7.d2 Bliss Lift Station Control Panels Pay Request No 2 and FinalQ& MLENK
Real People. Real Solutions.
June 10, 2020
Honorable Mayor and City Council
14727 2091h Street N
Scandia, MN 55073
RE: Bliss Lift Station Control Panels Pay Request No 2 and Final
Dear Mayor and Council:
2035 County Road D East
Maplewood, MN 55109-5314
Ph: (651) 704-9970
Fax: (651) 704-9971
Bolton-Menk.com
Enclosed please find Contractor's Request for Payment No. 2 and Final in the amount of $10,300 to
Innovo Automation for the services they provided on the above referenced project. The retainage has
been reduced to 0% as this is the last pay estimate for the project.
Also included are the contractor's and sub -contractor's IC -134's affidavits of tax withholding and the
corresponding lien waivers. Please call me at (612) 597-7140 if you have any questions or concerns
regarding this contractor's pay request.
Sincerely,
Ryan J. Goodman, P.E.
City Engineer
Enclosure: Contractor's Request for Payment No. 2 and Final, IC -134's, Lien Waivers
H:\SCND\N13118296\7-Construction\E-PayApplications\PayApp 2 (Final)\Mayor and City Council _RJG^Bliss Lift Station Control Panels Pay Request No 2 and Final.docx
Bolton & Menk is an equal opportunity employer.
ININ11014101
AUTOMATION
Innovo Automation
6845 20th Avenue S, Suite 140
Centerville, MN 55038-7761
BILL TO
INV DATE DUE DATE
5/8/2020 5/8/2020
City of Scandia
Adam Hawkinson
14727 209th Street North
Scandia, MN 55073
...................................................................................................................................................
YOUR PO/ORDER # REPRESENTATIVE
...................................................................:.......................................................... i ..................
CPK
SHIP TO
City of Scandia
Adam Hawkinson
14727 209th Street North
Scandia, MN 55073
Invoice
......................................
TERMS
Due on Receipt 11495
OTHER INFORMATION
20000
QTY r UOM r ITEM DESCRIPTION
....................5..........................................................................................................................................................................................
Project
Lift stations 1 & 2
Per quote created by Dustin Kemmis
Previous Invoice:
Completion of work performed by Innovo Automation as of
:3/11/20 (90%) - 11472 (PAID)
- Both lift stations are installed on new concrete pads and
excavation for new piping has been installed.
- Both lift stations have been powered and are currently
running the stations through the regular PLC programming
with relay back up.
- Lift stations are currently signaling alarms on the old
system (dialer at LS2, buzzer and beacon at LS1).
- Both sites have antennas mounted and wired as well as all
SCADA radio systems installed waiting for final
programming.
- LS1 has had old float system removed from well, new float
installed.
- Both lift stations have generator receptacles mounted and
wired in.
$92,700.00
UNIT PRICE EXTENSION
Thank you!
....................................................................................................................................................................... AMOUNT DUE
Please remit payment to Innovo Automation address above.
........................................................................................................................................................................:........................................................................................................:
www.innovoautomation.com BBB Member Since 2004 US DOLLARS `•.
:......................................................................................................................................................................................................................................... i.....
On late payments, the contract price shall, without prejudice to Seller's right to immediate payment, be increased by 1.5% per month on the unpaid balance, but
not to exceed the maximum permitted by law.
...................................................................................................................................................................................................................................................................................6
ININ11014101
AUTOMATION
Innovo Automation
6845 20th Avenue S, Suite 140
Centerville, MN 55038-7761
BILL TO
INV DATE DUE DATE
5/8/2020 5/8/2020
City of Scandia
Adam Hawkinson
14727 209th Street North
Scandia, MN 55073
...................................................................................................................................................
YOUR PO/ORDER # REPRESENTATIVE
...................................................................:.......................................................... i ..................
CPK
SHIP TO
City of Scandia
Adam Hawkinson
14727 209th Street North
Scandia, MN 55073
Invoice
......................................
TERMS
Due on Receipt 11495
OTHER INFORMATION
20000
QTY r UOM r ITEM DESCRIPTION
E...................5...................:..........................................E........................................................................................................................
1 Sales Current Invoice:
- SCADA programming for alarms and other
communications to master need to be downloaded, tested
and verified for information (3/11/20-3/13/20).
- Need to make program adjustments to master location
screen for new alarming on LS1 & LS2.
- Need to remove floats from LS2 well.
- Official hand over/start up and training to happen 3/16/20
along with operations manual and laminated final drawing
set placed in the enclosures.
Project Total:
$103,000.00
CITY OF SCANDIA
Signature of Agreement:
BOLTON & MENK, INC.
Signature of Agreement:
UNIT PRICE EXTENSION
10,300.00: 10,300.00
Thank you!
....................................................................................................................................................................... AMOUNT DUE $10.300.00:
Please remit payment to Innovo Automation address above.
E........................................................................................................................................................................d........................................................................................................5
www.innovoautomation.com BBB Member Since 2004 Tax ID No. 37-1800745 US DOLLARS `•.
..............................................................................................................................................................................................................................................................................i
On late payments, the contract price shall, without prejudice to Seller's right to immediate payment, be increased by 1.5% per month on the unpaid balance, but
not to exceed the maximum permitted by law.
....................................................................................................................................................................................................................................................................................
6/5/2020 https://www.mndor.state.mn.us/tp/eservices/_/Retrieve/0/c-/p6p8Sh9FX2g45XrRgeQHww_?FILE= Print2&PARAMS= 113870679596...
,Mlj DEPARTMENT
OF REVENUE
Contractor Affidavit Submitted
Thank you, your Contractor Affidavit has been approved.
Confirmation Summary
Confirmation Number:
1-666-350-624
Submitted Date and Time:
5 -Jun -2020 10:18:48 AM
Legal Name:
COMPLETE INGROUND SYSTEMS LLC
Federal Employer ID:
27-3714385
User Who Submitted:
1802965
Type of Request Submitted:
Contractor Affidavit
Affidavit Summary
Affidavit Number:
1432559616
Minnesota ID:
1802965
Project Owner:
CITY OF SCANDIA
Project Number:
1093
Project Begin Date:
20 -Nov -2019
Project End Date:
05 -Dec -2019
Project Location:
19189 LAYTON AVE. N MARINE ON THE ST CROIX MN
Project Amount:
$7,625.00
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)
withhold ing.tax@state.mn.us. Business hours are 8:00 a.m. - 4:30 p.m. Monday - Friday.
Please print this page for your records using the print or save functionality built into your browser.
https://www.mndor.state.mn. us/tp/eservices/_/Retrieve/0/c-/p6p8Sh9FX2g45XrRgeQHww_? FI LE_=Print2&PARAMS_=1138706795962652135 1 /1
M
� DEPARTMENT
OF REVENUE
RECEIPT AND WAIVER OF MECHANIC'S LIEN RIGHTS
Date: �Q 15j `LOZc
The undersigned hereby acknowledges receipt of the sum of S �� �Q J
I. ❑ as partial payment for labor, skill and material fumished
2, E2 as payment for all labor, /s�kill and material furnished or to be furnished (except the sum of
l(02 R • 0 I retainage or holdback)
t CuE Fuf, a6m+-Ovq(nC-
3. ❑ as full and final payment for all labor, skill and material fitmished or to be furnished
to the following described real property: (legal description, street address or project name)
and for value received hereby waives all rights acquired by the undersigned to file or record
mechanic's lien against said real property for labor, skill or material furnished to said real
property (only for the amount paid if Box I is checked, and except for retainage shown if Box 2
is checked). The undersigned affirms that all material furnished by the undersigned has been paid
for, and all subcontractors employed by the undersigned have been paid in full, EXCEPT:
INSTRUCTIONS:
Please complete and sign this lien salver on the line above. Once it has been fully signed, please return this
orteinal. slered II " wa'ver to us in the enclosed self-addressed stnm sed em elope. If you have any questions,
plenseeall nt (o SYa3�J-COO 'J�(O. Thankyou.
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