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5.o) Contractors Request for Payment No 3 Final_Quinnell AveBOLTONMF=NK, INC© Consulting Engineers & Surveyors 2035 County Road D East • Suite B • Maplewood, MN 55109-5314 Phone (651) 704-9970 • Fax (651) 704-9971 www.bolton-menk.com October 27, 2015 Honorable Mayor and City Council 14727 209th Street N Scandia, MN 55073 RE: Contractor's Request for Payment No. 3 & Final Quinnell Ave North Improvements Project No.: N15.109775 Dear Mayor and Council: Enclosed please find Contractor's Request for Payment No. 3 & Final for Dresel Contracting, Inc. for the services they provided on the above referenced project. All work has been completed as required by the Contract. IC-134's and Lien Waivers have been enclosed for final closeout. The Contractor's Request for Payment is for the amount of $27,469.29. At this time we recommend the Council make a payment in the amount of $27,469.29 to Dresel Contracting, Inc. for the work performed. The request includes payment of their retainage. Please call me at 612-597-7140 if you have any questions or concerns regarding this Contractor's payment request. Sincerely, Ryan J. Goodman, P.E. City Engineer Enclosure: Contractor's Request for Payment No. 3 & Final, IC- 134's, and Lien Waivers DESIGNING FOR A BETTER TOMORROW Bolton & Menk is an equal opportunity employer Date: 27-Oct-15 PUBLICLY BID CONTRACTOR'S PAY REQUEST Quinnell Avenue North and Lilleskogen Park Improvements Pay Request No. 3 & Final City Project No. N15.109775 City of Scandia, N1N For Period Ending: 27-Oct-15 Original Contract Amount $649,962.46 Approved Change Orders - Addition ($116,371.05) Approved Change Orders - Deduction $0.00 Revised Contract Amount $533,591.41 Completed Work to Date $492,548.14 Stored Materials on Hand $0.00 Sub -Total $492, 548.14 Retained Percentage 0% $0.00 Liquidated Damages $0.00 Total 1 $492,548.14 Total Amount Paid on Previous Estimates $465,078.85 Amount Due Contractor This Pay Request $27,469.29 Approved for Payment: Dresel Contracting, Inc. Signature Date 24044 July Avenue Chisago City, MN 55013 Printed Name and Title Checked and Approved as to Quantities and Amount: Signature Date Bolton & Menk, Inc. 2035 County Road D East, Suite B Maplewood, MN 55109 Printed Name and Title Approved for Payment: City of Scandia Name Title Date Partial Pay Estimate No.: 3 & Final QUINNELL AVENUE NORTH AND LILLESKOGEN PARK IMPROVEMENTS CITY OF SCANDIA, MN BMI PROJECT NO. N15.109775 WORK COMPLETED THROUGH OCTOBER 27, 2015 ITEM NO. ITEM UNIT PRICE AS BID PREVIOUS ESTIMATE COMPLETED TO DATE ESTIMATED QUANTITY ESTIMATED AMOUNT ESTIMATED QUANTITY ESTIMATED AMOUNT ESTIMATED QUANTITY ESTIMATED AMOUNT BASE BID PART 1- STREET IMPROVEMENTS 1 MOBILIZATION $28,440.00 1.00 LS $28,440.00 1 LS $28,440.00 1 LS $28,440.00 2 TRAFFIC CONTROL $5,940.00 1.00 LS $5,940.00 1 LS $5,940.00 1 LS $5,940.00 3 COMMON EXCAVATION EV - DITCHING $18.19 1310.00 CY $23,828.90 1311 CY $23,847.09 1311 CY $23,847.09 4 SAWING BITUMINOUS PAVEMENT -FULL DEPTH $2.37 210.00 LF $497.70 473 LF $1,121.01 473 LF $1,121.01 5 BITUMINOUS PAVEMENT RECLAMATION P $0.54 16700.00 SY $9,018.00 0 SY $0.00 0 SY $0.00 6 REMOVE SIGN $17.71 21.00 EA $371.91 0 EA $0.00 0 EA $0.00 7 REMOVE FENCE $2.43 230.00 LF $558.90 60 LF $145.80 60 LF $145.80 8 TEMPORARY MAILBOX $46.32 25.00 EA $1,158.00 0 EA $0.00 0 EA $0.00 9 SALVAGE AND REINSTALL MAILBOX $74.40 25.00 EA $1,860.00 0 EA $0.00 0 EA $0.00 10 REMOVE BITUMINOUS PAVEMENT $2.27 600.00 SY $1,362.00 1277 SY $2,898.79 1277 SY $2,898.79 11 SUBGRADE PREPARATION $0.61 18310.00 SY $11,169.10 977 SY $595.97 977 SY $595.97 12 SUBGRADE EXCAVATION $16.17 1800.00 CY $29,106.00 982 CY $15,878.94 1167 CY $18,870.39 13 AGGREGATE BASE, CLASS 5 $13.31 1100.00 TN $14,641.00 1829 TN $24,343.99 1829 TN $24,343.99 14 AGGREGATE SHOULDERING $22.00 700.00 TN $15,400.00 0 TN $0.00 0 TN $0.00 15 BITUMINOUS MATERIAL FOR TACK COAT $3.30 1250.00 GAL $4,125.00 450 GAL $1,485.00 450 GAL $1,485.00 16 TYPE SP 9.5 WEARING COURSE MIXTURE 3,C $70.93 4700.00 TN $333,371.00 0 TN $0.00 0 TN $0.00 17 RAILROAD CROSSING APRON $5,400.00 1.00 LS $5,400.00 1 LS $5,400.00 1 LS $5,400.00 18 TYPE SP 9.5 WEARING COURSE MIXTURE 3,C -DRIVEWAY $135.60 75.00 TN $10,170.00 0 TN $0.00 0 TN $0.00 19 AGGREGATE SURFACING, CLASS 5 - DRIVEWAY $18.11 225.00 TN $4,074.75 80 TN $1,448.80 80 TN $1,448.80 20 CLEARING AND GRUBBING $3,000.00 1.00 LS $3,000.00 1 LS $3,000.00 1 LS $3,000.00 21 COMMON TOPSOIL BORROW LV $19.65 1740.00 CY $34,191.00 912 CY $17,920.80 912 CY $17,920.80 22 SILT FENCE $3.29 890.00 LF $2,928.10 0 LF $0.00 0 LF $0.00 23 INLET PROTECTION $120.00 5.00 EA $600.00 11 EA $1,320.00 11 EA $1,320.00 24 EROSION CONTROL BLANKET $2.40 1320.00 SY $3,168.00 4004 SY $9,609.60 4004 SY $9,609.60 25 ANCHOR REINFORCED VEGETATION SYSTEM ARVS $39.30 120.00 SY $4,716.00 0 SY $0.00 0 SY $0.00 26 HYDRAULIC MATRIX TYPE HYDRAULIC MULCH $0.60 13550.00 SY $8,130.00 0 SY $0.00 0 SY $0.00 27 SEED MIXTURE 25-131 $2.40 930.00 LB $2,232.00 175 LB $420.00 175 LB $420.00 28 SEDIMENT CONTROL LOG $3.60 630.00 LF $2,268.00 250 LF $900.00 250 LF $900.00 29 STREET SWEEPER WITH PICKUP BROOM WITH OPERATOR $180.001 7.00 HR $1,260.00 18 HR $3,240.00 18 HR $3,240.00 30 4" DOUBLE SOLID LINE, YELLOW EPDXY $0.561 7100.00 LF $3,976.001 0 LF $0.00 0 LF $0.00 31 24" STOP BAR, WHITE EPDXY 1 $9.361 90.00 LF $842.40 0 LF $0.001 0 LF $0.00 32 PAVEMENT MESSAGE RR XING - WHITE EPDXY 1 $566.501 2.00 EA $1,133.001 0 EA $0.001 0 EA $0.00 TOTAL PART 1 - STREET IMPROVEMENTS COST: $568,936.76 $147,955.79 $150,947.24 PART 2 - STORM SEWER IMPROVEMENTS 33 REMOVE STORM SEWER PIPE 1 $9.561 320.00 LF $3,059.20 320 LF $3,059.20 320 LF $3,059.20 34 IMPROVED PIPE FOUNDATION 1 $8.001 150.00 LF $1,200.00 150 LF $1,200.00 150 LF $1,200.00 35 6" PVC PIPE, SDR 26 1 $29.101 120.00 LF $3,492.001 0 LF $0.001 0 LF $0.00 36 6" PVC PERFORATED PIPE, SDR 26, INCL ROCK & FABRIC $34.17 690.00 LF $23,577.30 0 LF $0.00 0 LF $0.00 37 6" PVC CLEAN OUT $435.00 4.00 EA $1,740.00 0 EA $0.00 0 EA $0.00 38 18" RC PIPE CULVERT, CL 5 $105.86 56.00 LF $5,928.16 56 LF $5,928.16 56 LF $5,928.16 39 24" RC PIPE CULVERT, CL 4 $178.50 48.00 LF $8,568.00 48 LF $8,568.00 48 LF $8,568.00 40 18" RC PIPE APRON $1,347.00 4.00 EA $5,388.00 4 EA $5,388.00 4 EA $5,388.00 41 24" RC PIPE APRON $1,218.00 2.00 EA $2,436.00 2 EA $2,436.00 2 EA $2,436.00 42 15" CMP PIPE CULVERT - DRIVEWAY $39.94 350.00 LF $13,979.00 350 LF $13,979.00 350 LF $13,979.00 43 15" GALVANIZED STEEL PIPE APRON 1 $291.821 22.00 EA $6,420.041 22 EA $6,420.0141 22 EA $6,420.04 44 RANDOM RIP RAP, CLASS III 1 $87.301 60.00 CY $5,238.001 60 CY $5,238.001 60 CY $5,238.00 TOTAL PART 2 - STORM SEWER IMPROVEMENTS: $81,025.70 $52,216.40 $52,216.40 TOTAL BASE BID: $649,962.46 $200,172.19 $203,163.64 CHANGE ORDER NO. 1 PART 1-DEDUCT 1 AGGREGATE SHOULDERING 1 $22.00 -350.00 TN -$7,700.001 0 TN $0.001 0 TN $0.00 2 COMMON TOPSOIL BORROW LV $19.65 -390.00 CY -$7,663.501 0 CY $0.001 0 CY $0.00 3 INLET PROTECTION 1 $120.00 -5.00 EA -$600.001 0 EA $0.001 0 EA $0.00 TOTAL PART 1 - DEDUCT: -$15,963.50 $0.00 $0.00 PART 2-DEDUCT 1 AGGREGATE SHOULDERING 1 $29.10 -120.00 LF -$3,492.001 0 LF $0.001 0 LF $0.00 2 COMMON TOPSOIL BORROW LV $34.17 -690.00 LF -$23,577.301 0 LF $0.001 0 LF $0.00 3 INLET PROTECTION 1 $435.00 -4.00 EA -$1,740.001 0 EA $0.001 0 EA $0.00 TOTAL PART 2 - DEDUCT: -$28,809.30 $0.00 $0.00 TOTAL CHANGE ORDER NO. 1: -$44,772.80 $0.00 $0.00 TOTAL BASE BID PLUS CHANGE ORDER NO. 1: $605,189.66 $200,172.19 $203,163.64 CHANGE ORDER NO. 2 1 AGGREGATE SHOULDERING $22.00 -350.00 TN -$7,700.00 0 TN 0.00 0 TN 0.00 2 MILL BITUMINOUS PAVEMENT (2.5" DEEP) $1.95 16700.00 SY $32,565.00 17112 SY 33,368.40 17112 SY 33,368.40 3 MOBILIZATION -RECLAIM $1,500.00 1.00 LS $1,500.00 1 LS 1,500.00 1 LS 1,500.00 4 TYPE SP 9.5 WEARING COURSE MIXTURE (3, C) $70.93 -4700.00 TN -$333,371.00 0 TN 0.00 0 TN 0.00 5 TYPE SP 9.5 WEARING COURSE MIXTURE (3, C)- DRIVEWAY $135.60 -75.00 TN -$10,170.00 0 TN 0.00 0 TN 0.00 6 TYPE SP 9.5 WEARING COURSE MIXTURE (3, B) $69.77 3100.00 TN $216,287.00 3123.92 TN 217,955.90 3123.92 TN 217,955.90 7 TYPE SP 9.5 WEARING COURSE MIXTURE (3, B)- DRIVEWAY $116.57 75.00 TN $8,742.75 60 TN 6,994.20 60 TN 6,994.20 8 BITUMINOUS PAVEMENT RECLAIMATION $0.54 -16700.00 SY -$9,018.00 0 SY 0.00 0 SY 0.00 9 BITUMINOUS PATCHING (3" THICK) $42.72 300.00 SY $12,816.00 300 SY 12,816.00 300 SY 12,816.00 10 RELOCATE AGGREGATE BASE CLASS 5 $6,900.00 1.00 LS $6,900.00 1 LS 6,900.00 1 LS 6,900.00 11 CULVERT SURFACE REPAIRS $9,850.00 1.00 LS $9,850.00 1 LS 9,850.00 1 LS 9,850.00 TOTAL CHANGE ORDER NO. 2: -$71,598.25 289,384.50 289,384.50 TOTAL CHANGE ORDER NO. 1 & 2: -$116,371.05 289,384.50 289,384.50 TOTAL BASE BID PLUS CHANGE ORDER NO. 1 & 2: $533,591.41 $489,556.69 $492,548.14 Q�p.XChapyn �O �O a G� �w 44F noCu-1f a4µMINNESOTA- REVENUE Contractor Affidavit Submitted Thank you, your Contractor Affidavit has been approved. Confirmation Summary Confirmation Number: Submitted Date and Time: Legal Name: Federal Employer ID: User Who Submitted: Type of Request Submitted: Affidavit Summary Affidavit Number: Minnesota ID: Project Owner: Project Number: Project Begin Date: Project End Date: Project Location: Project Amount: Subcontractor Summary 1-844-068-416 9-Nov-2015 10:37:28 AM DRESEL CONTRACTING INCORP 41-1523885 kellygreene Contractor Affidavit 469286912 3359216 CITY OF SCANDIA N15.109775 07-Jul-2015 17-Oct-2015 SCANDIA, MN $533,591.41 Name ID Affidavit Number MIDWEST ASPHALT CORP 7252554 1698807808 NORTH VALLEY INC 3744649 537346048 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 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. Q�p.XChanyP O� pJ� �O k 40 '-4oCu-t��4K https://www.mndor.state.mn.us/tp/eservices/ /Retrieve/0/b-/zXh2n3di5ZpF7p8JhmZ_KA_... 11/9/2015 Page 1 of 1 INNESO` A- REVENUE Contractor Affidavit Submitted Thank you, your Contractor Affidavit has been approved. Confirmation Summary Confirmation Number: Submitted Date and Time: Legal Name: Federal Employer ID: User Who Submitted: Type of Request Submitted: Affidavit Summary Affidavit Number: Minnesota to: Project Owner: Project Number. Project Begin Date: Project End Date: Project Location: Project Amount: Subcontractors: 0-532-365-376 9-Nov-2015 9:30:01 AM NORTH VALLEY INC 41-1906523 northva Contractor Affidavit 537346048 3744649 CITY OF SCANDIA N/A 20-Aug-2015 01-Sep-2015 QUINNELL AVE-SCANDIA $242,775.18 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 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. httns://www.nmdor.state-mn.us/tn/eservices/ /Retrieve/0/b-/nv7,Sv5HKwuildlcfYrc9 A ... 11/9/2015 Page 1 of 1 MINNESOTA• REVENUE Thank you, your Contractor Affidavit has been approved. Confirmation Summary Confirmation Number: Submitted Date and Time: Legal Name: Federal Employer ID: User Who Submitted: Type of Request Submitted: Affidavit Summary Affidavit Number: Minnesota ID: Project Owner: Project Number: Project Begin Date: Project End Date: Project Location: Project Amount: Subcontractors: 1-685-602-368 6-Nov-2015 2:00:02 PM MIDWEST ASPHALT CORP 41-0943785 mwasph Contractor Affidavit 1698807808 7252554 CITY OF SCANDIA N15.109775 28-Jul-2015 18-Aug-2015 SCANDIA, MN $13,559.65 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 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/eservicesl /Retrievel0lb-ITLmpFbCimktnbT3KTbU8v... 11/6/2015 CHISAGO CITY MINNESOTA DRESEL CONTRACTING INC. 24044 JULY AVE. CHISAGO CITY, MN 55013 PHONE: 651-257-9469 FAX: 651-257-1169 RECEIPT AND WAIVER OF MECHANIC'S LIEN RIGHTS SUBCONTRACTOR: North Valley Inc CONTRACTOR: Dresel Contracting, Inc. OWNER: City of Scandia PROJECT: Quinneil Avenue N & Lilleskoge STATE Number: Executed this 10/23/2015 For a valuable consideration (in the amount of $242,775.18), the receipt of which is hereby acknowledged as full and final payment for all labor, skill and material furnished or to be furnished to the above mentioned project 1. Effective upon receipt from CONTRACTOR of the amount stated to be due in said Final Request for Payment or such lesser amount as CONTRACTOR may acknowledge to be due in accordance with the provision of the SUBCONTRACT, SUBCONTRACTOR does now hereby absolutely waive all liens and rights or claims of lien against the PROPERTY which SUBCONTRACTOR ever had, has or may have, and does release the CONTRACTOR and OWNER from any claim, liability or debt by reason of labor, services, equipment, materials and rentals which have been or will be performed or furnished by SUBCONTRACTOR to or for the Project under the SUBCONTRACT, including, without limitation, all "claims", "changes", "extras" and other charges of any description. 2. SUBCONTRACTOR further represents and certifies that no lien has been filed against the PROPERTY by SUBCONTRACTOR or any laborer, sub -subcontractor or material -man who has directly or indirectly furnished labor, services, equipment, rentals or materials to or for the PROJECT under the SUBCONTRACT, and the SUBCONTRACTOR has paid all bills, taxes (including applicable Sales and Use Taxes) and charges at the agreed prices for all of said labor, services, equipment, rentals and materials which have been or are to be furnished to or for the PROJECT under the SUBCONTRACT. 3. In further consideration of such payment, North Valley Inc. releases and forever discharges Merchants Bonding Company, as Surety, from any and all claims, demands, actions, causes of action or suits of whatsoever kind of nature against the bond issued by Merchants to Dresel Contracting, Inc. as principal, bond no# MNC 4. SUBCONTRACTOR authorizes CONTRACTOR to complete any blank spaces in this Document. Note: If this instrument is executed by a corporation, it must be signed by an officer, and if executed by a partnership, it must be signed by a partner. Limited Liability Company, it must be signed by a member and/or officer. North Valley Inc (Subcontractor) B y (Owner, Partner, Officer) (Please Designate) ©M����0 ��- �J-W 5� I 0 Zv (Address) O �\J SS.��W- CH/SAGO CITY MINNESOTA DRESEL CONTRACTING INC. 24044 JULY AVE. CHISAGO CITY, MN 55013 PHONE: 651-257-9469 FAX: 651-257-1169 RECEIPT AND WAIVER OF MECHANIC'S LIEN RIGHTS SUBCONTRACTOR: Midwest Asphalt CONTRACTOR: Dresel Contracting, Inc. OWNER: City of Scandia PROJECT: Quinnell Avenue N & Lilleskoge STATE Number: Executed this 10/23/2015 For a valuable consideration (in the amount of $13,559.65), the receipt of which is hereby acknowledged as full and final payment for all labor, skill and material furnished or to be furnished to the above mentioned project 1. Effective upon receipt from CONTRACTOR of the amount stated to be due in said Final Request for Payment or such lesser amount as CONTRACTOR may acknowledge to be due in accordance with the provision of the SUBCONTRACT, SUBCONTRACTOR does now hereby absolutely waive all liens and rights or claims of lien against the PROPERTY which SUBCONTRACTOR ever had, has or may have, and does release the CONTRACTOR and OWNER from any claim, liability or debt by reason of labor, services, equipment, materials and rentals which have been or will be performed or furnished by SUBCONTRACTOR to or for the Project under the SUBCONTRACT, including, without limitation, all "claims", "changes", "extras" and other charges of any description. 2. SUBCONTRACTOR further represents and certifies that no lien has been filed against the PROPERTY by SUBCONTRACTOR or any laborer, sub -subcontractor or material -man who has directly or indirectly furnished labor, services, equipment, rentals or materials to or for the PROJECT under the SUBCONTRACT, and the SUBCONTRACTOR has paid all bills, taxes (including applicable Sales and Use Taxes) and charges at the agreed prices for all of said labor, services, equipment, rentals and materials which have been or are to be furnished to or for the PROJECT under the SUBCONTRACT. 3. In further consideration of such payment, Midwest Asphalt. releases and forever discharges Merchants Bonding Company, as Surety, from any and all claims, demands, actions, causes of action or suits of whatsoever kind of nature against the bond issued by Merchants to Dresel Contracting, Inc. as principal, bond no# MNC 4. SUBCONTRACTOR authorizes CONTRACTOR to complete any blank spaces in this Document. Note: If this instrument is executed by a corporation, it must be signed by an officer, and if executed by a partnership, it must be signed by a partner. Limited Liability Company, it must be signed by a member and/or officer. Midwest Asphalt (Subcontractor) By: 1�C1 (Owner, Partner, Officer) (Please Designate) MID WEE STD PTUAT T MR.PORIATI N (Address) -V ` BOUX bl '17 ROPKYNS, NY-N 55343 952-937-8033 rrNcwc_ ; CHISAGO CITY M►NNESOTA DRESEL CONTRACTING INC. 24044 JULY AVE. CHISAGO CITY, MN 55013 PHONE: 651-257-9469 FAX: 651-257-1169 RECEIPT AND WAIVER OF MECHANIC'S LIEN RIGHTS CONTRACTOR: Dresel Contracting, Inc. OWNER: City of Scandia PROJECT: Quinnell Avenue N & Lilleskoge STATE Number: NA Executed this 10/23/2015 For a valuable consideration (in the amount of $533,591.41), the receipt of which is hereby acknowledged as full and final payment for all labor, skill and material furnished or to be furnished to the above mentioned project 1. Effective upon receipt from OWNER of the amount stated to be due in said Final Request for Payment or such lesser amount as OWNER may acknowledge to be due in accordance with the provision of the CONTRACT, CONTRACTOR does now hereby absolutely waive all liens and rights or claims of lien against the PROPERTY which CONTRACTOR ever had, has or may have, and does release the OWNER from any claim, liability or debt by reason of labor, services, equipment, materials and rentals which have been or will be performed or furnished by CONTRACTOR to or for the Project under the CONTRACT, including, without limitation, all 'claims", "changes", "extras" and other charges of any description. 2. CONTRACTOR further represents and certifies that no lien has been filed against the PROPERTY by CONTRACTOR or any laborer, sub -subcontractor or material -man who has directly or indirectly furnished labor, services, equipment, rentals or materials to or for the PROJECT under the CONTRACT, and the CONTRACTOR has paid all bills, taxes (including applicable Sales and Use Taxes) and charges at the agreed prices for all of said labor, services, equipment, rentals and materials which have been or are to be furnished to or for the PROJECT under the CONTRACT. Note: If this instrument is executed by a corporation, it must be signed by an officer, and if executed by a partnership, it must be signed by a partner. Limited Liability Company, it must be signed by a member and/or officer. Dresel Contracting, Inc. (Contractor) / y (O e , Officer) (Please Designate) 2 G/c&4I ),/ /y A L-Q (Address) O ?, lV ` rV C�� sus 5,5-c-3