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HomeMy WebLinkAbout4.d. Request for Payment #5, O'Leary's Hills 2nd Addition, Valley Oak Street sAs QA%Ctt- /1Cr7~ CITY OF ROSEMOUNT APPLICATION F?O PAYMENT NO. 5 0 CITY PROJECT NO: 160 K SES / SEH FILE NO: !b702Z Q170e3 PROJECT: Q,Lf2,!'yS A%/s 2.-''d Ae(da i Vo- /let/ 061lUc(w CONTRACTOR: Fre. ferrej /:7&vikq CONTRACT DATE: /o/ Z'3/66 0I46e, APPLICATION DATE: J//f/57 acoMrq� %% V. S"S387 FOR PERIOD ENDING: /0/30/87 Total Contract Amount $ /,97,/Z-,9 74- Total Amount Earned $ %6S, Z9$ 50 Material Suitably Stored on Site, Not Incorporated into Work $ Contract Change Order No. Percent Complete %0OC;'o $ 2.3 Contract Change Order No. Percent Complete $ Contract Change Order No. Percent Complete $ GROSS AMOUNT DUE .................... $ /67,4-73 Zr— LESS 15$ RETAINAGE ................... $ 66 AMOUNT DUE TO DATE .................... $ z -" ,L6 LESS PREVIOUS APPLICATIONS ............ $ ! T"j 869 ?9 AMOUNT DUE THIS APP_LICAT-I0N._.1 ......... $ /84 fZ.,f 77 A O D,4qpC- V&3ct0-3qJ �? M. J (c), City dg Enin irector of Public Works --- - ---- APPLICATION FOR PAYMENT (UNIT PRICE CONTRACT) No. Jr Owner: ROSEMOUNT, MINNESOTA Owner's Project No. 1986-7 & 1986-8 Engineer's Project No. 87022 & 87023 LOCATION ROSEMOUNT, MINNESOTA Contractor Preferred Paving, Inc. Contract Date 10 a (c.) 24 So. Olive Contract Amount $197,129.75 Waconia, MN 55387 Contract for ST. CONST. VALLEY OAK ADDN. PHASE II O'LEARY'S HILLS 2ND Application Date J��v For Period Ending 101:301'6-7 APPLICATION FOR PAYMENT DESCRIPTION UNIT CONTRACT QUANTITY QUANTITY UNIT TO DATE PRICE TOTAL 2021.501 MOBILIZATION L.S. 1 3 $4,000.00 $`nnt WC61 2105.501 COMMON EXCAV. C.Y. 2,500. 0798 6.00 � S��(J 2105.521 GRANULAR BORROW (L.V.) C.Y. 2,500 5.75 S. Page 1 of 4 SHORT-ELLIOTT-HENDRICKSON, INC. u 2506.522 ADJUST FRAME AND RING CASTING EACH Page 2 of 4 oa 19 1 9` 150.00 $ 2850 APPLICATION FOR PAYMENT - Continued CONTRACT QUANTITY UNIT DESCRIPTION UNIT QUANTITY TO DATE PRICE TOTAL 2111.501 TEST ROLLING RD. STA. 18 t�.�• .'' 50.00 $31,95 2112.501 SUBGRADE PREPARATION RD. STA. 1$ 100.00 $ 262 2116.501 CORE EXCAV . C.Y. 1, 000 - 6.00 $-0- -0-2116.503 2116.503 AGGREGATE BACKFILL C.Y. 1"000 5.75 $-,0- .•Q-2118.501 2118.501 AGGREGATE SURFACING, CL. 5 (MOD.)' % ( "i? TON 1,000 8.00 $ 1j` 2211.503 AGG. BASE PLACED CLASS 5 C.Y. 660 7.30 $39 0211.504 4" AGG. BASE FOR SIDEWAL, CL. 5 S.F. 9,900 0jj1950 0.35 $3''7% 2331.504 BITUMINOUS MATERIAL { 25 FOR MIXTURE TON 56 '� 135.00 $/(003/ 2331.514 BASE COURSE MIXTURE TON 1,125 2o4-7. 12.37 _ $7 3a6 1 2341.504 BITUMINOUS MATERIAL a 5$ �!` V FOR MIXTURE TON 147 135.00 $ 2341.508 WEARING COURSE MIXTURE TON 1,300 13.50 $_A 6161 %J 2341.510 BINDER COURSE MIXTURE TON 1,300 12.87 2357.502 BITUMINOUS MATERIAL -15 FOR TACK COAT GAL. 885 a 1.50 i c� $j 0504.602 ADJUST VALVE 15 o0 6©t� BOX EACH 5 100.00 $ 0 2506.522 ADJUST FRAME AND RING CASTING EACH Page 2 of 4 oa 19 1 9` 150.00 $ 2850 APPLICATION FOR PAYMENT - Continued — Page 3 of 4 CONTRACT QUANTITY UNIT DESCRIPTION UNIT QUANTITY TO DATE PRICE TOTAL 2521.511 2" BITUMINOUS WALK S.F. 9,900 9900 $0.80 $ 7700 2531.501 CONCRETE CURB & GUTTER, DESIGN B618 L.F. 2,200 5.00 $�a� 2531.501 CONCRETE CURB & GUTTER, DESIGN D418 L.F. 2,680 abs 4.60 o0 $1Tq 2535.501 BITUMINOUS CURB L.F. 230 �$ 4.00 $ 7501 2545.511 LIGHTING UNIT, TYPE A EACH 2 955.00 00 S 2545.511 LIGHTING UNIT, TYPE B EACH 5 1,530.00 $(� 2545.532 UNDERGROUND _ 6� CONDUCTOR L.F. 1,600 2.40 $ 2545.552 FEED POINT EACH 3 2,178.00 $ -�f34 2554.505 PERMANENT BARRICADES L.F. 32Z 20.00 00 $ — Page 3 of 4 ns 1 6«n1 4WIN 1 v1% I n1 I1.141 - %,u11t,11IUeu TdtaI Chntract Amount $ 197,129. Total Amount Earned low 0 Material Suitably Stored on Site, Not Incoporated into Work Contract Change Order No. j Percent.Complete X00 °lo Contract Change Order No. Contract Change Order No. Percent Complete Percent Complete GROSS AMOUNT DUE ............... LESS .'ZN' % RETAINAGE......... AMOUNT DUE TO DATE ............. LESS PREVIOUS APPLICATIONS..... AMOUNT DUE THIS APPLICATION.... $ Z -3Ze4 ?- 16 7, -S"73 3zz $ �Z 713 6b $- 16.9 z 94;E— $ 4;E$ 14- d, a 69 2-9 LUNIKAWW5 AttIUAV U 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 _ 11141 1g Preferred Paving, Inc. COUNTY OF Carver SS STATE OF Minnesota Before me on this 4th day ofNovember , 19 87 personally appeared Bruc R. Anderson known to me, who being �c uTy sworn, did depose and say that he is the Vice President of the Contractor above mentioned; (Of?ice) thdz he executed the above Application for Payment and Affidavit on behalf of sa d Contractor; and that all of the statements contained therein are true, rrect and complete // My Commission Expires: C"thle 0. Hansen aue.Mamsoe , ConMn. ONn ety»�y ta ry The undersigned has chec e t e on roc ors pp ication 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 / 1 / /// 52 Page 4 of 4 SHORT E TT HICKS C. By aqi4