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Home My WebLink About4.h. Approve Payment #1, Contract 1988-6, Shannon Oaks r r .. . �� . � � � � � . . �.�� . � �.. . . . . . NORWEST BANK MINNESQTA, NATIONAL ASSOCIATION as Trustee (SEAL) By Its Corporate Trust Officer STATE OF MINNESOTA) )ss COUNTY OF DAKOTA ) The foregaing instrument was acknowledged before me this day of , 1988, by ' , for Norwest Bank Minnesota, National Association, a national banking association, on behalf of the association and pursuant to the authority granted by Norwest Bank Minnesata. Notary Public � � i � �� ; AFPLICATZON FIOR PAYMENT � � � � � ------------- - , _ (UNIT FRiCE GC)NTRACT) � � - - NO. 2 - . � . .,_. , OWNER: CITY OF ROSEMOUNT ' OWNER'S PROJECT NO. 1$5 ENGINEER'S PROJECT N4, -----$8194�----- LOCATIONt SHANNON OAK$ ""'-'--------- CONTRACT�R BITUMINOUS ROADWAYS, INC. CONTRACT DATE ------------------- ---- 282S_CEDAR AVENUE SOUTH C�NTRACT AMOUNT '� � s -------------------------- 5136,381. 50 MINNEAP ------------------- OLIS, MN 55407 "r' CONTR. FOR STREET_CQNSTRUCTIQN___SHANNQN OAKS AFPLIC.DATE---�0[20/88------------------------------------------------- -------- PERIOD END. ---��L?Of8a____--- .: APPLICATIQN FOR FAYMENT DESCRIPTION � � e�NTRACT�QUANTITY UNIT � UNIT Q(JANTITY TO DATE PRICE TQTAL 2Q21.501---M48ILIZATIQN ^� -____-L.S. _.._____ ..-- ------- --,�---_ ,___,�___--- , 1 1 40QQ.t30^S 400Q.Qfl 2101. 502 CLEARING TREE 100 55 25.001 $1375.Q0 2141. 507 GRUBBING �^ • TREE 100 62 25.�0 S 155Q.00 21a5. 501 CQMMON EXCAVATION (P) C,y, 2�9�� _ 26950 0.95 S 25602.50 2105. 521 GRANULI.IR BORROW (CV) C,Y. 1000 5004 . 2. 50 $ 12510.00 2105. 535 SALVAGED TCIPSOIL (p) C,y, 1850 1000 fl.95 S'950.00 2111 . 501 TEST R,OE,L�ING , R.S, 2$ '� 28 50.00 $ 1400.OQ � 2112. 501 SUBGRADE PREPARATIt?N R,S, 28 gs.00 s 2116. 501 CORE EXCAVATION C.Y. 1500 3146 1. 50 $ 4719.00 PAGE 1 OF 3 � SHQRT-ELLIQTT-HENDRICKSON, INC. � � � . . � s �CIChTION F�7R PAYMENT - Co�tinu� iUtal Gontract Amount � 136, 381 . 50 Total Amount Earned ��3tp29,Sp - ______. Material Suitably Stared on Site, Not Incoporated into Work $ Contract Change Order No. Percent_Complete g Contract Change Order Na. Pereent Complete � Contract Change Order �Zo. Percent Complete c� GROSS AMOUNT OUE.. . . . . . . . . .. . . . $63,029.SQ LESS 5 � RETAINAGE. . . . , . . . . $4151.48 . AMQUNT DU£ TO DATE. . . . , . . . . $58,878.02 LE$S PREViOUS APPLICATIONS. . . . . $8,464.�0 , AMQUNT DUE TNIS AFQLiCATI4N. .. . �50,413.52 CONTRACfiQR S AFF I Dl�V I T ----..-- e undersigne ontractor hereby sw�ars under penalty of perjury that (1) atl previaus progress. payments received from the Owner on accounL of w4rk perFormed under the contract reFerred t� abvve have been applied by the undersigned to discharge in fult all obligations of �he ander- signed incurred in cc�nnection with wark covered by prior� Applicat�ans for Payment under said contract, and (2) a11 materiat and equipment incorporated in sa�id 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 , 19 Bituminous Roadwa s, Ine, � � ' "'� , Co act4r ,;�, ' � , , �Y ��----�--- Name and Title COUNTY OF � � _..� 7 _�' .,. .-, ;r SS STATE OF �'� ,.r,�;u,� � Before e on this ,,? da of � c jc.r�� ; % (}. � -��C.�t.�..�L._.._... � I9 .��.,4- . personalty appeared �r% knvwn to me; w o being duly swnrn, did depase and say that he is the �- �5 , _ of the Contractor above mentioned; Office that he executed the above Application for Payment and Affidavit on behalf of said Contraetar; and that a11 of the statements contained therein are true, correct and complete. My Cammi s s i an Exp i res: ��ti��.rf. ��), /9�.3 ,�j �Jotar P l i c The undersigned has checked the Contractor's AppTication 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 fuli all of his obliga�ions in connection with the work covered by all prior Appaicatians for Payment. In accordance with the Contract, the undersigned approves payment to the Contractar of the Amo-unt Due. Date _ �O1Z-�;�� SNORT E QTT H DRIC tJC. By Page 3 0� 3 � • � 2116.503 AGGREGATE SACKFILL C•Y• 1500 3146 2,50 $ 7865.00 221i, 593 AGG. BASE PLACED, CL 5 C.Y. 3190 7.75 S 0211.594 4" AGG BASE FOR SIDEWALK, S. F —�^ 2I760 0..16 S 2341. 504 BIT. MAT. FOR MIXTURE TON --� 137 1�Q.0Q $ - 2341.508 WEARING COURSE MIXTURE TON 1S30 9.90 $ 2341.519 BINDER COURSE MIXTURE Tp� 900 7.$0 S 2357.502 BIT, MAT. FOR TACK COAT GAL. 400 1.25 S 2501.511 15" RC PIPE CULVERT CL 5 L. F �� 225 130 18.QO $ 234�.00 2501.515 15" RC PIPE APRON W/TRASH GUARD EACH 4 2 _ 200.00 $ 400.00 2511.501 RANDOM RZPRAP, CL III C.Y. 12 5.8 50.Oa S 29Q.00 2511.515 GEOTEXTZLE FILTER S.Y. 28 14 2.0(? S 28.Q4 2521. 511 2" BITUMINOUS WALK S. F. 21760 --�– 0.28 S 2554.501 PERMANENT BARRICADES L.F. 1� 31.25 S 2564.531 F & I SIGN PANELS, TYPE C S.F. 45 14.75 $ 0564.603 4" WIDE SOLID LINE, YELLOW PAINT L. F. 5400 ___________ 0. 19 $ 0564. 603 4" WIDE SOLID LINE, WHITE PAINT L.F, 115 0.19 $ 2575.501 ROADSIDE SEEDING ACRE 4.0 295.00 S 25�5•5Q2 SEED MIXTURE 5 �� LBS. 200 3.Qp $ � 2575. 511 MULCH MATERIAL, TYPE 1 TQN � 2�0.00 S . 2575. 519 DISC ANCHORZNG ACRE 4.0 55.Q0 $ � PAGE 2 OF 3 SHORT-ELLIOTT-HENDRICKSON , INC.