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Home My WebLink About4.d. Application for Payment #1, Acron Construction, City Projects #168 & #1710 APPLICATION FOR PAYMENT 5 v'� No. 1 Project: Rosemount, Minnesota- --- Shannon Parkway Owner: City of Rosemount Project No.: 168 & 171 Contractor: Arcon Construction Co. Inc.`��- Application Date: 10-19-87 For Period Ending: 10-16-87 STATEMENT OF WORK Original Contract Amount 1,073.560.12 Net Change by Change Order .. • i+J� Ora ;fl� - � x+ 'Y 1 "�. 4 x _ I xa w5 � .t � t � s ter ij :k' fSdp ° � •, Y i'y%` � a y�� { . A t a'7tie r� 5, #j 13 p .z Kit r� �r t: .. n„!j � .i _./"fes ,f� i }i tt'.�� f � f.�t•;r}� .T�e:! s Gros� un_r� ego Less 5% ; Retainage . Amount Due to Date 3l 3 8'J -Z. i'� -• 1 2 t 7 i'8 73o, 3/ Less Previous Payments _p... _ Payment Due This Application � .�-r 14,522.59 3o. -3/ � 59387 - ' DuE =&le = r Y • APPLICATION FOR PAYMENT No. l Project: Rosemount, Minnesota - Shannon Parkway Owner: City of Rosemount Project No.: 168 & 171 Contractor: Arcon Construction Co. Inc. Application Date: 10-19-87 For Period Ending: 10-16-87 STATEMENT OF WORK Original Contract Amount 1,073.560.12 Net Change 'b y Change Order - ExraWor .. t .XPi,.• �y'� .y K... e'•.Z t = .. � •' L '� '�i'}`YY + �ti,,e.h �y ; d y sr sZ•:il+��' p-yv �,„, ;✓y t' z �.v;"i<:?A-R'YT{, n%7?'.2��. �'Ai ortr w< �. i :{5"�!i.ss'$.•..�:i.'xit . �. •4i{CT��dt°iF'•3'.f+��l�'�i �.91� r��.::N3'� - .•y. Lii...'7FFiC } 2�e � Gro Amoun �;,s a moo, Less5 -Retainage �J�l ..3,5 /p/3S8 `�•.�-$ �,f ,- _. ].: 22.50 VW.S2 Less Previous Payments Payment Due This Application NOTE: ��l APPLICATION FOR PAYMENT = ECEIV D SNORT ELLIOTT HENDRICKSON, INC. ( UNIT PRICE CONTRACT) OCT 27 1987 NO. ---I--- S1. PAUL QUANTITIES AND UNIT PRICES HAVE BEEN REVISED IN ACCORDANCE WITH CHANGE ORDER NO. 1 OWNER: ROSEMOUNT, MINNESOTA OWNER'S PROJECT NO. 168 & 171 ENGINEER'S PROJECT NO. 87122 ---------------- LOCATION: ROSEMOUNT, MINNESOTA ------------------------------ CONTRACTOR ARCON CONSTRUCTION CO., INC. CONTRACT DATE 903 E. FOREST AVE., BOX 57 CONTRACT ------------------------- AMOUNT $1,073,560.12 MORA, MINNESOTA 55051 ------------------------------- ------------------ CONTR. FOR SHANNON PARKWAY STREET AND UTILITY CONSTRUCTION - S.A.P. 208-106-02 APPLIC.DATE ------------------------------------------- ------------------------- PERIOD END. ------------------------- APPLICATION FOR PAYMENT ----------------------- CONTRACT QUANTITY UNIT DESCRIPTION UNIT QUANTITY TO DATE PRICE TOTAL 2021.501 MOBILIZATION L.S. -------------------------------------- •50 1 14322.00 $ 7,161.00 2101.501 , CLEARING TREE 21 20 61.38 $ 1,288.98 2101.506 GRUBBING TREE 21 20 61.38 $ 1,288.98 2104.501 REMOVE CONCRETE CURB AND GUTTER L.F. 1050 2.04 $ 2104.521 SALVAGE CM PIPE CULVERT L.F. 20 5.11 $ 2104.501 REMOVE PIPE CULVERTS L.F. 20 58 5.11 $ 102.20 2104.509 REMOVE MANHOLES OR CATCH BASINS EACH 2 _3 204.60 $ 409.20 PAGE 1 OF 7 SHORT-ELLIOTT-HENDRICKSON, INC. PAGE 2 OF 7 SHORT-ELLIOTT-HENDRICKSON, INC. 2105. 501 COMMON EXCAVATION (P) C.Y. 36706 42833 1.30 $ 47, 717.80 2105.511 COMMON CHANNEL EXCAVATION C.Y. 438 1.38 $ 2105.535 SALVAGED TOPSOIL (L.V.) C.Y. 5825 1.22 $ 2111.501 TEST ROLLING RD.STA 96 102.30 $ 2112.501 SUBGRADE PREPARATION R.S. 96 153.45 $ 2116.501 CORE EXCAVATION C.Y. 1200 1.22 $ 2211.503 AGG BASE PLACED CL 5 (P) C.Y. 8495 8.18 $ 2211.504 AGG. BASE PLACED FOR WALK, CLASS 5 (P) C.Y. 996 10.23 $ 2221.503' AGGREGATE SHOULDERING PLACED, CL. 2 C.Y. 30 33.75 $ 2331.504 BITUMINOUS MATERIAL FOR MIXTURE TON 229 163.68 $ 2331.514 BASE COURSE MIXTURE TON 5077 6.64 $ 2341.504 BITUMINOUS MATERIAL FOR MIXTURE TON 330 184.14 $ 2341.508 WEARING COURSE MIXTURE TON 5077 7.67 $ 2357.502 BITUMINOUS MATERIAL FOR TACK COAT GAL. 2635 1.02 $ 2501.515 15" RC PIPE APRON_ W/TRASH GUARD EACH 3 9 423.52 $ 1,270.56 -2501.515 18" RC PIPE APRON W/TRASH GUARD EACH 1 1 478.76 $ 478.76 2501.515 21" RC PIPE APRON W/TRASH GUARD EACH 1 556.51 $ 2501.515 24" RC PIPE APRON W/TRASH GUARD EACH 1 630.16 $ 2501.515 27" RC PIPE APRON W/TRASH GUARD EACH 1 1 760.08 $ 760.08 2501.515 42" RC PIPE APRON W/TRASH GUARD .. EACH 2 1265.45 $ 2503.511 12" RCP STORM SEWER, DES. 3006, CL. V L.F. 495 1298 19.14 $ 9.474.30 PAGE 2 OF 7 SHORT-ELLIOTT-HENDRICKSON, INC. 2503.511 15" RCP STORM SEWER, DES. 3006, CL. V L.F. 378 1143 2503.511 18" RCP STORM SEWER, 19.14 $ 7,234.92 PAGE 3 OF 7 SHORT-ELLIOTT-HENDRICKSON, INC. DES. 3006, CL. V L.F. 913 850 21.33 $ 19,474.29 2503.511 21" RCP STORM SEWER, DES. 3006, CL. V L.F. 651 1489 23.14 $ 15,064.14 2503.511 24" RCP STORM SEWER, DES. 3006, CL. IV L.F. 70 1040 26.30 $ 1,841.00 2503.511 27" RC PIPE SEWER, DES. 3006, CL. IV L.F. 18 18 47.21 $ 849.78 2503.511 30" RC PIPE SEWER, DES. 3006, CL. IV L.F. 995 1381 34.31 $ 34, 138.45 2503.511 36" RC PIPE SEWER, DES. 3006, CL. IV L.F. 1972 69.99 $ 2503,511 42" RC PIPE SEWER, DES. 3006, CL. IV L.F. 50 467 79.18 $ 3,959.00 0503.608 15" RCP STORM SEWER, JACKED L.F. 78 113.55'$ 0503.608 36" RCP STORM SEWER, JACKED L.F. 120 360.02 $ 2504.602 ADJUST GATE VALVE BOX EACH 6 98.20 $ 2506.506 CONSTRUCT MANHOLE, DESIGN B L.F. 30 141 122.35 $ 3,670.50 2506.506 CONSTRUCT MANHOLE, DESIGN C L.F. 37.1 73 174.11 $ 6,459.48 2506.507 CONSTRUCT CATCH BASIN, DESIGN Y L.F. 17.85 50 123.98 $ 2,213.04 2506.509 CONSTRUCT CATCH BASIN, DESIGN X L.F. 1 1.84 132 139.53 $ 1,652.04 2506.511 RECONSTRUCT MANHOLE L.F. 17 20 95.13 $ 1,617.21 2506.516 CASTING ASSEMBLY, TYPE R-1733 EACH 28 111.50 $ 2506.516 CASTING ASSEMBLY, TYPE R-3067 EACH 45 176.97 $ 2506.522 ADJUST FRAME AND RING CASTING EACH 1 3 122.76 $ 122.76 PAGE 3 OF 7 SHORT-ELLIOTT-HENDRICKSON, INC. • 2511.501 RANDOM RIPRAP CL II C.Y. 44 2511.516 GEOTEXTILE FILTER 1.81 1457.77 FABRIC, TYPE IV S.Y. 176 2531.501 CONCRETE CURB & GUTTER, 35.80 $ 76.72 DESIGN D618 L.F. 19550 2521.511 2" BITUMINOUS WALK S.F. 73550 2531.507 8" CONCRETE DRIVEWAY 5.11 $ 0.97 PAVEMENT S.Y. 76 2545.511 LIGHTING UNITS, TYPE B EACH 27 2545.521 3" RIGID STEEL CONDUIT L.F. 400 2545.532 DIRECT BURIED CABLE L:F. 9000 2545.552 FEED POINT EACH 3 0563.601 TRAFFIC CONTROL L.S. 1 2564.531 SIGN PANELS - TYPE C S.F. 280 0564.602 TURN LANE PAVEMENT MESSAGE L.S. 6 0564.602 CROSS WALK PAVEMENT MESSAGE L.S. 1 2564.603 .4" WIDE SOLID LINE, WHITE L.F. 645 2564.603 4" WIDE SOLID LINE, YELLOW L.F. 10800 -2564.603 4" WIDE BROKEN LINE, WHITE L.F. 670 0564.603 4" WIDE BROKEN LINE, YELLOW L.F. 1180 0564.603 12" WIDE SOLID LINE, WHITE L.F. 26 0564.603 24" WIDE SOLID LINE, YELLOW L.F. 420 0565.602 HANDHOLE - TYPE C EACH 4 2575.501 ROADSIDE SEEDING ACRE 10 2575.502 SEED MIXTURE 5 LBS. 500 PAGE 4 OF 7 SHORT-ELLIOTT-HENDRICKSON, INC. 46.03 $ 3.17 $ 4.17 $ 0.28 $ 21.99 $ 1115.07 $ 9.20 $ 1.81 1457.77 $ 2557.50 $ 18.82 $ 35.80 $ 76.72 $ 0.20 $ 0.15 $ 0.21 $ 0.21 $ 5.11 $ 0.97 $ 358.05 $ 96.16 $ 2.54 $ 2575.505 SODDING S.Y. 6200 1.20 $ 2575.511 MULCH MATERIAL, TYPE 1 TON 20 100.25 $ 2575.519 DISC ANCHORING ACRE 10 42.96 $ 2575.523 WOOD FIBER BLANKETS S.Y. 1000 1.16 $ 0256.408 8" PVC, 12'-14'DEEP L.F. 50 50 18.60 $ 930.00 0256.408 8" PVC, 22'-24' DEEP L.F. 80 100 25.54 $ 2,043.20 0256.701 STANDARD MANHOLE, 8' DEEP EACH 1 961.62 $ 0256.702 EXCESS DEPTH STANDARD MANHOLE L.F. 15 55.24 $ 0256.706 MANHOLE DROP SECTION ON EXISTING MANHOLE L.F. 8.3 9 115.59 $ 959.40 0256.900 CONNECT TO EXISTING SEWER EACH 1 1 358.05 $ 358.05 0256.910 8" D.I.P. FORCEMAIN L.F. 1550 1550 12.38 $ 19, 189.00 0257.406 6" DIP WATERMAIN, CL 52 L.F. 162 14.97 $ 89.82 0257.408 8" DIP WATERMAIN, CL 52 L.F. 320 17.17 $ 0257.412 12" DIP WATERMAIN, CL 52 L.F. 1945 17.75 0257.416 16" DIP WATERMAIN, CL 52 L.F. 426 3200 24.95 $ 10,628.70 0257.419 BORE 24" STEEL CASING L.F. 86 105 96.16 $ 8.269.76 0257.421 JACK 16" DIP THRU CASING.L.F. 105 30.28 $ 0257.606 6" R.S.GATE VALVE & BOX EACH 10 321.22 $ 0257.608 8" R.S.GATE VALVE & BOX EACH 4 460.35 $ 0257.613 12" B.F.VALVE & BOX EACH 2 731.44 $ 0257.617 16" H.F.VALVE & BOX EACH 2 1366.72 $ 0257.630 FITTINGS LESS THAN 12" LB. 585 1.52 $ 0257.631 FITTINGS 12" & LARGER LB. 10640 1.04 $ 0257.633 LOWER WATERMAIN EACH 2 552.42 $ 0257.640 FIRE HYDRANT EACH 9 1117.11 $ PAGE 5 OF 7 SHORT-ELLIOTT-HENDRICKSON, INC. 0. 0 0257.806 INSULATION BD.FT. 64 0.95 $ 0257.903 CONNECT TO EXISTING WATERMAIN EACH 3 255.75 $ 255.75 0290.01 JAPANESE TREE LILAC 2" EACH 5 137.08 $ 0290.02 AMUR MAPLE 2" EACH 7 137.08 $ 0290.03 CANADA RED CHERRY 2" EACH 3 132.99 $ 0290.04 COLUMNAR BUCKTHORN 36" EACH 18 28.64 $ 0290.05 COMMON PURPLE LILAC 36" EACH 161 28.64 $ 0290.06 GOLD DROP POTENTILLA 18" EACH 76 18.41 $ 0290.07 DWARF AMUR MAPLE 18" EACH 33 21.48 $ 0290.08 RUGOSA ROSE #2 POT EACH 47 21.48 $ 0290.09 BLACK HILLS SPRUCE 6" EACH 15 132.99 $ 0290.10 COLORADO BLUE SPRUCE 6' EACH 15 132.99 $ 0290.11 COLORADO GREEN SPRUCE 6' EACH 27 .132.99 0290.12 AUSTRIAN PINE 6' EACH 11 132.99 $ 0290.13 PONDEROSA PINE 6' EACH 12 132.99 $ 0290.14 RIVER ROCK, 3/4 - 1-1/2" G.Y. 30 18.41 $ 0290.15 MULCH MATERIAL, TYPE 6 C.Y. 20 18.41 $ \.(11!vl\ 1 V\ 'I''"'II - tluf 11, tIiucu .Total Contract Amount $ 1,073, 6 0.1 2 Total Amount Earned 210,972.15 Material Suitably Stored on Site, Not Incoporated into Work $ Contract Change Order No. Percent -Complete $ Contract Change Order No. Percent Complete $ Contract Change Order No. Percent Complete $ , GROSS AMOUNT DUE.......... .. $ 210,972.15 LESS 5 % RETAINAGE......... $ 10,548.61 AMOUNT DUE TO DATE.......... $ 200,423.54 LESS PREVIOUS APPLICATIONS..... $ AMOUNT DUE THIS APPLICATION.... $ 200,423.54 CONTRACTOR'S AFFIDAVIT 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 October 26, , 19 87 By COUNTY OF SS STATE OF - Before njq onAh Js TV— day of (f� Arcon Construction Co., Inc. Contractor 19-J' personally appeared me, Wobean u y sworn, did depose and say tone isgtne c fiof the Contractor above mentioned; fl c that he executed the above Application for Payment and Affidavit on behalf of said Contractor; and that all of the statements contained therein are tr, coect an u lete. My Commission Expires: (Notary Pub c 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. , Date Page 7 of 7 SHORT ELLIOTT HENDRICKSON, INC. By