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Contractor's Application for Payment <br />Owner's Project No.: <br />Engineer's Project No.: <br />Agency's Project No.: <br />3 From 07/01/23 to 07/31/23 <br />A C D E F F1 F2 G H I J K L <br />Item Quantity Units <br />Unit Price <br />($) <br />Value of Bid Item <br />(C X E) <br />($) <br />Quantity Previous <br />Estimate <br />Value Previous <br />Estimate <br />Estimated <br />Quantity <br />Incorporated in <br />the Work <br />Value of Work <br />Completed to Date <br />(E X G) <br />($) <br />Contract Information <br />Bid Item <br />No. <br />Application Date:Application Period:Application No.: <br />Engineer: <br />Contractor: <br />Project: <br />Contract: <br />Previous Estimate <br />07/31/23 <br />B <br />% of <br />Value of <br />Item <br /> (J / F) <br />(%) <br />Balance to Finish <br />(F - J) <br />($)Description <br />Work Completed <br />Materials Currently <br />Stored (not in G) <br />($) <br />Work <br />Completed <br />and Materials <br />Stored to Date <br />(H + I) <br />($) <br />Progress Estimate - Unit Price Work <br />City of Little Canada <br />Bolton & Menk, Inc. <br />OMG Midwest, Inc. dba. Minnesota Paving & Materials <br />2023 Street Improvements <br />Owner: <br />0N1.127995 <br />23-01, 23-02, 23-03, 23-05 <br />46 2.00 EACH 972.79 1,945.58 1.00 972.79 8.00 7,782.32 7,782.32 400% (5,836.74) <br />47 1.00 EACH 581.67 581.67 - - - - - 581.67 <br />48 1.00 EACH 1,955.60 1,955.60 - - 1.00 1,955.60 1,955.60 100% - <br />49 3.00 EACH 1,604.59 4,813.77 - - - - - 4,813.77 <br />50 1.00 EACH 170.49 170.49 - - 10.00 1,704.90 1,704.90 1000% (1,534.41) <br />51 2.00 EACH 280.80 561.60 - - - - - 561.60 <br />52 2.00 EACH 451.29 902.58 1.00 451.29 1.00 451.29 451.29 50% 451.29 <br />53 1.00 EACH 53,000.00 53,000.00 0.43 22,910.00 0.43 22,910.00 22,910.00 43% 30,090.00 <br /> 65,736.45 26,740.96 37,210.99 37,210.99 57% 28,525.46 <br />54 2.00 EACH 280.80 561.60 - - 2.00 561.60 561.60 100% - <br />55 7.00 EACH 3,941.29 27,589.03 8.60 33,895.09 8.60 33,895.09 33,895.09 123% (6,306.06) <br />56 8.00 EACH 3,289.42 26,315.36 8.92 29,341.63 8.92 29,341.63 29,341.63 112% (3,026.27) <br />57 14.00 EACH 3,259.33 45,630.62 14.00 45,630.62 14.00 45,630.62 45,630.62 100% - <br />58 12.00 EACH 270.37 3,244.44 14.00 3,785.18 14.00 3,785.18 3,785.18 117% (540.74) <br /> 103,341.05 112,652.52 113,214.12 113,214.12 110% (9,873.07) <br />59 9.00 EACH 300.86 2,707.74 2.00 601.72 2.00 601.72 601.72 22% 2,106.02 <br />60 75.00 LF 36.05 2,703.75 75.00 2,703.75 75.00 2,703.75 2,703.75 100% - <br />61 2.00 EACH 451.29 902.58 2.41 1,087.61 2.41 1,087.61 1,087.61 121% (185.03) <br />62 48.00 LF 441.26 21,180.48 48.00 21,180.48 48.00 21,180.48 21,180.48 100% - <br />63 30.00 LF 122.35 3,670.50 24.00 2,936.40 24.00 2,936.40 2,936.40 80% 734.10 <br />64 4.00 LF 787.25 3,149.00 - - - - - 3,149.00 <br />65 5.00 EACH 982.81 4,914.05 1.00 982.81 3.00 2,948.43 2,948.43 60% 1,965.62 <br />66 4.00 EACH 351.01 1,404.04 6.00 2,106.06 6.00 2,106.06 2,106.06 150% (702.02) <br />67 4.00 EACH 832.38 3,329.52 5.00 4,161.90 5.00 4,161.90 4,161.90 125% (832.38) <br />68 1.00 EACH 270.78 270.78 - - - - - 270.78 <br />69 1.00 EACH 511.46 511.46 1.00 511.46 1.00 511.46 511.46 100% - <br />70 1.00 EACH 2,457.04 2,457.04 1.00 2,457.04 1.00 2,457.04 2,457.04 100% - <br />71 3.00 EACH 1,900.00 5,700.00 3.00 5,700.00 3.00 5,700.00 5,700.00 100% - <br />72 15.00 CY 175.50 2,632.50 13.81 2,423.66 13.81 2,423.66 2,423.66 92% 208.84 <br /> 55,533.44 46,852.88 48,818.51 48,818.51 88% 6,714.93 <br /> - <br />833,102.17$ 464,272.49$ 783,645.24$ -$ 783,645.24$ 94% 49,456.93$ TOTAL BASE BID <br />TOTAL PART 2: SANITARY SEWER <br />PART 3: WATERMAIN <br />TOTAL PART 3: WATERMAIN <br />PART 4: STORM SEWER <br />TOTAL PART 4: STORM SEWER <br />NEW RINGS AND CASTING (SANITARY) <br />ADJUST FRAME AND RING CASTING <br />RECONSTRUCT SANITARY STRUCTURE <br />CONNECT TO EXISTING SANITARY SEWER <br />REMOVE AND REPLACE HYDRANT & VALVE BOLTS <br />REMOVE AND REPLACE GATE VALVE BOLTS <br />REMOVE AND REPLACE FITTING BOLTS <br />REMOVE & REPLACE GATE VALVE BOX <br />REMOVE CASTING & RINGS (STORM) <br />CHIMNEY SEAL (INFI-SHIELD) <br />PATCH DOGHOUSE (SANITARY) <br />PATCH INVERT (SANITARY) <br />5' DIA SANITARY MANHOLE W/ OUTSIDE DROP - SAN-7 <br />ADJUST GATE VALVE BOX <br />CONNECT TO EXISITNG DRAINAGE STRUCTURE <br />CLEAN FLARED END OUTLET <br />RANDOM RIP RAP CLASS lll <br />NEW RINGS AND CASTING (STORM) <br />PATCH DOGHOUSE (STORM) <br />PATCH INVERT (STORM) <br />REPAIR STEP (STORM) <br />ADJUST CASTING (STORM) <br />SWALE REGRADING <br />58" SPAN RC PIPE-ARCH APRON WITH TRASH GUARD <br />58"X36" ARCH RCP <br />24" RC PIPE SEWER CLASS III <br />2'X3' CB RING SEAL (FLEX-SEAL) <br />Unit Price <br />EJCDC C-620 Contractor's Application for Payment <br />(c) 2018 National Society of Professional Engineers for EJCDC. All rights reserved.2 of 2 <br />DocuSign Envelope ID: C994DA10-F5B2-401B-A955-E395C1A77BBC