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Home My WebLink About4.e. Application for Payment #1, O'Leary's Hills 3rd Street & Utilityf CITY OF ROSEMOUNT APPLICATION Fr PAYMENT NO. CITY PROJECT NO: SEH FILE NO: V zor PROJECT: --- d 1 L.1101 1.3 Ails 3rd f�dldi ho,� CONTRACTOR: hh&*Ico' L4h ti; Ccs tp CONTRACT DATE:C W/0/67 //66/ &q/e Sf NGy APPLICATION DATE: 91Z3 A7 CoO--- F"43, M41% 5111 FOR PERIOD ENDING: ZZ 87 Total Contract Amount $ 1"Total Amount Earned $ 6/, (>02 93 Material Suitably Stored on Site, Not Incorporated into Work $ Contract Change Order No. Percent Complete Contract Change Order No. Percent Complete $ Contract Change Order No. Percent Complete $ GROSS AMOUNT DUE ................... $ 4 %,602 93 LESS $ RETAINAGE . .. ..... $b SO !s` AMOUNT DUE TO DATE ................. LESS PREVIOUS APPLICATIONS ............ $ AMOUNT DUE THIS APPLICATION ........... $, S ZZ 78 APPR VED; ichard M. IN City Engineer/birector of Public Works APPLICATION FOR PAYMENT - E_ -------------------------- (UNIT PRICE CONTRACT) NO. � � • Aq L OWNER: ROSEMOUNT, MINNESOTA OWNER'S PROJECT NO. 175 ENGINEER'S PROJECT NO. 87205 ---- LOCATION: ROSEMOUNT, MINNESOTA ------------------------------- CONTRACTOR AMERICAN CONTRACTING CORP. CONTRACT DATE -------------- 11661 EAGLE ST. N.W. CONTRACT ------------------------- AMOUNT $148,675.46 --------- COON RAPIDS, MN 55433 ----------------------- CONTR. FOR 0 LEARY'S HILLS 3RD ADDITION - STREET & ------------------------------------------------ UTILITY CONSTRUCTION APPLIC.DATE ---------- ___ Se.ple1.bVi_231287 ------ PERIOD END. Ieriber_Z?...._1987 ...... APPLICATION FOR PAYMENT ------ -- r,--- 1-�. CONTRAG7 Q�1J 1I+iTI'I' UNIT DESCRIPTION UNIT QUANTITY TO -DATE PRICE TOTAL -------------------------------------------- ------------------------------ I. SANITARY SEWER 0256.408 8" PVC, 10'-12'DEEP -- L.F- 710 585 13.16 $ 9,343.60 0256.408 8" PVC, 12' -14' DEEP L.F. 75 153 13.83 $---1,037.25 0256.408 8" PVC, 14' -16' DEEP L.F. 51 72 14.69 $ 749.19 49.190256.408 0256.408 8" PVC, 16'-18' DEEP L.F. 70 70 15.83 $ 1,108.10 0256.408 8" PVC, 18'-20' DEEP L.F. 80 30 18.51 $ 1.480.80 0256.408 8" PVC, 20'-22' DEEP L.F. 40 40 19.86 $ 794.40 0256.408 8" PVC, 22'-24' DEEP L.F. 50 126 23.87 $ 1,193.50 0256.514 12" RCP, CL. V, 24'-26' DEEP L.F. 307.2 304 36.53 $ 11,222.02 PAGE 1 OF 4 SHORT-ELLIOTT-HENDRICKSON, INC. 0256.701 STANDARD MANHOLE 8' DEEP EACH p 4 858.20 $ 0.00 0256.702 EXCESS DEPTH STANDARD MANHOLE L.F. 0 30.5 57.25 $ 0.00 0256.706 8" OUTSIDE DROP SECTION L.F. 23 25 136.12 $_ 3,130.76 0256.801 8" BY 4" PVC WYE EACH 23 23 31.00 $ 713.00 0256.803 4" PVC SERVICE L.F. 557 996 3.88 $,2 161.16 0256.900 CONNECT TO EXISTING SANITARY SEWER EACH 1 301.60 $ 301.60 II. WATERMAIN 0257. 406 ------------------- 6" DIP WATERMAIN, CL 52 L.F. 831-8 1569 10.85 $ 9.025.03 0257.408 8" DIP WATERMAIN, CL. 52 L.F. 459 455 12.85 $ 5,898.15 0257.606 6" R. S . GATE VALVE & BOX EACH 4 6 280.60 $ 1,122.40 0257.608 8" R.S. GATE VALVE & BOX EACH 1 1 380.80 $ 380.80 0257.630 FITTINGS LESS THAN 12" LB. 810 792 1.68 $ 1,360.80 0257.640 FIRE HYDRANT EACH 3 4 994.20 $ 2,982.60 0257.710 1" COPPER SERVICE L.F. 573 984 4.49 $ 2,572.77 0257.730 1" CORPORATION EACH 14 23 30.02 $ 420.28 0257.740 1" CURB STOP EACH 14 23 56.68 S 793.52 0257.806 INSULATION B.F. 0 128 1.14 $ 0.00 0257.903 CONNECT TO EXISTING WATERMAIN EACH 2 2 226.20 $ 452.40 III. STORM SEWER 0258.412 -------------------- 12" RCP STORM SEWER, CL. V L.F. p 185 19.35 $ 0.00 0258.415 15" RCP STORM SEWER, CL. V L.F. p 190 16.14 $ 0.00 0258.421 21" RCP STORM SEWER, CL. III L.F. 122 127 19.90 $ 2,427.80 0258.603 MANHOLE, TYPE B L.F. 6.5 125.88 $ 629'.x+0 0258.704 CATCH BASIN, TYPE X L.F. p 6 159.85 $ g,pp PAGE 2 OF 4 SHORT_ELLIOTT-HENDRICKSON, INC. PAGE 3 OF 4 SHORT-ELLIOTT-HENDRICKSON, INC. 0258.705 CATCH BASIN, TYPE Y L.F. 11.5 184.21 $ 0.00 0258.801 R 1733 MH CASTING FOR STORM SEWER EACH _0 1 115.00 $ 0.00 0258.808 R 3067 CB CASTING EACH 0 5 176.00 $ 0.00 0258.930 CONNECT TO EXISTING STORM SEWER EACH 1 1 301.60 $ 301.60 IV. STREETS 2105.521 GRANULAR BORROW (L.V.)---C.Y. 0 1000 1.39 $ 0.00 2111.501 TEST ROLLING RD.STA 0 16.5 16.00 $ 0.00 1112.501 SUBGRADE PREPARATION RD.STA 0 16.5 89.00 $ 0.00 2211.503 AGGREGATE BASE PLACED, CLASS 5 (P) C. Y. 0 910 9.00 $ 0.00 2341.504 BITUMINOUS MATERIAL FOR MIXTURE TON 0 58 168.00 $ 0.00 2341.508 WEARING COURSE MIXTURE TON 0 500 11.00 $ 0.00 2341.510 BINDER COURSE MIXTURE TON 0 500 10.70 $ 0.00 2357.502 BITUMINOUS MATERIAL FOR TACK COAT GAL. 0 300 1.60 $ 0.00 2504.602 ADJUST GATE VALVE BOX EACH 0 5 110.00 $ 0.00 2506.522 ADJUST'FRAME AND RING CASTING EACH 0 4 130.00 $ 0.00 2531.501 CONCRETE CURB & GUTTER, DESIGN D418 L.F. 0 3240 4.51 $ 0.00 2545.511 LIGHTING UNIT, TYPE A EACH 0 2 1000.00 $ 0.00 2545.511 LIGHTING UNIT, TYPE B EACH 0 2 1000.00 $ 0.00 2545.532 UNDERGROUND CONDUCTOR L.F. 0 730 2.13 $ 0.00 2545.552 FEED POINT EACH 0 2 1000.00 $ 0.00 2554.501 PERMANENT BARRICADES L.F. 0 16 33.07 $ 0.00 PAGE 3 OF 4 SHORT-ELLIOTT-HENDRICKSON, INC. APPLICAHON FOR PAYMENT - Continued Total. Contract Amount $148,675.4! Total Amount Earned Material Suitably Stored on Site, Not Incoporated into Work Contract Change Order No. Percent.Complete Contract Change Order No. Contract Change Order No. Percent Complete Percent Complete $ 61-602.93 t GROSS AMOUNT DUE ............... $ 61,1602.93 LESS 5 % RETAINAGE ......... $ 3,080.15 AMOUNT DUE TO DATE ............. $----58.522.78 LESS PREVIOUS APPLICATIONS ..... $ 0.00 CONTRACTOR'S AFFIDAVIT AMOUNT DUE THIS APPLICATION.... $ 518,522,78 The undersigned Contractor hereby swears under penalty of perjury 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 discharge in full all obligations of the under- signed incurred in connection with work 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 clear of all liens, claims, security interests and encumbrances. Dated September 23 _. 19 87. COUNTY OF Anoka Ss STATE OF &&&MA *z Before American Contracti Co tracto By -1-11 of I L L I RNA Ti Corporation September , 19 — 87 personally appeared known to me, who being -TuTy sworn, did depose of the Contractor above mentioned; '0V", "' " " - (Office) that he executed the above Application for Payment and Affidavit on behalf of said Contractor; and that all of the I statements contained therein arA true, correct and tete. My Commission Expires: May 28, 1991 V (Notary PublicY/(/ 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 all of his obligations in connection with 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. SHORT EL THEN ICKSOC` Date _,7 By � Page 4 of 4