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DocuSign Envelope ID: 18BCC2EB-5C45-4AO3-BBDA-FOAFAF992DFC
<br />NTINUATION SHEET
<br />APPLICATION AND CERTIFICATION FOR PAYMENT,
<br />containing Contractor's signed Certification is attached.
<br />In tabulations below, amounts are stated to the nearest dollar.
<br />Ebert Construction
<br />APPLICATION NO.: 6
<br />APPLICATION DATE: 04/23/20
<br />PERIOD TO: 04/30/20
<br />PROJECT NO.: 19520-0033
<br />A
<br />B
<br />C
<br />D
<br />E
<br />F
<br />G
<br />H
<br />I
<br />WORK COMPLETED
<br />MATERIALS
<br />TOTAL
<br />ITEM
<br />DESCRIPTION OF WORK
<br />SCHEDULED
<br />FROM PREVIOUS
<br />PRESENTLY
<br />COMPLETED
<br />%
<br />BALANCE TO
<br />RETAINAGE (IF
<br />NUM
<br />VALUE
<br />APPLICATION (D
<br />THIS PERIOD
<br />STORED (NOT IN
<br />AND STORED TO
<br />(G + C)
<br />FINISH (C - G)
<br />VARIABLE RATE)
<br />+ E)
<br />D OR E)
<br />DATE
<br />1
<br />Bonds, Insurance, Mobilize
<br />$5,000.00
<br />$5,000.00
<br />$5,000.00
<br />100.00%
<br />$250.00
<br />2
<br />General Conditions
<br />$21,000.00
<br />$11,550.00
<br />$1,050.00
<br />$12,600.00
<br />60.00%
<br />$8,400.00
<br />$630.00
<br />3
<br />Allowance
<br />$50,000.00
<br />$12,882.39
<br />$8,473.36
<br />$21,355.75
<br />42.71%
<br />$28,644.25
<br />$1,067.79
<br />4
<br />061000 Rough Carpentry M
<br />$59,700.00
<br />$59,700.00
<br />$59,700.00
<br />100.00%
<br />$2,985.00
<br />5
<br />061000 Rough Carpentry L
<br />$153,000.00
<br />$122,400.00
<br />$10,710.00
<br />$133,110.00
<br />87.00%
<br />$19,890.00
<br />$6,655.50
<br />6
<br />061753 Shop Fam Wood
<br />$3,000.00
<br />$3,000.00
<br />$3,000.00
<br />100.00%
<br />$150.00
<br />Trusses
<br />7
<br />064216 Wood Paneling
<br />$135,000.00
<br />$20,250.00
<br />$20,250.00
<br />15.00%
<br />$114,750.00
<br />$1,012.50
<br />8
<br />072119 Foamed -In -Place
<br />$17,000.00
<br />-
<br />$17,000.00
<br />-
<br />Insulation
<br />9
<br />081113 HM Doors and Frames
<br />$81,000.00
<br />$8,100.00
<br />$8,100.00
<br />10.00%
<br />$72,900.00
<br />$405.00
<br />10
<br />097733 FRP
<br />$4,500.00
<br />$4,500.00
<br />$4,500.00
<br />100.00%
<br />$225.00
<br />11
<br />101100 Visual Display Boards
<br />$7,800.00
<br />-
<br />$7,800.00
<br />-
<br />12
<br />102600 Wall and Corner
<br />$7,000.00
<br />$7,000.00
<br />Guards
<br />13
<br />105113 Metal Lockers
<br />$2,800.00
<br />$2,800.00
<br />1
<br />Carpentry (CO #1)
<br />$416.90
<br />-
<br />$416.90
<br />PAYMENT TOTALS
<br />$547,216.90
<br />$214,532.39
<br />$53,083.36
<br />$267,615.75
<br />48.91%
<br />$279,601.15
<br />$13,380.79
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