5.5a ERMUSR 05-09-2023 - Laserfiche WebLink

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SUPPLEMENTAL PAYMENT REQUEST YAve. N C .I, MN y - 7635453557 COMPANIESWkPV1tteNCvvo1inp �m Owner: Bill To: Elk River Municipal Utilities RJM Construction 1705 Main Street 830 Boone Ave N Elk River, MN 55330 Golden Valley, MN 55427 Attn: Justin Rice DESCRIPTION OF WORK PERFORMED: Installation of dissipator and skimmers in required manholes. STMH 101A, 102A, and 120. Date: 2/13/2023 1 to 1 2/14/2023 1 Job# 2117 ISPIRNO: 023 Project Name: Elk River Municipal Utility Location/Stationing: Elk River, MN Plan Page: Soil Type: Present at Site: Work Requested B : RJM Construction Weather: Field Order No.: Temp: Team Leader: LABOR MATERIALS Labor Reg Hours Reg Rate OT Hours OT Rate Per Diem Rate Per Diem Total Material Inc. Tickets/Invoices Units UOM Unit Price Total Mark B 11.0 $ 111.00 $ - $ $ pLaborTotal $ $ Travis G 11.0 $ 92.00 $ - $ $ $ $ Brian B 11.0 $ 89.00 $ - $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Total $ $ 3,212.00 $ $ EQUIPMENT $ $ Equipment Model Reg Hours Reg Rate Stdby Hours Stdby Rate Total $ $ $ $ $ $ $ $ $ $ $ $ $ $ Total $ $ $ SUBCONTRACTORS AND OUTSIDE SERVICES $ $ 01 EA $ $ $ $ 0 EA $ $ $ $ 0 EA $ $ $ $ 0 EA $ $ $ $ 0 EA $ $ $ $ 0 EA $ $ $ $ 0 EA $ $ $ $ 0 EA $ $ $I $ 1 01 EA 1 $ $ Total $ Total $ OTHER SUMMARY Description Units UM Rate Total Sub -total Labor $ 3,212.00 0.0 HR $ $ Sub -total Subsistence $ 0.0 HR $ $ Sub -total Equipment $ 0.0 HR $ $ Sub -total Other $ 0.0 HR $ $ Sub -total Material $ 0.0 HR $ $ Sub -total Subs/Outside Services $ 0.0 HR $ $ Excise Tax 0.000% $ 0.0 HR $ $ *Sub/Outside Services Mark-up 0.0% $ - 0.0 HR $ $ Profit and Overhead - Combined 10.0 % $ 321.20 0.0 HR $ $ *Additional Bond Expense $ Total 1 $ ITOTAL AMOUNT DUE $ 3,533.20 Schedule extended days, due to this request. Authorized Signature: Signature FX PCO AP CB OB Print Name and Title Date: Internal Admin. Use Only SPR Control # 2117-023 118