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DocuSign Envelope ID: 18BCC2EB-5C45-4AO3-BBDA-FOAFAF992DFC
<br />CONTINUATION 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.: 4
<br />APPLICATION DATE: 04/01/20
<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 />General Conditions
<br />$14,700.00
<br />$7,303.47
<br />$5,410.00
<br />$12,713.47
<br />86.49%
<br />$1,986.53
<br />$635.41
<br />2
<br />MPB - Walks - Materials
<br />$30,617.00
<br />$744.00
<br />$4,752.00
<br />$5,496.00
<br />17.95%
<br />$25,121.00
<br />$273.32
<br />3
<br />MPB - Walks - Labor
<br />$44,082.00
<br />$1,071.18
<br />$1,071.18
<br />2.43%
<br />$43,010.82
<br />$54.01
<br />4
<br />MPB - Curb - Materials
<br />$18,273.00
<br />$2,180.00
<br />$2,180.00
<br />11.93%
<br />$16,093.00
<br />$109.00
<br />5
<br />MPB - Curb - Labor
<br />$22,333.00
<br />$2,664.00
<br />$2,664.00
<br />11.93%
<br />$19,669.00
<br />$133.00
<br />6
<br />Lion - Walks - Materials
<br />$83,053.00
<br />$3,232.00
<br />$3,232.00
<br />3.89%
<br />$79,821.00
<br />$161.60
<br />7
<br />Lion - Walks - Labor
<br />$123,318.00
<br />-
<br />$123,318.00
<br />-
<br />8
<br />Lion - Curb - Materials
<br />$18,461.00
<br />$13,846.75
<br />$13,846.75
<br />75.01 %
<br />$4,614.25
<br />$692.04
<br />9
<br />Lion - Curb - Labor
<br />$22,563.00
<br />$16,922.25
<br />$16,922.25
<br />75.00%
<br />$5,640.75
<br />$846.01
<br />10
<br />Allowance
<br />$10,000.00
<br />$5,659.00
<br />$5,659.00
<br />56.59%
<br />$4,341.00
<br />$283.00
<br />1
<br />Site Concrete (CO #1)
<br />$3,311.40
<br />$3,311.40
<br />$3,311.40
<br />100.00%
<br />$166.00
<br />1
<br />Site Concrete (CO#2)
<br />($1,570.47)
<br />($1,570.47)
<br />($1,570.47)
<br />100.00%
<br />($79.00)
<br />1
<br />Site Concrete (CO #3)
<br />($4,286.00)
<br />($4,286.00)
<br />($4,286.00)
<br />100.00%
<br />($214.00)
<br />1
<br />Site Concrete (CO #4)
<br />($1,561.90)
<br />($1,561.90)
<br />($1,561.90)
<br />100.00%
<br />($78.00)
<br />PAYMENT TOTALS
<br />$383,293.03
<br />$46,283.68
<br />$5,410.00
<br />$7,984.00
<br />$59,677.68
<br />15.57%
<br />$323,615.35
<br />$2,982.39
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