HomeMy WebLinkAbout4.k. Approve Payment #4, Contract #1988-2, Hawkins Pond/Section 30 Sewer (�`T•`/ic d'� j��``' '
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CZT1F OP ROS�(�NT ` �
11PPLIG7ITION F+�R P1IYHSNT
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CITY PRQJECT NO: I7b I8I � SEN F2LE NQ: tr
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P'R4JECT; _..��,k�,uS /�O�VU 1 S6[..Tto� 30 ���tN2e ��CvER,
CONTRACT�R: ,�7VL��q� CpK�Sj�Z�,rG,�'to�tr CQNTRACT DhTE: � l3 ���i
-�� �O)G '¢cS��_� APPGICATIfJN DATE: �-�Z. � p ._
1���1-ft 6C,Q,j�t MJ• Sst?�'� FOR PE R I OD ENb I NG: Z- Z- �J St _
Tatal Contract Amount S /�O�C� °l..._.° Ta�al Amount �arned & �ka.�! '�71 46
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Material Suitably Stored on Site,
Not Incorpor�ted into Work � �
Contract Change Order No. � Percent Compiete �d07o r�Z,,.�.� c�3 8 g�
G4n tract Change Order No. • Fercent Complete g
Gontract Chanqe Order No. Per�ent Complet� � �,
GROSS AMpUNT iJUB . .. . . . . . . . . . . . . . . . . . . . $ t�� �O o4
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LFSS �# RSTl12N14GB . . . . . . . . . . . . . . . . . . . 8 �'S� `S�►
AMOtJNT DUB TO QATS . . . . . . . . . . . . . . . . . . . . $ �PjQ �j�Q�'
LESS. PREVIOUS 11PPLICATIQNS . . . . . . . . . . . . $_ j '4�, �.,,��� a3
AMOUNT DUB TNIS APPLICATIf?N . . . . . . . . . . . $ 3 s!
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, �f r=,,,�%'l��,./ ? / ., ��r�,�, i-� �. � �� ,z.2{�..U�
T�'ichard M. Me � �� << � �4 g
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City Engineerj i�reator of Pubiic Worke � t�,� . c� �• 1 ?G;a ��C
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2501. 525 44" SPAN R.C. PIPE -
1\RCH APRON EACH 4 4 9 50.f?O $ ;,8�t1.f►(i
2503.511 42" RC PIPE SEWER,
CL. III L.F. 32 32 90.00 $ J.,�Att.t)t)
25Q3.512 42" RG PIPE APRON EACH 1 1 95t}.OQ S 4SO.Q0
2503.571 ZNSTALL 42" RC PIPE
SEWER L.F. 40 4p 25.00 $
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25�6.611 RECONSTRUCT MANHOL� L.F. 2� �� � 60.(70 $ st 6.t)0
2511. 507 GRQUTED RIPRAP C.Y. 1C?4 _.5�. � , 45.OQ & �}��n �p
2511.511 GFtANULAR FILTER C.Y. 50 42.6 3t,�.04 $ 1.278.00
2575.501 SEEDING ACRE 20 99.�0 $
2575.502 SEED, MIXTURE 3 LH. 800 ' 1.20 S'
2575.505 SODDING S.Y. 3000 1.2b $
25?5.511 MULCH MATERIAL, TYPE l TON 40 119.Q0 $
2575.519 RISC ANCHORING AGRE 20 24.OQ $
SCHEDULE B - SECTION 30 $ANITARY SEWF;R EXTENSIDN
0256.408 8" PVC, 1t?'-ix' DEEP----'L.F. 6q0 964 iD.�p $ +►.6n�.o0
0256.4Q8 8" PVC, 12'-24' DEEP L.F, 3C?4 ��7 30.Q0 $ ?,570,�0
0256.408 8" PVC, 14'-16' IIEEP L.F. 400 12� li.�0 $ i ,342.oQ
0256.408 g" pVC, 16'-18' DEEP L.F. 97 i7Q 12.Ot7 $ 2,U�i0.0U
0256.908 8" PVC, 18'-20' DEEP L.F. 70 so 13.00 S 650,0�
0256.701 STANDARD MH, 8� DEEF EACN 8 e 750.Ot} $ ���oao.t�a
0256.702 EXCESS DEFTN STD MH L.F. 50 �►7.5 60.OG1 $ z,850.00
025b.801 8" X 4" PVC WYE EACH i� 9 5U.00 $ �5o.ov
0256.900 C�AfNECT TO EX. SEWER EACH 1 1 2QC1.00 $ 2o0.tt�
0256.9Q1 CUT INTO ER. WET WELL EACH 1 f 5t}Q.00 $ 500.00
211$. 501 AGG. SURFACING, CLASS 2 TON 25 1f�.00 $
25?5.5C11 SEEDING ACRE 2 94.0� $
2575. 502 SEED, MIXTURE 3 � LH. 8p 1. 2p $
P11GE 2 OF 4 ' SNfJRT-EI,LIOTT-HENDRICKSON, IiVC.
- . �LICATION Ft?R PAVMENT - Continu�
Tc,ta1 Contract Amount $ 170 ,852, Op Totai �Imount Earned
$ 1b5.471 .(?G
Material Suitabiy Stored on Site, Not Incoporated into Work -��
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Contract Change Order No. � Percent.Complete _ loo� $ 2���3�.q8
Contract Change Order Plo. T1,� Percent Complete �
Contract Change Order Wo. � Percent Complete �
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GROSS At�UNT DU€. . .. . . . . . . .. . $ 1��ic�.o� •
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LESS s % RETAINAGE.., . . .. . . # �,52t�.so
AMQUNT DUE TO DATE. . . . . . . . . . . . . $ lgp,gg�_,g4
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LESS PREVIOUS APPLICATIQNS. . . , . $ ���.�.��
CONTRACTOR'S AFFIDAYIT A��1NT DUE THIS APPLICATION. . . . $ 33.431.51
he undersigned Contractor hereby swears under penalty of perjury that (1) all prevlous progress.
payments received from the Owner on account of work performed under the contract referred Lo
abave have been applied by the undersigned to discharge in full ail obligativns af the under-
signed incurred in connection with work cavered by prior Apptications for Payrr�nt under safd
contract,
material and equipment incorporated in said Pro�ect or otherwise listed in or covered�bylthis
Appiication for Payment are free and clear of aTl liens, claims, security interests and
encumbrances.
Ddted Februarv 2 , 29 89 �nebak Construction
� . � Contractor
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By { � � �; ` � ; . , ,.,,
Name and Ti ti,e
COUNTY OF :.�',�,. ,� SS
STATE OF ,. – �
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Be fare me on th i s '� .:- .
� .--� day of ' ,: :.�., .. , 29 .. ., personal ly aPP�ar�d
own to me, w • beinq 3�uTy sworn, did depose
and say that he is the � . . ,- , ., ; , , �
of the Contracfior above rt�entfaned;
that he executed the abvve Applicationcfor Fayment and Affidav
and that al} of the statements contair►ed therein are true, correct�andncof °f said Contractar;
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My Cammission Expires: _ ��,'_s'' ,':3 ' �� ��;,: �Gr��S vptK
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Otei^y Pub .t��, o:�K��a touNtr
��''� �►CPrAmiSSc�r,�Litos 3•24•93 ,
The undersigned has checked the Contractor's Application for Payment shown ab4ve.A p vf"�"^^
this Applicatian is the Contractor's Affidavit statiny that all pr�v1aus payments to him
under this Contract have been applied by him ta discharge in fuil atl of h1s abligations 3n
connection with the work covered by all pr9or Appticatians for Payment.
In accordance with the Contract, the undersigned approves payment to the Contractor vf t►�e
Amount Due.
Oa te ���J Q SNORT E l OTT lt�iDR t CK N ta�:,
_._.�..� By �, �,,,�
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