CCP 06-25-2007 - Laserfiche WebLink

Home Browse Search

PAYMEN'APPLICATION . ~el . TO: City of New Brighton PROJECT City of New Brighton APPLICATION # 4 Jl: Distribution to: 803 Old Highway 8 NAME AND WTP No.4 Filter Rehabilitation PERIOD THRU: 06/01/ jP07 0 OWNER LOCATION: New Brighton, MN 5511;2 660 5th St. SW PROJECT #s: 000335-06001-0 0 ARCHITECT New Brighton, MN 55112 II. 0 FROM: EnComm Midwest, Inc. ARCHITECT: Bonestroo Rosene Anderlik & Associates DATE OF CONTRACT: 01/25/2007 CONTRACTOR I' 0 P.O. Box 520 2335 W. Trunk, Hwy 36 St. Paul, MN 55113 , 0 Isanti, MN 55040 FOR: L CONTRACTOR'S SUMMARY OF WORK Contractor's signature below is his assurance to Owner, concerning the payme~t herein applied for, that: (1) the Work has been performed as required in the Contract Documents,II<2) all sums previously Application is made for payment as shown below. paid to Contractor under the Contract have been used to pay Contractor's cos~ for labor, materials and other obligations under the Contract for Work previously paid for, and (3) ontractor is legally Continuation Page is attached. entitled to this payment. ! 1. CONTRACT AMOUNT $178,871.00 CONTRACTOR: ~i~ 2. SUM OF ALL CHANGE ORDERS ($4,055.00) -- Date: i 06/01/2007 By: r 3. CURRENT CONTRACT AMOUNT (Line 1 +1- 2) $174,816.00 Lon R. Hollister, President State of: MN ! 4. TOTAL COMPLETED AND STORED $174,816.00 (Column G on Continuation Page) County of: Isanti 5. RETAINAGE: Subscribed and sworn to before I a. 5.00% of Completed Work $8,740.80 me this 1st day of June 2007 (Columns D + E on Continuation Page) ; b. 5.00% of Material Stored $0.00 Notary Public: Amy Washenberger (Column F on Continuation Page) My Commission Expires: January 31,2010 Total Retainage (Line 5a + 5b or Column I on Continuation Page) $8,740.80 ARCHITECT'S CERTIFICATION , 6. TOTAL COMPLETED AND STORED LESS RETAINAGE $166,075.20 Architect's signature below is his assurance to Owner, concerning the payme"i' herein applied for, (Line 4 minus Line 5 Total) that: (1) Architect has inspected the Work represented by this Application, (2) such Work has been completed to the extent indicated in this Application, and the quality of workmanship and materials 7. LESS PREVIOUS PAYMENT APPLICATIONS $141,755.20 confonns with the Contract Documents, (3) this Application for Payment accur!itely states the amount of Work completed and payment due therefor, and (4) Architect knows of no reason why payment 8. PAYMENT DUE. I $24,320.00 I should not be made. 9. BALANCE TO COMPLETION CERTIFIED AMOU NT..... ..... .......... ................. ...... ...................... ..... ............... ..;.. i (Line 3 minus Line 6) $8,740.80 (If the certified amount is different from the payment due, you should attach an explanation. /nitial all SUMMARY OF CHANGE ORDERS ADDITIONS DEDUCTIONS /he figJHeslhel "'" -" match the ~ed ..,,,..t.) J Total changes approved in ARCHITECT: previous months $1,025.00 ($5,080.00) By: Oat : Total approved this month $0.00 $0.00 Neither this Application nor payment applied for herein is assignable or neg~iable. Payment shall be TOTALS $1,025.00 ($5,080.00) made only to Contractor, and is without prejudice to any rights of Owner or lrntractor under the NET CHANGES ($4,O55.00) Contract Documents or otherwise. t: .. PAYMENT APPLICATION Quantum Software Sillutions. Inc. Document \: