Stone Lake Addition Review of Invoices Letter & Invoices DEPARTMENT OF PUBLIC WORKSOty« TELEPHONE • (785)309-5725
Michael Fraser, Director of Public Works FAX • (785) 309-5713
Daniel Stack, P.E., City Engineer TDD • (785) 309-5747
Jim Teutsch, Operations Manager E-MAIL: mike.fras rrt salina.org
.411111IS
30
danstackQsalina.org
0 West Ash • P.O. Box 736 � jim.teutsch@salina.org
Salina, Kansas 67402-0736 sari/% WEBSITE • www.salina-ks.gov
January 10,2013
Mr. Dane Q.Barclay
Alsop Sand Company, Inc. and Sparrowhawk Land, LLC
105 Industrial Rd.
Concordia,KS 66901
Re: Stone Lake Addition
City of Salina Project No. 10-2816
Dear Mr. Barclay:
I am writing to inform you engineering staff have completed the review of invoices submitted for consideration
of payment as per the development agreement All of the items submitted for payment are approved and
eligible up to the Improvement Costs Cap(the"Cap")as defined in the development agreement.The"Cap"is
limited to$1,272,870.42.The interest you submitted is through the end of 2012.Any additional interest you
accumulate will also be eligible subject to the"Cap".The City of Salina will also make payment of$67,907.19
to you for the Cost Recovery Area related to the eight-inch waterline.
If you have any questions regarding this matter,do not hesitate to call at(785)309-5725.
Sincerely 1
Ia(/\dlBvl
Wayne elson,P.E.
Cc: Daniel It Stack, P.E.,City Engineer
Michael Schrage, Deputy City Manager
Rod Franz,Director of Finance
Jim Maes,ComPro Realty
Project file
Our Mission is to Build and Maintain a Clean, Safe Community
rtititit
B"ANK
N 0
y
IKANSAS;
December 12, 2012
Dane Barclay
Sparrowhawk Land LLC
PO Box 331
Concordia, KS 66901-0331
Re: Loan for Stone Lake Development
Dear Dane,
i have computed the interest an• osing co as equested for the Stone Lake Development loan. As of
December 31,2012. the total • 9,154.84. Th- s ayoff balance on the loan as of December 31, 2012 is
projected at$1,225,419.59. P -ase call r -• to payment to receive a verified payoff balance.
Should you need any additional information please do not hesitate to contact meat 785-822-0064 or
rtibixby@firstbankkansas.com.
We appreciate your business.
Sincerely, •
Melissa Bixby
Vice-President
SALINA - ASSARIA - KANOPOLIS - ELLSWORTH - McPHERSON - ABILENE
e"P)
's=ue � ADAC-Kansas,Inc.,Sham Division
_ Change order detail pages are replaced by this summary. Salina Branch
P 0 Box 1095
By my signature on this document LAGREFana the Saline KS 67402-1095
change orders numbered one through four and their values listed below. 785.823.5537 telephone
Change Order Summary 785.823.1615 fax
Dated 12/5/12
Job 697297
Stone Lake Addition
Details:
Date Reference Description
10/24/2012 Change Order 1 Additional Common Ex.,Erosion Control,Pipe Quantities Value
10/29/2012 Change Order 2 Added Concrete Items for Shoreline Drive P $ 21,341.84
11/16/2012 Change Order 3 Fire Hydrant Relocation $ 6,195.00
12/5/2012 Change Order 4 Final Quantities $ 1,950.00
$ 14,671.52
Change Order Totals:
$ 44,158.36
Original Contract:
01Current Contract Value: $C1,2446472;16$ 1,26,172;161
Submitted by ` r• f
i =" (signature)//t/70,72 Date
Approved '�y
by tf,' �1•i rt/ 1 • _I, . (signature) 1 �1 11 �2—
Date
liti,t
a'L AIA Document G702r" — 1992
Application and Certificate for Payment
TO OWNER: PROJECT: APPLICATION NO: Distribution to:
Alsop Sand Co..Inc.&Sparrowhawk Land LLC Stone Lake Addition PERIOD TO: 6 Final
105 Industrial Rd,Concordia KS 66901 Phase I /2/5/2012 OWNER 0
c/a Comfort', 15737th St,Saline KS 67401 CONTRACT FOR: ARCHITECT 0
FROM CONTRACTOR: VIA ARCHITECT: CONTRACT DATE: May 17,2012 CONTRACTOR• ❑
APAC-KANSAS,INC.,SHEARS CFS Engineers
DIVISION,SAUNA BRANCH 210 Southwlnd PL,STE 205 PROJECT NOS: / SJN 697297 FIELD ❑
P 0 BOX 1095.SAUNA KS 67402-1095 Manhattan KS 88603
OTHER ❑
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information
Application is made fen' and belief the Work covered by this Application for Payment has been completed in accordance
MA Document adforr payment,as shown below,in connection with the Contract.
,Continuation Sheet,is attached. with the Contract Documents. that all amounts have been paid by.the Contractor for Work for
which previous Certificates for Payment were issued and payments received from the Owner, and
1.ORIGINAL CONTRACT SUM $ 1,202,013.80 that current payment shown herein i due.
2.NET CHANGE BY CHANGE ORDERS $ 44,158.36 CONTRA' 17:1) P NSAS,INC.,SHEARS DIV.,SALINA BRANC
3.CONTRACT SUM TO DATE(Line 1121 , $ 1,246,172.16 3y # 4 '�4
4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1.248'172'16 State of: �* V.G.Hopkins,Vice-President/Salta neh
5.RETAINAGE: County of: SALINE
S. _Ya of Completed Work Subscribed and sworn to before
(Columna D+Eon G703) $ me this "`
D• _Yo of Stored Material 7 day of �ECEmE1
fl .20/
(Column F on 6703) $ Notary Public: y,f( 7ei�
My commission expires: 9/19/2014 (( MICHELLE M. MOON
Total Retainage(Lines 5a+5h,or Total in Column I of G703) $ 0.00 • INNOTARY PUBLIC
OTATE or AteAs I
6.TOTAL EARNED LESS RETAINAGE $ 1,246,172.16 ARCHITECT'S CERTIFICATE FOR PAYMENT 'wY APP7. EXPIRES 9.1, aviq 1
(Line 4 minus Line 5 Total) In accordance with the Contract Documents,based on on-site observations and the data comprising
7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 1,231,500.64 this application,the Architect certifies to the Owner that to the best of the Architect's knowledge,
(Line 6frorn prior Certificate) information and belief the Work has progressed as indicated, the quality of the Work is in
accordance with the Contract Documents, and the Contractor is entitled to payment of the
8.CURRENT PAYMENT DUE $ 14,671.52 AMOUNT CERTIFIED.
9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED - $
(Line 3 minus Line 6) $ 0.00 (Attach explanation if amount certified differs from the amount applied.Initial all figures on this
Application and on the Continuation Sheet that are changed to conform with the amount certified.)
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT:
Total changes approved in previous months by Owner S 29,486.84 $ 0.00 By: • Date:
14,4/1.64
Total approved this month $ $
44158.380.00 . This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Contractor
,
TOTAL S. $ named herein.Issuance,payment end acceptance of payment are without prejudice to any rights of
NET CHANGES by Change Order $ 44,158.38 the Owner or Contractor under this Contract.
CAUTION:You should sign an original AIA Contract Document,on which this text'appears In RED.An original assures that changes will not be obscured.
AIA Document G702^—1992.Copyright 0 1953,1903,1965,1971.1976.1883 and 1992 by ma American Institute of Architects All right,reserved.WARNING:This Ale Document Is protected by U.S.Copyright Law
and Intonational Limitless.Unauthorized reproduction or distribution of this AIA'Document,or any portion of it,may resort In sovom civil and criminal penalties,and will be prosecuted to No maximum extant
possible under the law.Purchasers are permitted to reproduce tan(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute el Architects'legal
counsel,copyrightelela.org.
MP 1/4:044
'i1 ® TN
=: = Document 6703 - 1992
Continuation Sheet •
AIA Document 0702Tm-1992.Application and Certificate for Payment,or 0732T -2009, APPIJCATION•N0:
Application and Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE: 11 Final
containing Contractor's signed certification is attached.
In tabulations below,amounts are in US dollars. PERIOD TO: 12/5/12
Use Column I'on Contracts where variable retainage for line items may apply. 12/5!12
ARCHITECT S PROJECT N0:
A B C D I E P O n Stone LIM°/SJN§97297
• WORK COMPLETED
•
MATERIALS TOTAL
ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE RETAINAGE
NO. VALUE APPLICATION THIS PERIOD STORED STORED TO DATE (G+C7 FINISH Wvarlibte roto)
(D+E) (Nor in Dor E) (D+E+F) (C-G)
1 :LEARING AND GRUBBING 22,103.55 22,193.556 22,193.55✓ 100%' 090
2 :O1 ON EXCAVATION 38,599.50 38,598.50 38,598.50"" 100% MOO
2 ;081 COMMON EXCAVATION 1,800.00 1,800.00cjiob .ac 1,BO0,00 100% 0.00
3 COMPACTION OF EARTHWORK 3,508,40 3,508.40 3,508.40✓ 100% 0.00
4 TEMPORARY SLOPE BARRIER 2,300.00 2,300.00 2,300.00✓ 100% 0.00
4 ;091 SLOPE BARRIER 1,575.50 1,575.80131 DI-Fel,le- I67&50 100% 0.00
6 -EMPORARY DITCH CHECK 167.50 157.50 157.50% 100% 0.00
5 CO 01 TEMPORARY DITCH CHECK 167.50 157.50 5 Cy 9'*' ,t,SO 157,50 100% 0.00
6 'EMPORARY INLET SEDIMENT BARRIER 350,00 360.00 360.00✓ 100% 0.00
7 6EDIMENT REMOVAL 105.00 105.00 105.00 J 100% 0.00
7 CO 01 SEDIMENT REMOVAL 315.00 315.00 3CY e‘loce. 315.00. 100% 0.00
-EMPORARY CONSTRUCTION
8 ENTRANCE 1,787.50 1,797.60 1,797.60✓ 100% 0.00
9 -EMPORARY FERTILQER 1,094.00 1,094.00 1,094.00✓ 100% 0.00
9 CO 4 TEMPORARY FERTILIZER 343.80 343.601'1 ,tZ'yc'CN.L.00 343,60 100% 0.00
•
GRAND TOTAL .
CAUTION:You should sign en original AIA Contract Document,on which this that appears In RED.An original assures that changes will not be obscured.
AIA Document 0703re-1992.Copyright 01983,1986,1988,1987,1970,1978,1983 and 1992 by The American Insituto ofAdukcb.All rights resolved.WARNING:This NA.Document M protected by U.S.Copyright
Law and International Treaties.Unauthorized reproduction or distribution of thin AlAe Document,or any portion of It,may result In severe civil and criminal penalties,and will be prosecuted to the maximum nstunt
pastime under the law.Purchasam aro pemy0od to Npmduoe ten(10)copies of Ws documoni when completod.To report copyright violations of AIA Contract Documents.earmll The American Institute of Aretaeoln'legal
counsel.aipydghteala.org.
..,M
•
AI I' Document G703Th - 1992
Continuation Sheet
AIA Document G702TM-1992.Application and Certificate for Payment,or G732TM-2009,
APPUCAT{ON NOAPPhcation and Ce tifcae for Payment,Construction Manager as Adviser Edition, APPLICATION DATE:
6 Finalcontnini0g Contractor's signed certification is attached.
In tabulations below,amounts are in US dollars. PERIOD TO: 12/5/12
Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 1215l12
A B C D E P 0 HStone Lake f SJN 097297
WORK COMPLETED
MATERIALS TtIVAL
ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS
PRESENTLY COMPLETED AND ori BALANCE TO
N0. VALUE RETAINAGE
APPLICATION . THIS PERIOD STORED STORED TO DATE (G*C) FINISH
(D+EJ (Na 1n D or E) (D+E+F) (C-G) QJ'varlable rate)
•
10 TEMPORARY SEED 413,70 413.70 413.70) 100% 0.00
10 ;04 TEMPORARY SEED 121.38 121.38 VT.% 1)002 At? 121.38 100% 0.00
MOBIUZATION(EMERGENCY EROSION
11 IIONTR0L) 420.00 420.00 42000 1 100% 0.00
CO MOBILWITION(EMERGENCY
•
11 EROSION CONTROL) (420.00) (420.00) —1 eke-12.0.00 (420.00) 100% 0.00
12 SERMANENT SEEDING 5,906.26 5,808.25 5,908.25/ 100% 0.00
12 .104 PERMANENT SEEDING 1,618.31 1,818.31 1.31 M. MI&.'J5 1,818,31 100% 0,00
13 A5.2 CURB INLET 37,800.00 37,800.00 37,800.00 vi 100% 0.00 •
14 STORM PIPE,18"RCP 10,584.00 10,584.00 10,684.00✓ 100% 0.00
15 STORM PIPE,24'RC 9,114.00 9114.00 . 9,114.001 100% 0.00
10 STORM PIPE,30'RCP 20,827.80 20,827.80 20.827.80✓ 100% 0.00
17 END SECTION,24"RC 625.00 ' 625.00 526.00✓ 100% 0.00
18 END SECTOR,30'RC . 2,100,09 2,100.00 - 2,100.001 100% 0.00
19 STONE RIP RAP.050 c 6' 7,142.30 7,142.30 7,142.30✓ 100% 0.00
STANDARD CONCRETE CURB AND
20 :MITER 63,816.10 53,815.10 63,618.1D✓ 100% 0.00
20 7.`.O#1 CONCRETE CURB AND GUTTER 0,124.50 0,124.50 790I-Cd1l,99 0,124.50 100% 0.00
GRAND TOTAL .
CAUTION:You should sign nn original AIA Contract Document,on which this text appears In RED.An original assures that changes will not be obaaurod.
AIA Document 0703`v-1992.Copyright 01983,1989 1986,1067,1970,1975,1983 and 1992 by The American Instlaao of Architects.All rights reserved.WARNING:Thio AM.Doclmiord is protuctat by U.R.Copyright
Law and International Treaties.Wlauthorhad reproduction or dtstdbutlon of this AIA°nomrmen&or any portion of It,may result In aovero clog and criminal penalties,and will be prosecuted to the maximum extent
possible undor Ilio law.Purehasem aro permitted to rapoduce ten(10)melon of this document when comp/Mad.To report mpyrlghl Nolo/ions of AlA Contract Documents,e-mail Tho American hmabua or Arehaocts'logo'
counsel,copydghtiele.org.
reeves..
0
ific,... AI
..,, ,. A Document G703m - 1992
Continuation Sheet
AIA Document G702114-1992,Application and Certificate for Payment,or G732TK-2009, APPLICATION NO:
Application and Certificate for Payment,Construction Manager as Adviser Edition, APPUCA'UOON DATE: 6 Final
containing Contractor's signed certification Is attached.
In tabulations below,amounts are in US dollars. PERIOD TO: 12/5/12
Use Colman I on Contracts what variable retainage for line items may apply. . ARCHITECT'S PROJECT NO: 12/5/12
A B C D . ! E P • G IJStone Lao/SJN 897297
WORK COMPLETED
MATERIALS ' TOTAL
�'M SCHEDULED PRESENTLY (X)MPLE EDAND % BALANCE TO RETAINAGE
NO. DESCRIPTION OF WORK VALUE FROM PREVIOUS STORED STORED TO DATE O+ FINISH
APPLICATION THIS PERIOD (NaTOREDt in D or B) (D+Q+17 ( C) (C-0) (fu�iablarare)
. 1
21 SPILL CURB 8,417.00 0,417.00 0,417.00 V 100% 0.00
REINFORCED CONCRETE VALLEY
22 BUTTER 1031700 18,317.00 16,317.001 100% 0.00
23 CONCRETE PAVEMENT 278,829.80 278,829.80 278,62000 1 100% 0.00
23 bo 4 CONCRETE PAVEMENT (705.80) (06.80) -4 Sy LC0 2940 (705,60). 100% 0.00
24 rAGG.SUBGRAOE MOD.(MILLINGS) 101,398.50 101,398.50 101,393601 100% 0.00
25 4"CONCRETE SIDEWALK 10"WIDE 1038.00 1,838,00 1,838.00✓ 100% 0.00
25 CO 44"CONCR SIDEWALK.10"WIDE 1,291.60 1,291.50 ill 5y al,So 1,291.50 100% 0.00
26 I"CONCRETE SIDEWALK,4'WIDE 4,768.60 4,768,60 4,758.50 V 100% 0.00
20 CO 4 4"CONCR SiDEWALt(4'WIDE (441.00) (441.00) .- Iy S'1@ 31$C (441.00) 100% 0.00
27 SIDEWALK CONCRETE RAMP 5,776.00 5,778,00 5,776.00✓ 100% 0.00
20 '0'TYPE 1 CONCRETE RAMP 1,942.50 1,942,50 1,942.60 V 100% 0.00 •
29 4'TYPE I CONCRETE RAMP 6,197.50 5,197,50 5,187,607 100% 0.00
GRAND TOTAL
CAUTION:You should sign on original AIA Contract Document,on which this text appears in RED.An original assurer that changes will not be obscured.
AM Document 0703' -1992.Copyright 01983,1965,1988,1967,1970,1978,1983 end 1992 by The American Institute of Aroaitocts.All rights rossrvad.WARNING:This PJe Documont Is protected by U.S.Copyright
Law and International booties.Unauthorized reproduction or dintdbution of this NA Document,or any portion of 14 may result In novena civil and criminal penalties,and will be prosecuted to the mailman extent
possible molar the law.Pudtasom are ponNtted to mprodu0o tan(10)copies of this document when completed To report oopydght violations of AIA Contract Documents,e-m9 The American Irrmk uto of Amhacte
ll ' I
counsel,copyright®ala.org. a1o9s
rnriocM,
lie 'Jri‘
r A\: 'Document G703'° — 1992
Continuation Sheet
AIA Document G702111-1992,Application and Certificate for Payment,or 07327m-2009, APPLJCATION.NO:
•
Application and Certificate for Payment,Construction Manager as Adviser Edition,
APPLICATION DATE:
containing CoOwatoYe signed certification is attached. C Final
In tabulations below,amounts are in US dollars. PERIOD TO: 12/5/12
Use Colson I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 1215!12
A B C D E F G H5tono Lase!SIN 897297
WORK COMPLETED
MATERIALS TOTAL
ITEM SCHEDULED PRESENTLY COMPLETED X BALANCE TO
NO. DESCRIPTION OP WORK PROM PREVIOUS RETAINAGE
VALUE APPLICATION THIS PERIOD STORED STORED TO DATE (G«CJ GJ (7f variable ram)
(D+EJ (Nor In U or EJ (D+E+F)
•
30 EMERGENCY ACCESS DRIVE 5,720.00 6,720.00 6,720.00/ 10014 0.00
31 i2'WATERhWN 41,733.30 41,733,30 1. '
41,739,30 100% 0.00
31 CO412"WATER MAIN 107.10 107.10 3I-P 04353D 107.10 10094 • 0.00
•
32 r WATER MAIN 100,508.10 108,598.10 '
108,398.10✓ 10094 0.00
CO 48'WATER MAIN 2,483.30 2,463.30 10 LPf)'i)3 2,483.30 100% 0.00
33 11/2'WATER SERVICE' 6,070.00 5,870.00 5,67a00'/ 1009E 0.00
34 1"WATER SERVICE 1,979.25 1,979.26 1;979.25✓ 10094 0.00
34 C04 1"WATER SERVICE 273.00 273.00 0k LF.g/13,2/5" 275.00 100% 0.00
35 FIRE HYDRANT AND VALVE ASSEMBLY 26,20000 25,200.00 25,200.00/, 100% coo
38 11/2'SERVICE ASSEMBLY 5,250.00 5,250.00 5,250,001 100% 0.00
37 1"SERVICE ASSEMBLY 4,725,00 4,725.00 4,725.001 100% 0.00
•
•
GRAND TOTAL , .
CAUTION:You should sign an original AIA Contract Document,on which thin text appears in RED.An original assures that changes will not be obscured.
AIA Document 0703m-1892.Copyright 0 1963,1966,1966,1067,1970,1978,1983 mrd 1992 by Tho American Inatteute or Art poets.All rights reserved WARNING:Thta NAe Document Is protected by U.S.Copyright
Law and International Trestles.Unouthorfind reproduction or distribution of this NA document,or any portion of It.may result to sowre civil and criminal portables,and wilt be prosecuted to the maximum extend
possible under tlwr law.Purchasers oro pommod to reproduce tot(10)copies of this document when completed To report oopydght Wardens of AIA Contract Documents,o'ma9 The Amodoan Imbexo of Ard tecte'legal
counsel,coplrlgMeala.org.
^11^44
Atikt,A
ii., . IA Document G703' ® 1992
Continuation Sheet
•
AIA Document 0702TM-1992,Application and Certifdate for Payment,or G732111-2009,
APPUCATIOM NO:
Application and Certificate for Payment,Construction Manager as Adviser Edition, • APPLICATION DATE: • 6 Final
containing Contractor's signed certification is attached.
In tabulations below,amounts are in US dollars: PERIOD TO: 12/6/12
Use Column I on Contracts where variable retainage for line items may apply. ARCHITECTS PROJECT NO: 12/5112
A B C D E P ' O H Stone Lar0/SJN 697287
WORK COMPLETED
MATERIALS TOTAL
ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLEED AND % BALANCE TO RETAINAGE
NO. VALUE FINISH
APPLICATION . THIS PERIOD STORED SPORED TO DATE (G+C) (IJvorfoble rate)
(D+E) (Not in D or E) (D+E+F) ' (C-G) )
37 C04 t'SERVICE ASSEMBLY 630.00 030.00 r2(-,� g315.>, 630.00 100% .0.00
38 CURB SHUTOFF AND VALVE BOX 10,106.25 10,10025 10,100.26✓ 1003 0.00
36 CO 4 CURB SHUTOFF AND VALVE BOX 677.60 677,50 07 EC(0 flt.'TS 677.60. 10034 .000
TAPPING VALVE AND SLEEVE
30 12-X1221r 5,400.00 8,400.00 8,400.00✓ 10039 '0.00
40 FITTINGS' 10,500.00 10600.00 10,600.001 100% 0.00
•
41 BORE AND CLOSE 5082000
50,820.00 60,820.00✓ 10091 0.00
•
41 0001 BORE AND CLOSE 3,485.00 3,485.00 IS L•FA a31.o0 3,485.00 10091 0.00
REMOVE AND REPLACE CONCRETE
42 SIDEWALK 924.00 024.00 024.00✓ 10034 0.00
43 SANITARY SEWER PIPELINE,16' 30,984.00 30684.00 39,984.00✓ 10091 0.00
I
49 CO R7 SANITARY SEWER PIPELINE,15" 3,931.20 3,031.20 58.51-Fe-61,10 3,031.20 100% 0.00
43 CO 04 SANITARY SEWER PIPL31NE,15" 616.24 615.24 91,1"e (et ZD 618.24 10011 0.00
•
GRAND TOTAL
CAUTION:You ahould sign an original AIA Contract Document,on which this text appears In RED.An original assures that changes will not be obscured.
NA Document 0703"-1992.Copyright 01983.1905,1060,1987,1070,1078,1983 and 1992 by Tho American Institute orArehltocte,All rights reagend,WARNING: Yale AIA°hocument Is protoctod by U.S.Copyright
Law and International Treatise.Unauthorized reproduction or distribution of No Ale hocument,or any portion of it,may resell In severe civil and criminal ponnitles,and will be praeacutcd to tM maximum extent
possible under the law.Muchmore am permitted to reproduce tan(10)copies of this document when complotod.To report copyright violations of AIA Contract Documents,c-mall The Amehan Institute of Architects'legal
counsel,copyrlgld@aia.org.
surer.
` :
y''"'` A`', M, Document G703": — 1992
Continuation Sheet
AIA Document G702TM-1992,Application and Certificate for Payment,or G732r"42009, APPLICATION NO:
Application and Certificate for Payment,Construction Manager as Adviser Edition,
APPLICATION DATE:
containing Contractor's signed certification is attached. 6 Final
In tabulations below,amounts are in US dollars. PERIOD T0: 12/5/12
Use Column I on Contracts wham variable retainage for line kerns may apply. • ARCHITECT'S PROJECT NO: 1215/12
A B C D E P 0 N Stone Lice/SJN 697297
WORK COMPLETED
MATERIALS TOTAL
ITEM SCHEDULED • PRESENTLY C(MwLEIED AM) Ys BALANCE TO
NO.
DESCRIPTION OF WORK VALUE FROM PREVIOUS STORED STORED 70 DATE FINISH
(c-G)
RETAINAGE
APPLICATION TEES PERIOD (G+C) (IJwrlabte nrro)
(D+E) (Not In D or E) (D+E+F)
(C-G)
44 SANITARY SEWER PIPELINE,8" 104,340.60 104,340.00 104,340,60✓ 1009( 0.00
44 CO 04
SANITARYSEWER PIPELINE,9" 685.14 888,14 15.9 L 4Jc 888.14 1001( 0.00
44 µR4 SANITARY SEWER PIPEUNE,8" 775.32 775.32 14,2LFe's4,(,D 775.32 10054 0.00
4'"STANDARD SANITARY SEWER
45 MANHOLE,TYPE 1 31,500.00 31,500,00 31,500.00✓ 10011 0.00
48 EXTRA DEPTH MANHOLE 28,775.00 28,775.00 20,775.00✓ 1005, 0.00
46 CO 4 EXTRA DEPTH MANHOLE 1,850.50 1,858.50 5,5 t_FgiySps 1,058,50 10091 0,00
47 SANITARY SEWER 4'SERVICE LINE 38082.00 36,68200 . dd;; 38,86200✓ 1009E 0.00
47 CO4 SANITARY SEWER 4'SERVICE LINE (1,052.10) (1,062.10) — ,H ELF.(0631.5-0 (1,05210) 70094 0.00
48 SANITARY SEWER TEES 3,570.00 3,570.00 . 3,570.00✓ 10091 0.00
48 CO 01 SANITARY SEWERTEFS 105.00 10800 I G0.&' lo6,c0 105.00 10091. 0.00
40 ADJUST EXISTING MANHOLE TO GRADE 15,750.00 15,750.00 16,750 001 10091 0.00
•
GRAND TOTAL .
CAUTION:You should sign an original AIA Contract Document on which this text appears In RED.An original assures that changes will not be obscured.
AA Document 0703"'-1992 Copyright 01983,1988:1980,1987,1970,1978,1983 end 1992 by The American Institute of Architects.AlrrlgM,reserved,WARNING:this AIAe Document la protected by U.S.Copyright
Law and International Treaties.Unauthorized reproduction or Medd billion of this Ale Document,or any portion or It,may result In severe civil and crtminal penalties,ern will be prosecuted to the maximum extent
possible under the law.Purchasers are permitted to traduce ten(10)copies of Oils document when completed To report copyrlgM violations of ALA Contract Documents,e-mail The American Institute of Architects'regal
crumol,copyrlghtealaocp.
e,nrm,
;i o •
�- IA Document G703Th - 1992
Continuation Sheet
AIA Document G7027'4-1992,Application and Certificate for Payment,or G732174-2009, APPLICATION NO:
Application and Certificate for Payment,Construction Manager as Adviser Edition,
APPLICATION DATE: 8 Final
containing Contractor's signed certification is attached. 1215/12
In tabulations below,amounts are in US dollars. PERIOD TO: 12/5/12
Use Column I on Contracts where variable retainage for line items may apply. , ARCHITECT'S PROJECT NO:
A R C D i E F' 0 Nbt000 LE488/SJN lettut
WORK COMPLETED
• MATERIALS TOTAL
ITEM DESCRIPTION OF WORK SCHEDULED FROhi � PRESENTLY COMPLETEDAND % •
BALANCE TO RETAINAGE
NO. VALUE APPLICATION THIS PERIOD STORED STORED TO DATE (G+C) FINISH (j/variable rofs)•
(D+E) ' (Not in Dor E) (D+E+F) • —Cr)
80 CONNECT TO EXISTING MANHOLE 1,732.50 1,73280 1,732.50✓ 100% 0.00
31 CONSTRUCTION STAKING 10,558.00 • 10,688.00 10,688.00" 100% 0.00
62 TRAFFIC CONTROL 3,097.50 3,097.60 3897 WV 100% 0.00
63 TYPE III BARRICADES 7,485.60 7,485.50 7,485.60 V 100% 0.00
COY/-SHORELINE OFiIVEAb-2 CURB •
61 INLET 4,725.00 4,725.00 Igo.ekLi S.OE 4,725.00 100% 0.00
55 CO 52-SHORELINE DRIVE 18"RCP 1,470.00 1,470.00 tIDt.F QP'3io7S 1,470.00 100% 0.00
55. CO d4-SHOREUNE DRIVE 18"RCP (147.00) (147.00) —1f(
,7r (147.00) 100% 0.00
58 CO V3 Reloads Fire Hydrants 1,950.00 1,950.00 1,950.00 100% 0.00
57 CO 4 PianError-Consultant's Portion 8,769.47 6.769.47
0,768.47 100% 0.00
C
,( l. l y
'Move/FLO4 . •,l Cl .C1,c2).4". •
e 601'n2
Te Coy nanae.%„iu I,.-o4 \I+af ',-.11:'t'c 7 AFPK, 33;4, 7-0 13,, ttop»,
GRAND TOTAL 1, 5,vt.1b 1,LI1,U5u.84 15,uaT.54 1,Ab,I/2.15 luux s • - .
44
CAUTION:You should sign art original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured.
AIA Document 0703"-1992.Copyright o 1083,1985,1985,1987,1970,1978,1083 and 1992 by The Amorlcan Institute of Architects.Al?rights reserved.WARNING:Thle AlA°Document If protected by U.S.Copyright
Law and International Treating.Unauthorized reproduction or distribution of Iles AlA°Document,or any portion of it.may result In severe civil and criminal ponaittos,and will be prosecuted to the maximum extent,
poasibio under lbs law.Purchasers are permitted to reproduce ton(10)copies of this documerd when completed To report oopyrlght violations of AIA Contract Documents,s-ma0 The American Institute of Architects'legal
counsel,copyright®ata.or9, .
,0121/19,1