09.d2 2023 Street Improvement Project - Contractor's Request for Payment No 3 Final
14727 209 th St. N., Scandia, Minnesota 55073
Phone (651) 433 -2274 Fax (651) 433 -5112 http://www.ci tyofscandia.com
December 19, 2023
Honorable Mayor and City Council
City of Scandia
14727 209th Street N.
Scandia, MN 55073-8503
Re: Contractor’s Request for Payment No. 3 & Final
2023 Street Improvement Project
Dear Mayor and Council:
Enclosed please find Contractor’s Request for Payment No. 3 & Final, for the 2023 Street
Improvement Project. We recommend the council approve the Contractor’s Request for Payment
No. 3 & Final and pay $26,064.69 to Asphalt Surface Technologies Corporation. This amount
includes the work required to complete punchlist items and includes withholding 0% retainage.
Please call me at (612) 597-7140 if there are any questions or concerns regarding this
Contractor’s Payment request.
Sincerely,
Ryan J. Goodman, P.E.
City Engineer
Enclosures: Contractor’s Request for Payment No. 3 & Final, IC134s and Lien Waivers
From
1.
2.
3.
4.
5.
a.X
b.X
c.
6.
7.
8.
9.
Signature:Signature:
Name:Name:
Date:
Title:Title:
Approved by City of ScandiaRecommended by Bolton & Menk, Inc.
Date:
Amount due this application
Contractor:
Balance to finish, including retainage (Line 3 - Line 4)1,805.35$
The undersigned Contractor certifies, to the best of its knowledge, the following:
(1) All previous progress payments received from Owner on account of Work done under the Contract have been applied on
account to discharge Contractor's legitimate obligations incurred in connection with the Work covered by prior Applications for
Payment;
(2) Title to all Work, materials and equipment incorporated in said Work, or otherwise listed in or covered by this Application for
Payment, will pass to Owner at time of payment free and clear of all liens, security interests, and encumbrances (except such as
are covered by a bond acceptable to Owner indemnifying Owner against any such liens, security interest, or encumbrances); and
(3) All the Work covered by this Application for Payment is in accordance with the Contract Documents and is not defective; and
(4) The provisions of M. S. 290.92 have been complied with and that all claims against me by reason of the Contract have been
paid or satisfactorily secured.
Name:
Signature:
Asphalt Surface Technologies Corporation a/k/a ASTECH Corp.
Contractor's Certification
Date:
Title:
Less previous payments
$ 669,939.33
$ -
Work Completed
Stored Materials
Total Retainage (Line 5.a + Line 5.b)
Amount eligible to date (Line 4 - Line 5.c)
Contractor:
Engineer:
Project:
0N1.128237
Contractor's Application for Payment
Application No.:3 & Final
City of Scandia
Asphalt Surface Technologies Corporation a/k/a ASTECH Corp.
Bolton & Menk, Inc.
2023 Street Improvement Project
Owner's Project No.:
Engineer's Project No.:
Agency's Project No.:
Application Period:
Contract:
Owner:
11/30/2023
Application Date:11/30/2023
671,744.68$
-$ Net change by Change Orders
7/1/2023 to
Original Contract Price
671,744.68$
Retainage
Current Contract Price (Line 1 + Line 2)
Total Work completed and materials stored to date
(Sum of Column G Lump Sum Total and Column J Unit Price Total) 669,939.33$
-$
-$
26,064.69$
643,874.64$
-$
669,939.33$
EJCDC C-620 Contractor's Application for Payment
(c) 2018 National Society of Professional Engineers for EJCDC. All rights reserved.
Contractor's Application for Payment
Owner's Project No.:
Engineer's Project No.:
Agency's Project No.:
3 & Final From 07/01/23 to 11/30/23
A C D E F F1 F2 G H I J K L
Item Quantity Units
Unit Price
($)
Value of Bid Item
(C X E)
($)
Quantity Previous
Estimate
Value Previous
Estimate
Estimated
Quantity
Incorporated in
the Work
Value of Work
Completed to Date
(E X G)
($)
1 1.00 LUMP SUM 30,000.00 30,000.00 1.00 30,000.00 1.00 30,000.00 30,000.00 100% -
2 1.00 LUMP SUM 1,815.00 1,815.00 1.00 1,815.00 1.00 1,815.00 1,815.00 100% -
3 1.00 LUMP SUM 3,300.00 3,300.00 1.00 3,300.00 1.00 3,300.00 3,300.00 100% -
4 5.00 EACH 220.00 1,100.00 - - - - - 1,100.00
5 1.00 EACH 1,100.00 1,100.00 2.00 2,200.00 2.00 2,200.00 2,200.00 200% (1,100.00)
6 3.00 EACH 1,347.50 4,042.50 3.00 4,042.50 3.00 4,042.50 4,042.50 100% -
7 268.00 LIN FT 15.95 4,274.60 220.00 3,509.00 220.00 3,509.00 3,509.00 82% 765.60
8 2.00 EACH 962.50 1,925.00 4.00 3,850.00 4.00 3,850.00 3,850.00 200% (1,925.00)
9 698.00 LIN FT 3.00 2,094.00 645.00 1,935.00 645.00 1,935.00 1,935.00 92% 159.00
10 180.00 SQ YD 7.81 1,405.80 240.78 1,880.47 240.78 1,880.47 1,880.47 134% (474.67)
11 20,540.00 SQ YD 0.90 18,486.00 21,431.00 19,287.90 21,431.00 19,287.90 19,287.90 104% (801.90)
12 470.00 LIN FT 26.40 12,408.00 470.00 12,408.00 470.00 12,408.00 12,408.00 100% -
13 140.00 LIN FT 31.90 4,466.00 140.00 4,466.00 140.00 4,466.00 4,466.00 100% -
14 350.00 CU YD 22.00 7,700.00 425.00 9,350.00 425.00 9,350.00 9,350.00 121% (1,650.00)
15 1,030.00 SQ YD 2.53 2,605.90 1,148.00 2,904.44 1,148.00 2,904.44 2,904.44 111% (298.54)
16 1,940.00 CU YD 20.90 40,546.00 1,027.00 21,464.30 1,027.00 21,464.30 21,464.30 53% 19,081.70
17 20,540.00 SQ YD 1.00 20,540.00 20,540.00 20,540.00 20,540.00 20,540.00 20,540.00 100% -
18 770.00 TON 19.80 15,246.00 261.25 5,172.75 261.25 5,172.75 5,172.75 34% 10,073.25
19 40.00 TON 44.00 1,760.00 40.00 1,760.00 40.00 1,760.00 1,760.00 100% -
20 20.00 TON 44.00 880.00 12.60 554.40 22.19 976.36 976.36 111% (96.36)
21 10.00 TON 44.00 440.00 - - - - - 440.00
22 1,860.00 TON 88.66 164,907.60 1,919.87 170,215.67 1,983.25 175,834.75 175,834.75 107% (10,927.15)
23 3,100.00 TON 85.52 265,112.00 3,163.17 270,514.30 3,163.17 270,514.30 270,514.30 102% (5,402.30)
24 1,440.00 GALLON 3.20 4,608.00 1,625.00 5,200.00 1,625.00 5,200.00 5,200.00 113% (592.00)
25 180.00 SQ YD 55.00 9,900.00 226.50 12,457.50 226.50 12,457.50 12,457.50 126% (2,557.50)
26 28.00 LIN FT 77.16 2,160.48 58.00 4,475.28 58.00 4,475.28 4,475.28 207% (2,314.80)
27 2.00 EACH 504.90 1,009.80 4.00 2,019.60 4.00 2,019.60 2,019.60 200% (1,009.80)
28 130.00 LIN FT 87.12 11,325.60 152.00 13,242.24 152.00 13,242.24 13,242.24 117% (1,916.64)
29 10.00 EACH 469.20 4,692.00 12.00 5,630.40 12.00 5,630.40 5,630.40 120% (938.40)
30 24.00 LIN FT 97.06 2,329.44 26.00 2,523.56 26.00 2,523.56 2,523.56 108% (194.12)
31 2.00 EACH 678.50 1,357.00 2.00 1,357.00 2.00 1,357.00 1,357.00 100% -
32 6.00 LIN FT 266.56 1,599.36 6.00 1,599.36 6.00 1,599.36 1,599.36 100% -
33 8.00 LIN FT 274.40 2,195.20 16.00 4,390.40 16.00 4,390.40 4,390.40 200% (2,195.20)
34 2,620.00 LIN FT 2.42 6,340.40 1,591.00 3,850.22 1,591.00 3,850.22 3,850.22 61% 2,490.18
35 51.00 EACH 132.00 6,732.00 51.00 6,732.00 51.00 6,732.00 6,732.00 100% -
36 80.00 CU YD 55.00 4,400.00 40.00 2,200.00 42.00 2,310.00 2,310.00 53% 2,090.00
37 480.00 SQ YD 8.80 4,224.00 480.00 4,224.00 480.00 4,224.00 4,224.00 100% -
38 260.00 SQ YD 10.45 2,717.00 260.00 2,717.00 260.00 2,717.00 2,717.00 100% -
671,744.68$ 663,788.30$ 669,939.33$ -$ 669,939.33$ 100% 1,805.35$
Contract Information
Bid Item
No.
CLEARING AND GRUBBING
SALVAGE AND REINSTALL MAILBOX
REMOVE BITUMINOUS PAVEMENT - DRIVEWAY
RECLAIM BITUMINOUS PAVEMENT (8" THICK)
SALVAGE AND REINSTALL LANDSCAPING
SALVAGE AND REINSTALL CONCRETE APRON
REMOVE STORM PIPE/CULVERT
Application Date:Application Period:Application No.:
MOBILIZATION
11/30/23
B
BASE BID
% of
Value of
Item
(J / F)
(%)
Balance to Finish
(F - J)
($)
Work Completed
Materials Currently
Stored (not in G)
($)
TOTAL BASE BID
CLEAN PIPE CULVERT
SEDIMENT REMOVAL
SUBGRADE EXCAVATION
TRAFFIC CONTROL
Description
TYPE SP 9.5 WEARING COURSE MIXTURE (3,C) - DRIVEWAY
12" CMP, CULVERT (DRIVEWAY)
12" CMP, APRON (DRIVEWAY)
15" CMP, CULVERT (DRIVEWAY)
15" CMP, APRON (DRIVEWAY)
REMOVE TRASH GUARD
SAWING BITUMINOUS PAVEMENT - FULL DEPTH
AGGREGATE SURFACING, 1/2" MINUS TRAP ROCK -
AGGREGATE SURFACING, CLASS 5
TYPE SP 9.5 UPPER WEARING COURSE MIXTURE (3,C)
TYPE SP 12.5 LOWER WEARING COURSE MIXTURE (3,C)
BITUMINOUS MATERIAL FOR TACK COAT
GEOTEXTILE FABRIC, TYPE V NON-WOVEN
HAUL AWAY EXCESS MATERIAL TO CITY GRAVEL STREETS
TOLERANCE RECLAIM
Work
Completed
and Materials
Stored to Date
(H + I)
($)
Progress Estimate - Unit Price Work
City of Scandia
Bolton & Menk, Inc.
Asphalt Surface Technologies Corporation a/k/a ASTECH Corp.
2023 Street Improvement Project
Owner:
0N1.128237Engineer:
Contractor:
Project:
Contract:
Previous Estimate
AGGREGATE SHOULDERING
AGGREGATE SURFACING, 3/4" MINUS LIMESTONE -
CULVERT END PROTECTION
TOPSOIL BORROW
TURF RESTORATION, SEED MIXTURE 25-151 AND BLANKET
TURF RESTORATION, SEED MIXTURE 35-241 AND BLANKET
18" CMP, CULVERT (DRIVEWAY)
18" CMP, APRON (DRIVEWAY)
15" RC PIPE (CLASS 5)
18" RC PIPE (CLASS 5)
SILT FENCE - MACHINE SLICED
Unit Price
EJCDC C-620 Contractor's Application for Payment
(c) 2018 National Society of Professional Engineers for EJCDC. All rights reserved.1 of 1