$0 2564.6d3 4" WI�E' Sl?LID LINE, YEI,LCIW L.F. 11.303 1G$C�0 0,I5 S 1.Fi95.45 2564.6fl3 4" WiDE BROKEN LINE, WHITE L.F. 645 fi70 0.22 $ 135.4� 0$64.603 4" WIDE 8R£3KEN LiNE, YELLOW L.l�. 1,064 11$a 0.21 $ Z23.44 (J564.6d3 12" WIDE SOLID LINE, WHITE L.F. 54 26 5.22 $ 2fi5.94 05b4.6a3 24" WIDE SOLID LINE, YELLOW L.F. 244 42� 0.97 $ 236.68 (3565.602 NANDHOLE - TYPE C EACH 4 4 358.05 $ 1,432.24 2575.501 ROADSIDE �EEDING ACR� 8 14 96.16 $ ?69.28 2575.5�2 SEEU MIXTURE 5 LBS. 4Q0 50t� 2.54 $ 1 ,016.00 PRGE 4! OF 7' SHORT-ELLIOTT-HENDRICKSON, INC. )�-'�-;� _'�r�.:-' � � � � . ! • 2575. 505 SODDING S.Y. 6,?4C3 6200 1.2fl S 8,04Q.00 2575. 511 MULCH MATERIAL, TYPE 1 T(�N 16 2tJ 100.25 5 1 ,60�.f}0 25?5.519 DZSC ANCHORiNG ACRE $ ll? 42.96 $ 343.68 " 2575. 523 Wt)OD FIHER HLAI�fKETS S.Y. 1000 1.16 $ 025b.4d$ g" PVC, 12' -14'DEEP L.F. 54 50 18.60 S 930.00 a256.40$ $" PVC, 22'-24' DEEP L.F. 100 10� 25.54 $ Z,554.OQ 0256.701 STANDARD MANHOLE, 8` DEEP EACH 1 1 461,fi2 S 961.62 0256.?02 EXCESS DEPTH STANDARD MANHOLE L.F. 15.6 15 55.24 $ $61 .74 0256.7Ofi MANHQLE DROP SECTION t?N EXSSTING MANH�LE L.F. 8.3 9 1i5.59 $ 959.4Q 025b.90fl Cf}NNECT TO EXiSTING SEWER EACH 1 1 358.05 $ 358.05 a256.910 $" D.I.P. F�RCEMAIN ` L.F. ,1,550' 1550 12.38 $ 19,189.0(� 0257.406 6" flIP WATERMA�N, CL 52 L.F. 94 162 I4.99 $ 1 ,407.i$ 0257.408 8" DIP WATERMAIN, CL 52 L.F. 254 320 17.I7 S 4,361.18 0257.412 12" p;P WATERMAiN, CL 52 L.F. 248 1945 17.75 $ 4,402.00 0257.4i6 i6° DIP WRTERMAIN, CL 52 L.F. 3.2x2 3200 24.95 S so,l��.�o . 0257.419 B4RE 24" STEEL CAS2NG L.F, 96 105 96.16 $ 9,231 .�6 4257.421 JACK 16" DIP THRU CASING L.F. 120 105 3a.2$ $ 3,G33.60 025�.606 fi" R.S.GATE VALVE & HOX EAG'�i ,�^ 10 3�1.22 $ 1 ,g27,32 a257.608 $" R.S.GATE VALVE 1� HOX EAGH � 4 460.35 S_ 1,381.05 025?.6I3 12" B.F.VALVE & BfJX EACH 2 731.44 $ �257.fi17 16" B.€.VALVE & SOX EACH 3 2 I36$.72 $ 4,1t3d.16 0257.630 FITTiNGS LESS THAN ].2" LH. 1,a00 585 1.52 $ 1,520.QO 0257.631 FITTINGS 12" & LAR�GER L8. 10,390 1064Q 1.04 $ 10.805.60 �257'.633 LOWER W14TERMAIN EACH 1. 2 552.�42 S 552.�2 0257.644 FIRE HYDRANT EACH 6 4 1i17.11 $ 6,'702 .6�i PAGE 5 OF 7 SHORT-ELLI�TT-HENDRICKSON, TNC. I � 1 , . , -' ;� . f� _: . � � �257. $�6 INSULATIOIV HD.FT. 522 - 64 0.95 S 486,�Q 0257.903 CONNECT TO EXISTING WATERMAIN EACH � 3 255.75 $_ 1 ,023.00 �29�.02 JRPANESE TREE LILAC 2" EACH 5 . 5 13?.4$ S 6$5.4Q 029t?.02 AMUR MAPLE 2" EACH ? 7 l�?.t}8 $ 959.56 0290.03 CANADA RED CHERRY 2" ERCH �.___.__ 3 I32.99 S - 398.97 4290.Q4 COLUMNAR HUCKTHORN 36" EACH - �t£� 18 28,b4 $_�1� 0290.�5 COMMON PURPLE LILRC 36" EACH 164 161 28.64 S 4,696.96 _ --�.�, 0290.06 GQLD DROP POTENTILLA 18" EACH 73 76 18.41 $ 1,343.93 0290.0� DWARF AMUR MAPLE IS" EACH 52 33 21.48 s f .116.96 0290.OS RUC,{�SA ROSE �2 POT LACH - 4? 4? 21.48 �_ 1.4Q9.56 0290.04 BLACK HILLS SPRUCS 6' EACH 15 15 132.99 $_ 1 ,994.85 0290.10 CULOttADO SLUE SPRUCE b' EACH 16 15 132�99 S 2 .12'�.$4 - d290.11 COLORADO GREEN SPRUCE fi' EACH , 26 27 132.99 5-3,�457 ?� 0290.12 AUaTRIAN PINE 6' EACH 25 11 I32.99 S�3,32�.75 ' 0290.23 PtJNDEROSA FINE 6' E A C H Q 290.14 RIVER ROCK 3 4 �- ,� 1� 1 32.99 $ � • / i-IJ2 C.Y. 54.7 30 18.4], S 1,007.03 0290. 15 MUL�H MATERIAI►, TYPE 6 C.Y. 15.0 20 1$.41 S 276.15 �,�,�,����; , ! � - - � '• ,: ° PL I CA'f I0N �'OR PAYMENT - Con ti n� . . �atal C�rtract R� n � �0� 560. 12 u t $ � Total Amount Earned $ 1 ,226,752 .15 Material Su#tably Stared on Site, Not Incaporated into Wark $ Contract Change t}rder No. � Percent.Complete 100 � �� Contract Change 4rder No. . 2 Percent Complete 100 � NA Contract Ghange Order No. � Percent Complete t , o $ 14 .350.0E� `� 1U0 £3,974 .02 GROSS AMOUNT DUE.. ........... . $ � .��o.a�� .�.� LESS � RETAINAGE..... .. .. � . AMQUN7 DUE TQ DATE.. ... ........ $_� , �s n r n,�� 1 � LESS PREYIOUS APPLICATI4l�S..... $ 1,174,801 .15 AMK3UNT DUE TttIS 'RAPLICATIBN. ... $ 75,275.t�2 COMTRACTOR'S AFFIDAVIT e un ers gne ontractar herebyswears �nder pena]ty of per�ury that (1) a�1 prevfaus progress. payments receiv�d from the Owner on account of work p�rformed under the cttntract referred to above t►ave been appiied by the undersigned to dfscharge in fu11 all obligations of the uader- signed incurred in connection with wc�rk cpv�r�d by prior App]lcatians for Payrnent under said contract, and {2) all material and eqaipment incorporated in said Pro�ect or atherwise listed in vr covered b�r this ApRlieation for Payment are €ree and clear of all liens, elaims, securfty interests and encumbrances. D�ted Januarv ?.6 , 19 89 . Arcan Construction Co. , Inc. Contractor By A1 Sj e ga ec�e ary COUNTY OF Kanabec � SS STATE 4F _ Mi nn s� a - Before me on this 26th day pf � �anu�ar _ , 19 �9 personatly appeared A1 .sjoberq knt�in to nre., w�io being c�u`�y sworn, did depose and say that e is the secretar of the Contractor above mentioned; ce that he executed the above Application for Payment and Affddavit on behal said Contractar; and that al l of the���,���eon�advrt�e��e ein are tr e� correct and lete. � . �°► vtkn c.d�sseH � t�(y Cortun i s s i an Exp i r������rr�r�ru�rc_���n�►��ra �.�'/ � ,,,� � �-�•,. KANAt�EC C(?11NIY � My Commiss►on Ex�ures J�n. 11, 1993 ���8t"�/ �U�C�- The ur�dersigned has checked the Cantractor's�Appiicatian for Payn�ent shoMm above. A part of thjs Applicat#on is the Contractor's Affidavit stating that all pr�viaus payments to him under this Contract have been applied by him to discharge in f�ll al1 of h1s abligatfons in cor�nectian wi th the work covered by ,a,t 1 prior Appl icatfons for Payment. In accordance with the Cantract, the undersigned a:pproves payn�nt to the Contractor of the Amaunt Oue. ?_'I � � �� SHORT E H RICK5 , NC. Date gy Page � of �