06.l 2024 Tennis Court Reconstruction Project - Contractor's Request for Payment No 5 Final
14727 209 th St. N., Scandia, Minnesota 55073
Phone (651) 433 -2274 Fax (651) 433 -5112 https://www.cityofscandia.com
November 18, 2025
Honorable Mayor and City Council
City of Scandia
14727 209th Street N.
Scandia, MN 55073-8503
Re: Contractor’s Request for Payment No. 5 & Final
2024 Tennis Court Reconstruction Project
Dear Mayor and Council:
Enclosed please find Contractor’s Request for Payment No. 5 & Final, for the 2024 Tennis Court
Reconstruction Project. We recommend the council approve the Contractor’s Request for
Payment No. 5 & Final and pay $4,704.36 to Veit & Company, Inc. This amount includes work
required to complete remaining punch list items and drop retainage from 1% to 0%.
Please call me at (651) 308-1491 if there are any questions or concerns regarding this
Contractor’s Payment request.
Sincerely,
Isiah Bubany, P.E.
Project Engineer
Enclosures: Contractor’s Request for Payment No. 5 & Final, Consent of Surety to Final Payment,
Warranty Bond, IC134s, and Lien Waivers.
Contractor's Application for Payment
Engineer:Bolton &Menk,Inc.
Owner's Project No.:_
Engineer's Project No.:QN1.13375%
Agency's Project No.:------------
Owner:City of Scandia
Contractor:Veit &Company,Inc.
Project:2024 Tennis Court Reconstruction Project
Contract:
Application No.:5 and Final
Application Period:From
Application pate:10/9/2025
7/6/2025 to 10/3/2025
1.Original Contract Price
2.Net change by Change Orders
3.Current Contract Price (Line 1 +Line 2)
4.Total Work completed and materials stored to date
(Sum of Column G Lump Sum Total and Column J Unit Price Total)
5.Retainage
a·K $405,987.40 Work Completed
b.X $Stored Materials
c.Total Retainage (Line 5.a +Line 5.b)
6.Amount eligible to date (Line 4-Line 5.c)
7.Less previous payments
8.Amount due this application
9.Balance to finish,including retainage (Line 3 -Line 4)
$
$
$
$
$
$
$
$
$
$
$
400,486.00
(1,545.00)
398,941.00
405,987.40
405,987.40
401,283.04
4,704.36
(7,046.40)
/
Contractor's Certification
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)AII 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.5.290.92 have been complied with and that all claims against me by reason of the Contract have been
paid or satisfactorily secured.
Contractor:Veit &Company,Inc.
Signature:
Name:
[
".'1 GriigkallyslgnodbyNatoStono
DN:C-US,Nate Stenegees@viseO.Vu,CR"NaSITfDate:2025.10.10d1.09.30-0s00
Date:
Title:
10/10/2025
Sr.PM
Recommended by Bolton &Menk,Inc.Approved by Scandia
By:
Name:
Title:
Date:
By:
Name:
Title:
Date:
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.:
5 and Final From 07/06/25 to 10/03/25
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 48,000.00 48,000.00 1.00 48,000.00 1.00 48,000.00 48,000.00 100% -
2 1.00 LUMP SUM 8,380.00 8,380.00 1.00 8,380.00 1.00 8,380.00 8,380.00 100% -
3 4.00 EACH 125.00 500.00 4.00 500.00 4.00 500.00 500.00 100% -
4 3.00 EACH 60.50 181.50 3.00 181.50 3.00 181.50 181.50 100% -
5 1,510.00 SQ YD 2.30 3,473.00 1,510.00 3,473.00 1,510.00 3,473.00 3,473.00 100% -
6 460.00 LIN FT 4.20 1,932.00 460.00 1,932.00 460.00 1,932.00 1,932.00 100% -
7 330.00 CU YD 9.10 3,003.00 330.00 3,003.00 330.00 3,003.00 3,003.00 100% -
8 1,270.00 CU YD 18.25 23,177.50 1,270.00 23,177.50 1,270.00 23,177.50 23,177.50 100% -
9 90.00 CU YD 60.00 5,400.00 90.00 5,400.00 90.00 5,400.00 5,400.00 100% -
10 950.00 CU YD 20.75 19,712.50 950.00 19,712.50 950.00 19,712.50 19,712.50 100% -
11 520.00 TON 25.00 13,000.00 520.00 13,000.00 520.00 13,000.00 13,000.00 100% -
12 430.00 LIN FT 31.75 13,652.50 430.00 13,652.50 430.00 13,652.50 13,652.50 100% -
13 6.00 EACH 643.00 3,858.00 6.00 3,858.00 6.00 3,858.00 3,858.00 100% -
14 230.00 SQ FT 18.50 4,255.00 242.00 4,477.00 242.00 4,477.00 4,477.00 105% (222.00)
15 16.00 LIN FT 107.00 1,712.00 16.00 1,712.00 16.00 1,712.00 1,712.00 100% -
16 1.00 EACH 3,280.00 3,280.00 1.00 3,280.00 1.00 3,280.00 3,280.00 100% -
17 1.00 EACH 9,230.00 9,230.00 1.00 9,230.00 1.00 9,230.00 9,230.00 100% -
18 2.00 EACH 245.00 490.00 2.00 490.00 2.00 490.00 490.00 100% -
19 1.00 EACH 1,490.00 1,490.00 1.00 1,490.00 1.00 1,490.00 1,490.00 100% -
20 220.00 LIN FT 7.40 1,628.00 220.00 1,628.00 220.00 1,628.00 1,628.00 100% -
21 2.00 EACH 225.00 450.00 - - - - - 450.00
22 710.00 SQ YD 3.00 2,130.00 2,120.00 6,360.00 2,312.00 6,936.00 6,936.00 326% (4,806.00)
23 170.00 SQ YD 3.00 510.00 146.00 438.00 171.00 513.00 513.00 101% (3.00)
24 5.00 CU YD 88.00 440.00 5.00 440.00 5.00 440.00 440.00 100% -
25 1.00 LUMP SUM 1,840.00 1,840.00 1.00 1,840.00 1.00 1,840.00 1,840.00 100% -
26 1.00 LUMP SUM 2,800.00 2,800.00 1.00 2,800.00 1.00 2,800.00 2,800.00 100% -
27 260.00 TON 157.00 40,820.00 260.00 40,820.00 260.00 40,820.00 40,820.00 100% -
28 100.00 GAL 5.60 560.00 100.00 560.00 100.00 560.00 560.00 100% -
29 150.00 LIN FT 6.30 945.00 300.00 1,890.00 300.00 1,890.00 1,890.00 200% (945.00)
30 1,410.00 SQ YD 12.25 17,272.50 1,598.00 19,575.50 1,598.00 19,575.50 19,575.50 113% (2,303.00)
31 450.00 LIN FT 37.50 16,875.00 450.00 16,875.00 450.00 16,875.00 16,875.00 100% -
32 140.00 LIN FT 76.50 10,710.00 140.00 10,710.00 140.00 10,710.00 10,710.00 100% -
33 450.00 LIN FT 72.00 32,400.00 450.00 32,400.00 450.00 32,400.00 32,400.00 100% -
34 3.00 EACH 2,990.00 8,970.00 3.00 8,970.00 3.00 8,970.00 8,970.00 100% -
303,077.50 310,255.50 310,906.50 310,906.50 103% (7,829.00)
35 1.00 LUMP SUM 671.00 671.00 1.00 671.00 1.00 671.00 671.00 100% -
36 550.00 CU YD 12.25 6,737.50 550.00 6,737.50 550.00 6,737.50 6,737.50 100% -
37 530.00 CU YD 20.50 10,865.00 498.00 10,209.00 498.00 10,209.00 10,209.00 94% 656.00
38 290.00 TON 25.00 7,250.00 265.50 6,637.50 265.50 6,637.50 6,637.50 92% 612.50
39 190.00 LIN FT 30.75 5,842.50 190.00 5,842.50 190.00 5,842.50 5,842.50 100% -
40 2.00 EACH 643.00 1,286.00 2.00 1,286.00 2.00 1,286.00 1,286.00 100% -
41 80.00 LIN FT 6.80 544.00 80.00 544.00 80.00 544.00 544.00 100% -
42 60.00 SQ YD 3.00 180.00 42.00 126.00 42.00 126.00 126.00 70% 54.00
43 1.00 LUMP SUM 1,400.00 1,400.00 1.00 1,400.00 1.00 1,400.00 1,400.00 100% -
44 150.00 TON 138.00 20,700.00 150.00 20,700.00 150.00 20,700.00 20,700.00 100% -
45 60.00 GAL 5.60 336.00 55.00 308.00 55.00 308.00 308.00 92% 28.00
46 180.00 LIN FT 6.30 1,134.00 223.00 1,404.90 223.00 1,404.90 1,404.90 124% (270.90)
Contract Information
Bid Item
No.
REMOVE NET POST
REMOVE CONCRETE PAD
SELECT GRANULAR BORROW (MODIFIED)
AGGREGATE BASE, CLASS 5
6" PERF PVC PIPE DRAIN
6" PVC CLEANOUT
6" CONCRETE WALK
REMOVE BITUMINOUS PAVEMENT
REMOVE FENCE
COMMON EXCAVATION - SUITABLE MATERIAL (EV) (P)
Application Date:Application Period:Application No.:
MOBILIZATION
GRUBBING
COMMON EXCAVATION - UNSUITABLE MATERIAL (EV) (P)
FILTER MEDIA
Previous Estimate
10/09/25
B
BASE BID
% of
Value of
Item
(J / F)
(%)
Balance to Finish
(F - J)
($)Description
Work Completed
Materials Currently
Stored (not in G)
($)
Work
Completed
and Materials
Stored to Date
(H + I)
($)
Progress Estimate - Unit Price Work
City of Scandia
Bolton & Menk, Inc.
Veit & Company, Inc.
2024 Tennis Court Reconstruction Project
Owner:
0N1.133754Engineer:
Contractor:
Project:
Contract:
SILT FENCE, TYPE MACHINE SLICED
STORM DRAIN INLET PROTECTION
TURF RESTORATION, SEED MIXTURE (25-131), AND BLANKET
TURF RESTORATION, SEED MIXTURE (35-241), AND BLANKET
RANDOM RIP RAP CLASS III
12" RC PIPE, CLASS 5
12" RC PIPE APRON
48" DIA OCS
STRUCTURE MARKER
STABILIZED CONSTRUCTION EXIT
ACRYLIC SURFACING PICKLEBALL/TENNIS COURT
CONCRETE MAINTENANCE STRIP
6' HT. GALVANIZED CHAIN LINK FENCE
10' HT. GALVANIZED CHAIN LINK FENCE
NET, POSTS AND ANCHORS
ALTERNATE 1
TOTAL BASE BID:
SALVAGE AND RESPREAD EXISTING TOPSOIL
TRAFFIC CONTROL
PICKLEBALL COURT PAVEMENT (2,C)
BITUMINOUS MATERIAL FOR TACK COAT
SAW CUT & SEAL JOINT
6" PVC CLEANOUT
SILT FENCE, TYPE MACHINE SLICED
TURF RESTORATION, SEED MIXTURE (25-131), AND BLANKET
SALVAGE AND RESPREAD EXISTING TOPSOIL
TENNIS COURT PAVEMENT (2,C)
GRUBBING
COMMON EXCAVATION - UNSUITABLE MATERIAL (EV) (P)
SELECT GRANULAR BORROW (MODIFIED)
AGGREGATE BASE, CLASS 5
6" PERF PVC PIPE DRAIN
BITUMINOUS MATERIAL FOR TACK COAT
SAW CUT & SEAL JOINT
Unit Price
EJCDC C-620 Contractor's Application for Payment
(c) 2018 National Society of Professional Engineers for EJCDC. All rights reserved.1 of 2
Contractor's Application for Payment
Owner's Project No.:
Engineer's Project No.:
Agency's Project No.:
5 and Final From 07/06/25 to 10/03/25
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)
($)
Contract Information
Bid Item
No.
Application Date:Application Period:Application No.:
Previous Estimate
10/09/25
B
% of
Value of
Item
(J / F)
(%)
Balance to Finish
(F - J)
($)Description
Work Completed
Materials Currently
Stored (not in G)
($)
Work
Completed
and Materials
Stored to Date
(H + I)
($)
Progress Estimate - Unit Price Work
City of Scandia
Bolton & Menk, Inc.
Veit & Company, Inc.
2024 Tennis Court Reconstruction Project
Owner:
0N1.133754Engineer:
Contractor:
Project:
Contract:
47 790.00 SQ YD 12.25 9,677.50 790.00 9,677.50 790.00 9,677.50 9,677.50 100% -
48 130.00 LIN FT 37.50 4,875.00 130.00 4,875.00 130.00 4,875.00 4,875.00 100% -
49 60.00 LIN FT 76.50 4,590.00 60.00 4,590.00 60.00 4,590.00 4,590.00 100% -
50 130.00 LIN FT 72.00 9,360.00 130.00 9,360.00 130.00 9,360.00 9,360.00 100% -
51 4.00 EACH 2,990.00 11,960.00 4.00 11,960.00 4.00 11,960.00 11,960.00 100% -
97,408.50 96,328.90 96,328.90 96,328.90 99% 1,079.60
400,486.00$ 406,584.40$ 407,235.40$ -$ 407,235.40$ 102% (6,749.40)$
52 (50.00) LIN FT 6.30 (315.00) (50.00) (315.00) (50.00) (315.00) (315.00) 100% -
53 50.00 LIN FT 76.50 3,825.00 50.00 3,825.00 50.00 3,825.00 3,825.00 100% -
54 (3.00) EACH 2,990.00 (8,970.00) (3.00) (8,970.00) (3.00) (8,970.00) (8,970.00) 100% -
- - - -
(5,460.00)$ (5,460.00)$ (5,460.00)$ -$ (5,460.00)$ 100% -$
55 (435.00) CY 18.25 (7,938.75) (468.00) (8,541.00) (468.00) (8,541.00) (8,541.00) 108% 602.25
56 435.00 CY 27.25 11,853.75 468.00 12,753.00 468.00 12,753.00 12,753.00 108% (899.25)
-
3,915.00$ 4,212.00$ 4,212.00$ -$ 4,212.00$ 108% (297.00)$
398,941.00$ 405,336.40$ 405,987.40$ -$ 405,987.40$ 102% (7,046.40)$ PROJECT TOTAL:
CHANGE ORDER NO. 1 TOTAL:
BASE BID + ALTERNATE + CHANGE ORDERS NO. 1 & 2
CHANGE ORDER NO. 1
SAW CUT & SEAL JOINT
6' HT. GALVANIZED CHAIN LINK FENCE
NET, POSTS AND ANCHORS
CHANGE ORDER NO. 2
COMMON EXCAVATION - UNSUITABLE MATERIAL (EV) (P)
EXCAVATE BITUMINOUS PAVEMENT (EV)
CHANGE ORDER NO. 2 TOTAL:
BASE BID + ALTERNATE 1 TOTAL:
10' HT. GALVANIZED CHAIN LINK FENCE
NET, POSTS AND ANCHORS
TOTAL ALTERNATE 1:
ACRYLIC SURFACING TENNIS COURT
CONCRETE MAINTENANCE STRIP
6' HT. GALVANIZED CHAIN LINK FENCE
Unit Price
EJCDC C-620 Contractor's Application for Payment
(c) 2018 National Society of Professional Engineers for EJCDC. All rights reserved.2 of 2
Contractor Affidavit Submitted
Thank you, your Contractor Affidavit has been approved.
Confirmation Summary
Confirmation Number:1-137-176-032
Submitted Date and Time:30-Oct-2025 2:05:00 PM
Legal Name:ACTION FENCE INC
Federal Employer ID:20-8284334
User Who Submitted:actionfence
Type of Request Submitted:Contractor Affidavit
Affidavit Summary
Affidavit Number:1966026752
Minnesota ID:8771387
Project Owner:CITY OF SCANDIA
Project Number:ON1.111754
Project Begin Date:15-Oct-2024
Project End Date:20-May-2025
Project Location:SCANDIA TENNIS & PICKLEBALL
Project Amount:$69,775.00
Subcontractors:No Subcontractors
Important Messages
A copy of this page must be provided to the contractor or government agency that hired you.
Contact Us
If you need further assistance, contact our Withholding Tax Division at 651-282-9999, (toll-free) 800-657-3594, or (email)
withholding.tax@state.mn.us. Business hours are Monday through Friday 8:00 a.m. to 4:30 p.m. Central Time.
Please print this page for your records using the print or save functionality built into your browser.
30/10/2025, 14:05 mndor.state.mn.us/tp/eservices/_/Retrieve/0/Dc/2L6XStD6vN3UmyaZNGTdtg__?FILE__=Print2&PARAMS__=408560425333480…
https://www.mndor.state.mn.us/tp/eservices/_/Retrieve/0/Dc/2L6XStD6vN3UmyaZNGTdtg__?FILE__=Print2&PARAMS__=4085604253334806224 1/1
Contractor Affidavit Submitted
Thank you, your Contractor Affidavit has been approved.
Confirmation Summary
Confirmation Number:0-835-751-392
Submitted Date and Time:17-Oct-2025 11:21:44 AM
Legal Name:CURB MASTERS INC
Federal Employer ID:41-1606037
User Who Submitted:Linda H
Type of Request Submitted:Contractor Affidavit
Affidavit Summary
Affidavit Number:336539648
Minnesota ID:2207114
Project Owner:CITY OF SCANDIA
Project Number:ON1.111754
Project Begin Date:09-Sep-2024
Project End Date:23-May-2025
Project Location:2024 TENNIS COURT RECONSTRUCTION
Project Amount:$21,768.25
Subcontractors:No Subcontractors
Important Messages
A copy of this page must be provided to the contractor or government agency that hired you.
Contact Us
If you need further assistance, contact our Withholding Tax Division at 651-282-9999, (toll-free) 800-657-3594, or (email)
withholding.tax@state.mn.us. Business hours are Monday through Friday 8:00 a.m. to 4:30 p.m. Central Time.
Please print this page for your records using the print or save functionality built into your browser.
1
Paula Peters
From:Jake Klute <klutejake@gmail.com>
Sent:Friday, October 24, 2025 11:27 AM
To:Paula Peters
Subject:[EXTERNAL] Fwd: Your Recent Contractor Affidavit Request
IC134
---------- Forwarded message ---------
From: MN Revenue e-Services <eservices.mdor@state.mn.us>
Date: Fri, Oct 24, 2025 at 11:24 AM
Subject: Your Recent Contractor Affidavit Request
To: <klutejake@gmail.com>
This email is an automated notification and is unable to receive replies.
Contractor Affidavit Submitted
Thank you, your Contractor Affidavit has been approved.
Confirmation Summary
Confirmation Number: 1-691-528-672
Submitted Date and Time: 24-Oct-2025 11:24:49 AM
Legal Name: JKLUTE LLC
Federal Employer ID: 33-3239802
User Who Submitted: CSRKLUTE
Type of Request Submitted: Contractor Affidavit
Affidavit Summary
Affidavit Number: 134262784
Minnesota ID: 1016548
Project Owner: CITY OF SCANDIA
Project Number: 240290
Project Begin Date: 07-May-2025
Project End Date: 17-May-2025
Project Location: SCANDIA
Project Amount: $25,512.00
Subcontractors: No Subcontractors
Important Messages
A copy of this page must be provided to the contractor or government agency that hired you.
Contact Us
Veit & Company, Inc.
Release and Waiver of Lien Rights For Final and Complete Payment
Project:
Subcontractor:
240290. . 2024 Tennis Court Reconstruction Project
20880 Olinda Trail N
Scandia, MN 55073
Action Fence Inc
1851 Radisson Road NE
Blaine, MN 55449
The Undersigned, hereby acknowledges receipt of payment in full from Veit & Company , Inc. for all work ,
equipment, and material furnished to the above Project and therefore waives and releases all rights to
make any claim on any labor and material bond covering the Project , and waives and releases all
mechanic's liens, stop notice , and equitable lien rights which the undersigned may have on the Project.
This waiver and release is for the benefit of, and may be relied upon by , all persons holding any property
interest in the Project , the construction lender, any construction fund holder, the prime contractor, and the
principal and sureties on any labor and material bond.
The undersigned does hereby represent and warrant that the undersigned has fully paid for all labor and
materials, any and all welfare , pension, vacation or other contributions required to be made on account of
employment of such laborers or mechanics so provided by the undersigned and does hereby agree to
indemnify and hold each of the foregoing , the Project , work of improvement and real property free and
harmless from any and all claims or liens .
Our work is complete on the Project at this time and there will be no further billing to the above named
subcontractor and/or Veit & Company , Inc .
100 Veit & Company , Inc .
Date Format -MM/0O/YY
By signing below I represent and warrant that I am a duly authorized
representative of the company and have the legal capacity to execute
and deliver this Waiver of Lien and Release
Firm :
By :
Date:
/ Printed Name and Tltle
0 /r~OdS-
Page 1
_p
10/16/25 04 :44 :44 PM
Viewpoint Remote .rpt
Release and Waiver of Lien Rights For Final and Complete Payment
Veit & Company, Inc.
240290. . 2024 Tennis Court Reconstruction Project
The Undersigned, hereby acknowledges receipt of payment in full from Veit & Company, Inc. for all work,
equipment, and material furnished to the above Project and therefore waives and releases all rights to
make any claim on any labor and material bond covering the Project, and waives and releases all
mechanic's liens, stop notice, and equitable lien rights which the undersigned may have on the Project.
Court Surfaces & Repair
16215 Yalta St NE
Ham Lake, MN 55304
20880 Olinda Trail N
Scandia, MN 55073
This waiver and release is for the benefit of, and may be relied upon by, all persons holding any property
interest in the Project, the construction lender, any construction fund holder, the prime contractor, and the
principal and sureties on any labor and material bond.
The undersigned does hereby represent and warrant that the undersigned has fully paid for all labor and
materials, any and all welfare, pension, vacation or other contributions required to be made on account of
employment of such laborers or mechanics so provided by the undersigned and does hereby agree to
indemnify and hold each of the foregoing, the Project, work of improvement and real property free and
harmless from any and all claims or liens.
Our work is complete on the Project at this time and there will be no further billing to the above named
subcontractor and/or Veit & Company, Inc.
Project:
Subcontractor:
By signing below I represent and warrant that I am a duly authorized
representative of the company and have the legal capacity to execute
and deliver this Waiver of Lien and Release
Firm:
By:
Printed Name and Title
Date:
Court Surfaces & Repair
Page 1 10/16/25 04:47:39 PM
Date Format - MM/DD/YY Viewpoint Remote .rpt
100 Veit & Company, Inc.