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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 07/29/23 to 09/01/23 <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 />($) <br />Work <br />Completed <br />and Materials <br />Stored to Date <br />(H + I) <br />($) <br />Contract Information <br />Bid Item <br />No. <br />Application Date:Application Period:Application No.: <br />Previous Estimate <br />09/05/23 <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 />Progress Estimate - Unit Price Work <br />City of Little Canada <br />Bolton & Menk, Inc. <br />OMG Midwest, Inc. Minnesota Paving & Materials <br />Twin Lake Boulevard Improvements <br />Owner: <br />0N1.125376 <br />23-04 <br />Engineer: <br />Contractor: <br />Project: <br />Contract: <br />1,664,371.72$ 446,120.02$ 935,293.14$ -$ 935,293.14$ 56% 729,078.58$ <br />122 56.00 LF 214.50 12,012.00 - 56.00 12,012.00 12,012.00 100% - <br />123 1.00 LS 4,646.40 4,646.40 - 1.00 4,646.40 4,646.40 100% - <br />124 1.00 EACH 8,237.00 8,237.00 - 1.00 8,237.00 8,237.00 100% - <br />125 60.00 LF 105.60 6,336.00 - 60.00 6,336.00 6,336.00 100% - <br />126 3.00 EACH 2,100.00 6,300.00 - 3.00 6,300.00 6,300.00 100% - <br />127 914.00 LF 3.17 2,897.38 - 914.00 2,897.38 2,897.38 100% - <br />128 309.00 LF 2.04 630.36 - 309.00 630.36 630.36 100% - <br />41,059.14$ -$ 41,059.14$ -$ 41,059.14$ 100% -$ <br />1,705,430.86$ 446,120.02$ 976,352.28$ -$ 976,352.28$ 57% 729,078.58$ <br />BASE BID + ALTERNATE 1 + CHANGE ORDER 1 + CHANGE ORDER 2 <br />PROJECT TOTAL <br />FLUSHING HYDRANT <br />SEDIMENT CONTROL LOG WOOD FIBER <br />CHANGE ORDER 2 <br />REMOVE AND REPLACE 29" SPAN RC PIPE-ARCH <br />RECONSTRUCT SANITARY MANHOLE <br />36” STORM JETTING AND TELEVISING <br />CONSTRUCTION ENTRANCE <br />SILT FENCE <br />CHANGE ORDER 2 TOTAL <br />PROJECT TOTAL <br />BASE BID + ALTERNATE 1 + CHANGE ORDER 1 <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.4 of 4