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DocuSign Envelope ID: B21CAEBD-7600-4BB5-BB91-7BFCFA6AOB90
<br />CONTINUATION SHEET
<br />Page 3 of 3
<br />Application and Certification for Payment, containing
<br />Contractor's signed certification is attached.
<br />In tabulations below, amounts are stated to the nearest dollar.
<br />Use Column I on Contracts where variable retainage for line items may apply.
<br />Invoice # : 9520003315
<br />Contract : 19520-0033 Elk River Multi -Purpose Facility and Lion John Weicht Park
<br />Application No.: 15
<br />Application Date : 09130120
<br />To: 09130120
<br />Architect's Project No.:
<br />A
<br />B
<br />C
<br />D E
<br />F
<br />G
<br />H
<br />I
<br />Item
<br />Description of Work
<br />Scheduled
<br />Work Com
<br />feted
<br />Materials
<br />Total
<br />%
<br />Balance
<br />Retainage
<br />From Previous
<br />This Period
<br />No.
<br />Value
<br />Presently
<br />Completed
<br />(G 1 C)
<br />To Finish
<br />Application
<br />In Place
<br />Stored
<br />and Stored
<br />(C-G)
<br />(D+E)
<br />To Date
<br />Not in D or E
<br />D+E+F
<br />31 B
<br />Lions Earthwork
<br />510,815.67
<br />510,815.67
<br />0.00
<br />0.00
<br />510,815.67
<br />100.00%
<br />0.00
<br />25,540.79
<br />32A
<br />Asphalt Paving
<br />293,489.00
<br />293,489.00
<br />0.00
<br />0.00
<br />293,489.00
<br />100.00%
<br />0.00
<br />14,674.45
<br />32B
<br />Concrete/Sidewalk/Curb/Gutter
<br />384,713.41
<br />383,446.94
<br />1,266.47
<br />0.00
<br />384,713.41
<br />100.00%
<br />0.00
<br />19,235.67
<br />32C
<br />Multipurpose Landscaping
<br />27,000.00
<br />27,000.00
<br />0.00
<br />0.00
<br />27,000.00
<br />100.00%
<br />0.00
<br />1,350.00
<br />32D
<br />Lions Landscaping
<br />94,480.00
<br />94,480.00
<br />0.00
<br />0.00
<br />94,480.00
<br />100.00%
<br />0.00
<br />4,724.00
<br />32E
<br />Chain Link Fence
<br />150,325.79
<br />150,325.79
<br />0.00
<br />0.00
<br />150,325.79
<br />100.00%
<br />0.00
<br />7,516.30
<br />33A
<br />Utilities
<br />635,496.55
<br />635,496.55
<br />0.00
<br />0.00
<br />635,496.55
<br />100.00%
<br />0.00
<br />31,774.83
<br />313.1
<br />Precast Concrete
<br />1,182,922.00
<br />1,182,922.00
<br />0.00
<br />0.00
<br />1,182,922.00
<br />100.00%
<br />0.00
<br />59,146.10
<br />313.2
<br />Precast Concrete
<br />930,000.00
<br />930,000.00
<br />0.00
<br />0.00
<br />930,000.00
<br />100.00%
<br />0.00
<br />46,500.00
<br />313.3
<br />Precast Raker/Plank/Stadia
<br />1,048,025.00
<br />1,048,025.00
<br />0.00
<br />0.00
<br />1,048,025.00
<br />100.00%
<br />0.00
<br />52,401.25
<br />01-00
<br />General Conditions/Requirements
<br />1,250,912.96
<br />1,228,266.20
<br />19,071.48
<br />0.00
<br />1,247,337.68
<br />99.71%
<br />3,575.28
<br />0.00
<br />90-50
<br />General Liability Insurance
<br />268,451.52
<br />268,451.52
<br />0.00
<br />0.00
<br />268,451.52
<br />100.00%
<br />0.00
<br />0.00
<br />90-60
<br />Construction Contingency
<br />70,229.02
<br />0.00
<br />0.00
<br />0.00
<br />0.00
<br />0.00%
<br />70,229.02
<br />0.00
<br />90-80
<br />Builders Risk Insurance
<br />65,184.58
<br />65,184.58
<br />0.00
<br />0.00
<br />65,184.58
<br />100.00%
<br />0.00
<br />0.00
<br />99-99
<br />Contractors Fee
<br />489,303.96
<br />484,410.92
<br />2,446.52
<br />0.00
<br />486,857.44
<br />99.50%
<br />2,446.52
<br />24,342.86
<br />Grand Totals
<br />26,501,607.40
<br />26,325,714.84
<br />78,736.26
<br />0.00
<br />26,404,451.10
<br />99.63%
<br />97,156.30
<br />1,241,173.96
<br />
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