HomeMy WebLinkAbout4.e. Request for Payment #2, O'Leary's Hills 3rd Addition, Streets & Utilitiesr
Grp,
CITY OF ROSEMOUNT i
APPLICATION FOR PAYMENT
NO. T
CITY PROJECT NO:--L76- %6- SEH FILE NO: 67ZG1S-
PROJECT: OCL-easy s /7i�s 3r. lT�4a��,�o►�
CONTRACTOR: rt
� 't'► Corp, CONTRACT DATE: �� 87 Sf. kty APPLICATION DATE:
Oh jOld S, /1►�/ SS'f33 FOR PERIOD ENDING: // ZS $%
Total Contract Amount $ Ei%s Total Amount Earned
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 .................... $_ i3-�� ZS.6 ee
LESS S $ RETAINAGE .........
AMOUNT DUE TO DATE ... $ 1 Z!,
LESS PREVIOUS APPLICATIONS ............ $ �$,Su 7b
AMOUNT DUE THIS APPLICATION $ 6,9,02,1. ZS
AP -V D:
01
ichard He .t
City Engineer/ rector of Public Works
r '
APPLICATION FOR PAYMENT
-------------------------
(UNIT PRICE CONTRACT)
NO. 2
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. ICONTRACT
-------------------------
AMOUNT
$148,675.46
--- -----
COON RAPIDS, MN 55433
-----------------------
CONTR. FOR
'-----------------------------
OLEARY'S HILLS 3RD ADDITION -STREET &
------------
UTILITY
CONSTRUCTION
--------------------
APPLIC.DATE
------------------------
--
---1VausA�ie�_25---- 1982_-----
PERIOD END.
APPLICATION FOR
-----------------------
PAYMENT
CONTRACT
DESCRIPTION UNIT QUANTITY
-
QUANTITY
TO DATE
UNIT
PRICE
TOTAL
I.
---- --------------------------
SANITARY SEWER
-----------------
0256. 408
--------------------
8" PVC, 10' -12' DEEP L.F. 710
585
13.16
$__9343,60
0256.408
8" PVC, 12'-14'DEEP L.F. 75
153 `
13.83
$ 1037.25
0256.408
8" PVC, 14' -16' DEEP L.F. 51
72
14.69
$ 749.19
0256.408
8" PVC, 16'-18' DEEP L.F. 70
70
15.83
$ 1108:10
0256.408
8" PVC, 18'-20' DEEP L.F. 80
30
18.51
$ 1480_88
0256.408
8" PVC, 201-22' DEEP L.F. 40
40
19.86
$ 794.40
0256.408
8" PVC, 221-24' DEEP L.F. 5D
126
23.87
$ 1191.50
0256.514
12" RCP, CL. V,
24'-26' DEEP L.F. 307.2
304
36.53
$_1_1.2.2.2.._07
PAGE 1 OF 4
SHORT-ELLIOTT-HENDRICKSON,
INC.
0256.701
STANDARD MANHOLE 8' DEEP
EACH
1
4
858.20
$ 858.20
0256,702
EXCESS DEPTH STANDARD
MANHOLE
L.F.
0
30.5
57.25
$
0256.706
8" OUTSIDE DROP SECTION
L.F.
23
25
136.12
$ 3130.76
0256.801
8" BY 4" PVC WYE
EACH
?3
23
31.00
$ 713.00
0256.803
4" PVC SERVICE
L.F.
1041
996
3.88
$ 4039.08
0256.900
CONNECT TO EXISTING
SANITARY SEWER
EACH
1
1
301.60
$ 301.60
II.
WATERMAIN
0257.406
-------------------------
6" DIP WATERMAIN, CL 52
L.F.
1 r 1 5
1569
10.85
$ 16437.75
0257.408
8" DIP WATERMAIN, CL. 52
D.F.
,4159
455
12.85
$ 5898.15
0257.606
6" R.S.GATE VALVE & BOX
EACH
5
6
280.60
$_ 140.3.00
0257.608
8" R.S. GATE VALVE & BOX
EACH
1
1
380.80
$
0257.630
FITTINGS LESS THAN 12"
LB.
89-1
792
1.68
$ 1496.88
0257.640
FIRE HYDRANT
EACH
3
4
994.20
$ 2982.60
0257.710
1" COPPER SERVICE
L.F.
993
984
4.49
"$ 4458.57
0257.730
1" CORPORATION
EACH
23
23
30.02
$ 690.46
0257.740
1" CURB STOP
EACH
23
23
56.68
$ 1303.64
0257.806
INSULATION
B.F.
0
128
1.14
$
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.
167
185
19.35
$ 3231.45
0258.415
15" RCP STORM SEWER,
CL. V
L.F.
19A
190
16.14
$ 3066.60
0258.421
21" RCP STORM SEWER,
CL. III
L.F.
1 22
127
19.90
$27.80
0258.603
MANHOLE, TYPE B
L.F.
c
6.5
125.88
$ 629.40
0258.704
CATCH BASIN, TYPE X
L.F.
ss'/�r %
6
159.$5
$ 911 _15
PAGE 2 OF
4 SHORT-ELLIOTT-HENDRICKSON,
INC.
0258.705
0258.801
0258.808
0258.930
IV.
2105.521
2111.501
2112.501
2211.503
2341.504
2341.508
2341.510
2357 502
2504.602
2506.522
2531.501
2545.511
2545.511
2545.532
2545.552
2554.501
PAGE 3 OF 4 SHORT-ELLIOTT-HENDRICKSON INC
CATCH BASIN, TYPE Y
L.F.
12.3
11.5
184.21
$
2265.79
R 1733 MH CASTING FOR
STORM SEWER
EACH
1
1
115.00
$
115.00
R 3067 CB CASTING
EACH
5
5
176.00
$
880.00
CONNECT TO EXISTING
STORM- SEWER
EACH
1
1
301.60
$
301.60
STREETS
GRANULAR BORROW (L.V.)--
C.Y.
0
1000
1.39
$
TEST ROLLING
RD.STA 1b 5
16.5
16.00
$
264,00
SUBGRADE PREPARATION
RD. STA
16.5
16.5
89.00
$
1468.50
AGGREGATE BASE PLACED,
CLASS 5 (P)
C.Y.
942
910
9.00
$
8478.00
BITUMINOUS MATERIAL FOR
MIXTURE
TON
60-07
58
168.00
$
10091.76
WEARING COURSE MIXTURE
TON
51t_fi1
500
11.00
$
5627.71
BINDER COURSE MIXTURE
TON
611 hr
500
10.70
$ 6544.66
BITUMINOUS MATERIAL FOR
TACK COAT
GAL.
350
300
1.60
$ 560.00
ADJUST GATE VALVE BOX
EACH
5
5
110.00
$
550.00
ADJUST FRAME AND RING
CASTING
EACH
3
4
130.00
$
390.00
CONCRETE CURB & GUTTER,
DESIGN D418
L.F. _3321
3240
4.51
$ _14977.71
LIGHTING UNIT, TYPE A
EACH
9
2
1000.00
$
LIGHTING UNIT, TYPE B
EACH
n
2
1000.00
$
UNDERGROUND CONDUCTOR
L.F.
n
730
2.13
$
FEED POINT
EACH
0
2
1000.00
PERMANENT BARRICADES,
L.F.
0
16
33.07
$
PAGE 3 OF 4 SHORT-ELLIOTT-HENDRICKSON INC
�. APPLICATION FOR PAYMENT - Continued
Total' Contract Amount $148, b75.* Total Amount Earnev
Material Suitably Stored on Site, Not Incoporated into Work
$ 134,256.88
Contract Change Order No. Percent -Complete
Contract Change Order No. Percent Complete $
Contract Change Order No. Percent Complete $
GROSS AMOUNT DUE ............... $ 134,256.88_
LESS 5 % RETAINAGE......... $ 6.712.85
AMOUNT DUE TO DATE ............. $ 127,544.03
LESS PREVIOUS APPLICATIONS $ 58,522.78
AMOUNT DUE THIS APPLICATION.... $ 50, 021.2
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 November 25, 1982 American Contracting Corporation
COUNTY OF Aunka SS
STATE OF MinnPcnt;�
C racto
By
' tume anu lime)
William 0. Horbal, President
Before me on this 25th day of Nounm 19 personally appeared
William n NariLl mown to me, who bein�y sworn, did depose
and say that he is the PrPsirippi of the Contractor above mentioned;
Office
that he executed the above Application for Payment and Affidavit on behalf of said Contractor;
and that all bg, ,i;,ements contained therein are true, orrect a complete.
MYYx$N kgli H,AA MIR Gd so ( o� l
t} ANnKA COl1NTY (Notary Pub i
FAy,ommissio,Expires may 28,1991
Thevvndees'i"gK6Cias~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
IZ-jam/? SHORT E T H RICKSO ,
By
Page 4 of 4