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Contractor's Application for PaymentOwner's Project No.:Engineer's Project No.:Agency's Project No.:1 From07/01/22to 08/01/22AC D E F F1 F2 G H I J K LItem Quantity UnitsUnit Price($)Value of Bid Item(C X E)($)Quantity Previous EstimateValue Previous EstimateEstimated Quantity Incorporated in the WorkValue of Work Completed to Date(E X G)($)1 1.00 LUMP SUM 5,192.00 5,192.00 - 0.50 2,596.00 2,596.00 50% 2,596.00 2 1.00 LUMP SUM 6,500.00 6,500.00 - 0.50 3,250.00 3,250.00 50% 3,250.00 3 4,844.00 LIN FT 22.30 108,021.20 - - - - 108,021.20 4 4,844.00 LIN FT 6.23 30,178.12 - 4,740.00 29,530.20 29,530.20 98% 647.92 5 6.00 EACH 200.00 1,200.00 - 6.00 1,200.00 1,200.00 100% - 6 61.00 EACH 75.00 4,575.00 - - - - 4,575.00 155,666.32 - 36,576.20 - 36,576.20 23% 119,090.12 7 1.00 LUMP SUM 1,200.00 1,200.00 - 0.50 600.00 600.00 50% 600.00 8 2,580.00 LIN FT 22.30 57,534.00 - - - - 57,534.00 9 2,580.00 LIN FT 6.23 16,073.40 - 2,580.00 16,073.40 16,073.40 100% - 10 3.00 EACH 200.00 600.00 - 3.00 600.00 600.00 100% - 11 32.00 EACH 75.00 2,400.00 - - - - 2,400.00 77,807.40$ -$ 17,273.40$ -$ 17,273.40 22% 60,534.00$ 233,473.72$ -$ 53,849.60$ -$ 53,849.60$ 23% 179,624.12$ ALTERNATE TOTALBBASE BID% of Value of Item (J / F)(%)Balance to Finish (F - J)($)MOBILIZATIONTRAFFIC CONTROLDescriptionWork CompletedMaterials Currently Stored (not in G)($)Work Completed and Materials Stored to Date (H + I)($)Contract InformationBid Item No.8" CIPP LINING (6.0 MM LINER)CLEANING & TELVISINGTRIM PROTRUDING TAPSROBOTICALLY REINSTATE LATERALSTRIM PROTRUDING TAPSROBOTICALLY REINSTATE LATERALSTRAFFIC CONTROLPrevious EstimateBASE BID TOTALALTERNATE: MCMENEMY ST8" CIPP LINING (6.0 MM LINER)CLEANING & TELVISINGApplication No.:Engineer:Contractor:Project:Contract:08/10/22BASE BID + ALTERNATEProgress Estimate - Unit Price WorkCity of Little CanadaBolton & Menk, Inc.Hydro-Klean, LLC2022 Sewer Lining ProjectOwner:0C1.127373Application Date:Application Period:Unit PriceEJCDC C-620 Contractor's Application for Payment(c) 2018 National Society of Professional Engineers for EJCDC. All rights reserved.1 of 1DocuSign Envelope ID: 8B3F47DB-96E0-48E7-A412-77BC7CB02240
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