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09.c2 2023 Street Crack Filling and Seal Coat Project - Contractor's Request for Payment No 1 14727 209 th St. N. PO Box 128 , Scandia, Minnesota 55073 Phone (651) 433 -2274 Fax (651) 433 -5112 http://www.ci.scandia.mn.us June 13, 2023 Honorable Mayor and City Council City of Scandia 14727 209th Street N. Scandia, MN 55073-8503 Re: Contractor’s Request for Payment No. 1 2023 Crack Filling and Seal Coat Project Dear Mayor and Council: Enclosed please find Contractor’s Request for Payment No. 1, for the 2023 Crack Filling and Seal Coat Project. We recommend the council approve the Contractor’s Request for Payment No. 1 and pay $150,824.37 to Allied Blacktop Company. This amount includes work required to route and seal cracks, and seal coat the roads in this year’s project. This request includes withholding 5% retainage. Please call me at (612) 597-7140 if there are any questions or concerns regarding this Contractor’s Payment request. Sincerely, Ryan J. Goodman, P.E. City Engineer Enclosures: Contractor’s Request for Payment No. 1 From 1. 2. 3. 4. 5. a.X b.X c. 6. 7. 8. 9. Name:Name: Date: Title: 158,762.50$ 168,376.50$ 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) 6/12/2023 Application Date:6/13/2023 139,576.50$ 28,800.00$ Net change by Change Orders 5/29/2023 to Original Contract Price Contractor's Application for Payment Application No.:1 City of Scandia Allied Blacktop Company Bolton & Menk, Inc. 2023 Crack Filling and Seal Coat Project Owner's Project No.: Engineer's Project No.: Agency's Project No.: Application Period: Contract: Owner: Contractor: Engineer: Project: 0N1.130046 7,938.13$ -$ 150,824.37$ 7,938.13$ 150,824.37$ Work Completed Stored Materials Total Retainage (Line 5.a + Line 5.b) Amount eligible to date (Line 4 - Line 5.c) Less previous payments 5% $ 158,762.50 $ - Date: Signature: Allied Blacktop Company Contractor's Certification Amount due this application Contractor: Balance to finish, including retainage (Line 3 - Line 4)9,614.00$ Date: By: Title: By: Title: Approved by City of Scandia 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. Recommended by Bolton & Menk, Inc. Name: 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.: 1 From 05/29/23 to 06/12/23 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) ($) 1 1.00 LS 10,000.00 10,000.00 - 0.80 8,000.00 8,000.00 80% 2,000.00 2 1.00 LS 5,000.00 5,000.00 - 0.95 4,750.00 4,750.00 95% 250.00 3 18,000.00 GAL 2.50 45,000.00 - 18,000.00 45,000.00 45,000.00 100% - 4 550.00 TN 105.00 57,750.00 - 550.00 57,750.00 57,750.00 100% - 5 7,500.00 LBS 2.50 18,750.00 - 7,500.00 18,750.00 18,750.00 100% - 6 5,250.00 LF 0.45 2,362.50 - - - - 2,362.50 7 2.00 EA 165.00 330.00 - - - - 330.00 8 48.00 SF 8.00 384.00 - - - - 384.00 139,576.50$ -$ 134,250.00$ -$ 134,250.00$ 96% 5,326.50$ 24" STOP BAR Progress Estimate - Unit Price Work City of Scandia Bolton & Menk, Inc. Allied Blacktop Company 2023 Crack Filling and Seal Coat Project Owner: 0N1.130046 ROUTE & SEAL DOUBLE YELLOW STRIPE RAIL ROAD MESSAGE Application Date:Application Period:Application No.: Previous Estimate 06/13/23 B BASE BID % of Value of Item (J / F) (%) Balance to Finish (F - J) ($) MOBILZATION TRAFFIC CONTROL Description Work Completed Engineer: Contractor: Project: Contract: Materials Currently Stored (not in G) ($) Work Completed and Materials Stored to Date (H + I) ($) Contract Information Bid Item No. BITUMINOUS MATERIAL FOR SEAL COAT SEAL COAT AGGREGATE, FA-2 (MOD) BASE BID TOTAL Unit Price EJCDC C-620 Contractor's Application for Payment (c) 2018 National Society of Professional Engineers for EJCDC. All rights reserved.1 of 2 Contractor's Application for Payment Owner's Project No.: Engineer's Project No.: Agency's Project No.: 1 From 05/29/23 to 06/12/23 A C D E F F1 F2 G H I J K L Item Quantity Units Unit Price ($) Value of Bid Item (C X E) ($) Quantity Previous Estimate Value Previous Estimate Estimated Quantity Incorporated in the Work Value of Work Completed to Date (E X G) ($) Progress Estimate - Unit Price Work City of Scandia Bolton & Menk, Inc. Allied Blacktop Company 2023 Crack Filling and Seal Coat Project Owner: 0N1.130046 Application Date:Application Period:Application No.: Previous Estimate 06/13/23 B % of Value of Item (J / F) (%) Balance to Finish (F - J) ($)Description Work Completed Engineer: Contractor: Project: Contract: Materials Currently Stored (not in G) ($) Work Completed and Materials Stored to Date (H + I) ($) Contract Information Bid Item No. 9 1.00 LS 1,250.00 1,250.00 - 0.95 1,187.50 1,187.50 95% 62.50 10 4,690.00 GAL 2.50 11,725.00 - 3,103.00 7,757.50 7,757.50 66% 3,967.50 11 140.00 TN 105.00 14,700.00 - 140.00 14,700.00 14,700.00 100% - 12 450.00 LB 2.50 1,125.00 - 347.00 867.50 867.50 77% 257.50 28,800.00$ -$ 24,512.50$ -$ 24,512.50$ 85% 4,287.50$ 168,376.50$ -$ 158,762.50$ -$ 158,762.50$ 94% 9,614.00$ TRAFFIC CONTROL TOTAL CHANGE ORDER TOTAL BASE BID + CHANGE ORDER NO. 1 BITUMINOUS MATERIAL FOR SEAL COAT AGGREGATE FA-2 MODIFIED ROUTE AND SEAL CRACKS CHANGE ORDER Unit Price EJCDC C-620 Contractor's Application for Payment (c) 2018 National Society of Professional Engineers for EJCDC. 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