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Contractor's Application for PaymentOwner's Project No.:Engineer's Project No.:Agency's Project No.:2 From07/01/23to 07/28/23AC 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)($)Work Completed and Materials Stored to Date (H + I)($)Contract InformationBid Item No.Application Date:Application Period:Application No.:Previous Estimate07/28/23B% of Value of Item (J / F)(%)Balance to Finish (F - J)($)DescriptionWork CompletedMaterials Currently Stored (not in G)($)Progress Estimate - Unit Price WorkCity of Little CanadaBolton & Menk, Inc.OMG Midwest, Inc. Minnesota Paving & MaterialsTwin Lake Boulevard ImprovementsOwner:0N1.12537623-04Engineer:Contractor:Project:Contract:48 13.00 EACH 203.83 2,649.79 - - - - 2,649.79 49 10.00 LF 30.09 300.90 - 10.00 300.90 300.90 100% - 50 1.00 EACH 2,888.39 2,888.39 - 2.00 5,776.78 5,776.78 200% (2,888.39)51 1.00 EACH 3,359.75 3,359.75 - - - - 3,359.75 52 10.00 LF 40.12 401.20 - 20.00 802.40 802.40 200% (401.20)53 13.00 EACH 995.13 12,936.69 - - - - 12,936.69 54 13.00 EACH 204.90 2,663.70 - - - - 2,663.70 55 3.00 EACH 817.37 2,452.11 - - - - 2,452.11 56 1.00 EACH 351.02 351.02 - - - - 351.02 28,003.55 - 6,880.08 6,880.08 21,123.47 57 2.00 EACH 3,309.61 6,619.22 - 2.00 6,619.22 6,619.22 100% - 58 2.00 EACH 5,114.85 10,229.70 - 2.00 10,229.70 10,229.70 100% - 59 1.00 EACH 4,061.79 4,061.79 - 2.00 8,123.58 8,123.58 200% (4,061.79)60 3.00 EACH 360.51 1,081.53 - - - - 1,081.53 61 1.00 EACH 9,186.67 9,186.67 - - - - 9,186.67 62 230.00 LF 58.17 13,379.10 - 243.00 14,135.31 14,135.31 106% (756.21)63 10.00 LF 114.33 1,143.30 - 55.00 6,288.15 6,288.15 550% (5,144.85)64 180.00 SY 58.17 10,470.60 - 611.00 35,541.87 35,541.87 339% (25,071.27)65 350.00 LBS 17.05 5,967.50 - 187.00 3,188.35 3,188.35 53% 2,779.15 62,139.41 - 84,126.18 84,126.18 (21,986.77)66 3.00 EACH 421.22 1,263.66 - 1.00 421.22 421.22 33% 842.44 67 5.00 EACH 501.46 2,507.30 - - - - 2,507.30 68 210.00 LF 24.07 5,054.70 - 102.00 2,455.14 2,455.14 49% 2,599.56 69 2.00 EACH 2,186.35 4,372.70 - 2.00 4,372.70 4,372.70 100% - 70 1.00 EACH 2,066.00 2,066.00 - 1.00 2,066.00 2,066.00 100% - 71 1.00 EACH 7,060.50 7,060.50 - - - - 7,060.50 72 253.00 LF 60.68 15,352.04 - - - - 15,352.04 73 227.00 LF 64.19 14,571.13 - 55.00 3,530.45 3,530.45 24% 11,040.68 74 33.00 LF 181.53 5,990.49 - - - - 5,990.49 75 3.00 EACH 3,149.14 9,447.42 - 1.00 3,149.14 3,149.14 33% 6,298.28 76 2.00 EACH 4,282.43 8,564.86 - - - - 8,564.86 77 1.00 EACH 11,112.26 11,112.26 - - - - 11,112.26 78 1.00 EACH 10,911.68 10,911.68 - - - - 10,911.68 79 1.00 EACH 2,707.86 2,707.86 - - - - 2,707.86 80 1.00 EACH 15,745.72 15,745.72 - 1.00 15,745.72 15,745.72 100% - 81 60.00 CY 130.38 7,822.80 - - - - 7,822.80 124,551.12 - 31,740.37 31,740.37 92,810.75 82 69.00 EACH 220.00 15,180.00 - 69.00 15,180.00 15,180.00 100% - 83 20.00 LF 24.07 481.40 - - - - 481.40 84 50.00 CY 45.13 2,256.50 - - - - 2,256.50 85 3,487.00 CY 21.72 75,737.64 - 2,179.00 47,327.88 47,327.88 62% 28,409.76 86 4,809.00 CY 11.42 54,918.78 - 3,819.00 43,612.98 43,612.98 79% 11,305.80 REMOVE FRAME AND RING CASTING (SANITARY)REMOVE SEWER PIPE (SANITARY)PART 2: SANITARY SEWERRECONSTRUCT SANITARY MANHOLE RECONSTRUCT MANHOLE BENCH & INVERTSCONNECT TO EXISITING WATERMAIN8" GATE VALVE & BOX W/ LOCKING LID AND MUD PLUG8" GATE VALVE & BOXCONNECT TO EXISTING SANITARY PIPECONNECT TO EXISTING SANITARY STRUCTURE8" PVC SANITARY SEWER, SDR 35NEW RINGS AND CASTING (SANITARY)SEAL MANHOLE (INFI-SHEILD)TOTAL PART 2: SANITARY SEWERPART 3: WATERMAINDIP FITTINGSREMOVE DRAINAGE STRUCTUREREMOVE PIPE APRONREMOVE STORM SEWER PIPE12" RC APRONADJUST GATE VALVE BOXHORIZONTAL WATERMAIN OFFSET8" WATERMAIN, C900 W/ TRACER WIRE12" WATERMAIN, DIP CL 52 INCL. POLY WRAP4" POLYSTYRENE NSULATIONPART 4: STORM SEWERTOTAL PART 3: WATERMAINCONSTRUCT DRAINAGE STRUCTURE DESIGN 2'X3'CONSTRUCT DRAINAGE STRUCTURE DESIGN 48-4022CONSTRUCT DRAINAGE STRUCTURE DESIGN 60-4022CONSTRUCT DRAINAGE STRUCTURE DESIGN 60-4020CONSTRUC DRAINAGE STRUCTURE DESIGN RAIN GUARDIAN15" RC APRON36" RC APRON12" RC PIPE SEWER CLASS V15" RC PIPE SEWER CLASS V36" RC PIPE SEWER CLASS IIIEXCAVATION - COMMONCOMMON EMBANKMENTCONSTRUCT DRAINAGE STRUCTURE DESIGN OCSRANDOM RIPRAP CLASS IIIGRUBBINGREMOVE SEWER PIPE (STORM)SALVAGE & REINSTALL RIPRAPTOTAL PART 4: STORM SEWERPART 5: SIDEWALKUnit PriceEJCDC C-620 Contractor's Application for Payment(c) 2018 National Society of Professional Engineers for EJCDC. All rights reserved.2 of 3DocuSign Envelope ID: D17A109B-F622-4608-ADEA-F18CC54657C6
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