HomeMy WebLinkAbout4.g. Request for Payment #6, White Lake Acres, City Project #1984-5c
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APPN
LICATIOFOR PAYMENT
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C E
RKS
7
Q 1
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�C 3 01986 (UNIT PRICE .CONTRACT),��
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NO.
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(Revised)
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Owners CITY OF ROSEMOUNT,
MN.
Owner's Project No.
1984-5
Engineer's Project No.
85039_
LOCATION
_ROSEMOUNT, MINNESOTA
Contractor Valley -Paving,
Inc.
Contract Date
_8050-D Highway
101
Contract Amount $171,904.25
Shakopee. MN
55379
+
Contract for STREET CONSTRUCTION
IN WHITE LAKE ACRES - ROSEMOUNT, MINNESOTA. -
Application Date November 121,
1986
For Period Ending Ima
In, 'IAAF
CONTRACT
QUANTITY UNIT
DESCRIPTION
UNIT
QUANTITY
TO DATE PRICE
TOTAL
1. 2021.501 MOBILIZATION
L.S.
1
1 $81000.00
$ 8,000.
2. 2101.501 CLEARING
_TREE
300
537 4.00
$ 2.-148.
3. 2101.507 GRUBBING
TREE
300
552 21.00
$.11,592.
4. 2103.501 REMOVE BUILDING
FOUNDATION
EACH
l
1 18000.00
$--1,000,
5. 2104.521 SALVAGE C.M.
CULVERT PIPE
L.F.
76
66 6.00
$ 396.
6. 2105.501 COMMON EXCA-
VATION (P)
C.Y.
42,200
42,200 1.00
$ 4.200.
Page _.1._. of
SHORT—ELLIOTT—HENDRICKSON, INC.
t
.
APPLICATION FOR PAYMENT
- Continued
CUR
E�
1987
CONTRACT
QUANTITY
UNIT -
DESCRIPTION
UNIT
QUANTITY
TO DATE
PRICE
TOTAL
7.
2105.505
MUCK EXCA-
VATION (P) C.Y.
1,500
1,500 $
3.00
$4=
8.
2105.522
SELECT GRANULAR
BORROW. (P) C . Y .
3,500
3400
5.00
X17.., 50Q.._
9.
2105.535
SALVAGED TOPSOIL
(LV) C.Y.
3,600
3,600
.90
$ 3,242
10.
2111.501
TEST ROLLING R.S.
54
54
8.00
$ 432.
11.
2112.501
SUBGRADE
PREPARATION R.S.
54
54
70.00
$ 3,780.
12.
2116.501
CORE
EXCAVATION C.Y.
500
203
.50
$ 101_55
13.
2211.503
AGGREGATE BASE
PLACE, CLASS
5, (P) C.Y.
1,650
lt65O
8.00
$ 13,200.
14.
2221.503
AGGREGATE SHOULDERING
PLACED CLASS
2 (P) C.Y.
825
825
9.60
$__7,920,
15.
2341.504
BITUMINOUS MATERIAL'
FOR MIXTURE TON
105
112.49
202.00
$ 22,722.1
16.
2341.508
WEARING COURSE
MIXTURE TON
1,750
1,500
9.45
$ 14,175
17.
2501.511
15" R.C. PIPE
CULVERT,
CLASS IV _ L.P. :
210
198
23.25
$4,603.
18.
2501.511
24" C.M. PIPE
CULVERT L.P.
75
75
18.40
$ 1.380.
19.
2501.515
15" R.C. PIPE
APRONS EACH
8
10
386.00
$ 3,860.
20.
2501.515
24" C.M. PIPE
APRONS EACH
2
3
124.00
$ 372.
21.
2501.571
INSTALL SALVAGED
CM PIPE L.F.
50•
42
6.00
$ 252.
Page
---z._. of
=_
APPLICATION FOR PAYMENT - Continued CLERK8' 2
CONTRACT
QUANTITY
UNIT..
DESCRIPTION
UNIT
QUANTITY
TO DATE
PRICE
TOTAL
22. 2554.501 TRAFFIC BARRIER,
DESIGN "A"
L.F.
970
975
8.60
$ 8,385.
23. 2554.521 ANCHORAGE
ASSEMBLIES
EACH
4
4
410.00
$ 1.640.
24. 2575.501 ROADSIDE
SEEDING
ACRE
7.40
g
100.00
25. 2575.502 SEED,
MIXTURES
LB.
370
1.60
$ 640.
26. 2575.505 SODDING
S.Y.
80
=
2.00
$
27. 2575.511 MULCH MATERIAL
TYPE 1
TON
8.3
13.9
150.00
$ 2.085.
28. 2515.511 MULCH MATERIAL
TYPE 5
TON
2.50
500.00
$
29. 2575.519DISC
ANCHORING
ACRE
4.15
a
75.00
S 600.'
** TOTAL CMMta= QUANTITIES '$180,496.34
Change Order # 1
Bituminous�r
L.F.
350
3.00
11050.
Remove House & Frame
L.S.
1
1500.00
11500.
Camoon Excavation
C.Y.
(DEDUCT)-
(1800)
1.00
(11800.)
Aggregate Base
C.Y.
21
8.00
168.
15" RC Pipe Culvert CL IV
L.F.
24
123.25
558.
15" RC Pipe Apron
Each
2
386.00
772.
Aggregate Shouldering CL 11
C.Y.
(DEDUCT)
(33)
9.60
(316.80'.
** TOTAL CHANGE ORDER # 1
$1,931.20
ShM ee Order .. # 2
Common Excavat on
C.Y.
978
1.00
978.
Aggregate Base
C.Y.
38
8.00
304.
** TOTAL CHANGE ORDER # 2
$1,282.00
Page 3 of 4
i
F5 198? p 1
: APPLICATION FOR PAYMENT - Continued
Total Contract Amount $ 171,904.25 Total Amount Earned $77,42,4,28
Material Suitably Stored on Site, Not Incorporated into Work $
Contract Change Order No. _ 1 .Percent, Complete 100% $
1.93 20
Contract Change Order No. _2 Percent Complete 100%
-.—_ $ 1,282.00
Contract Change Order No. Percent Complete
GROSS AMOUNT DUE .................. $180,738.18
LESS 5a % RETAINAGE..............
$ ..9#036.91
AMOUNT DUE TO DATE ................ $I71,7D1.27
LESS PREVIOUS APPLICATIONS........ $ 161,397.86`
AMOUNT DUE THIS APPLICATION. ... $ I6.303=41
CONTRACTOR'S AFFIDAVIT
The undersigned Contractor hereby swears under penalty of purjury that (1) all
previous progress payments received from the Owner on account of work performed
under the contract referred to above have been applied by the undersigned to di:
charge in full all obligations of the undersigned incurred in connection with wi
covered by prior Applications for Payment under said contract,
and (2) all material and equipment incorporated in said Project or
otherwise listed in or covered by this Application for Payment are free and clez
of all liens, claims, security interests and encumbrances.
Dated November 12 , 1986 Val3ev Pav
Inc.
(, nt e
By ./
A. and Title)
COUNTY OF Scott ) President
STATE OFMinneso to
Before me on this nth day of
R Noven+?er , 198 personally appeared
known to me, who being duly sworn, did depose
and say that he is the Pres ent of the Contractor above
Office
mentioned: Valley Paving, Inc Ri• ! chard A. Carron that he executed the above
Application for Payment and Affidavit on behalf of said Contractor; and that
all of the statements contained't re true, correct and complete.
ter,
My Commission Expires CAIVA a A. tl.,�,� : i
,, ..
June ldersi8 .\ ^panty (N aR P*tic) J
if.
The un gned has thetc' C. 's Application for Payment shown above
A part of this Atrli t � `"•
ors Affidavit stating that all previc
payments to him under this Contract have been applied by him to discharge in ful
all of his obligations in connection witch 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.
Date -LZ,� �B6 SHORT -EL 0 -HE
ICKSO C.
Page 4 _ of 4 By:
CLERK'S
r FELE 198V-01
With prejudice to Valley Paving, Inc.'s right to maintain
a cause of action for disputed amount.
atu—re