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Contractor's Application for PaymentOwner's Project No.:Engineer's Project No.:Agency's Project No.:7 From11/01/23to 11/28/23A C 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)($)Progress Estimate - Unit Price WorkCity of Little CanadaBolton & Menk, Inc.OMG Midwest, Inc. Minnesota Paving & MaterialsTwin Lake Boulevard ImprovementsOwner:0N1.12537623-04Engineer:Contractor:Project:Contract:11/30/23B% of Value of Item (J / F)(%)Balance to Finish (F - J)($)DescriptionWork CompletedMaterials Currently Stored (not in G)($)Work Completed and Materials Stored to Date (H + I)($)Contract InformationBid Item No.Application Date:Application Period:Application No.:Previous Estimate1,664,371.72$ 1,665,148.41$ 1,741,010.96$ -$ 1,741,010.96$ 105% (76,639.24)$ 122 56.00 LF 214.50 12,012.00 56.00 12,012.00 56.00 12,012.00 12,012.00 100% - 123 1.00 LS 4,646.40 4,646.40 1.00 4,646.40 1.00 4,646.40 4,646.40 100% - 124 1.00 EACH 8,237.00 8,237.00 1.00 8,237.00 1.00 8,237.00 8,237.00 100% - 125 60.00 LF 105.60 6,336.00 60.00 6,336.00 60.00 6,336.00 6,336.00 100% - 126 3.00 EACH 2,100.00 6,300.00 3.00 6,300.00 3.00 6,300.00 6,300.00 100% - 127 914.00 LF 3.17 2,897.38 954.00 3,024.18 954.00 3,024.18 3,024.18 104% (126.80)128 309.00 LF 2.04 630.36 309.00 630.36 309.00 630.36 630.36 100% - 41,059.14$ 41,185.94$ 41,185.94$ -$ 41,185.94$ 100% (126.80)$ 1,705,430.86$ 1,706,334.35$ 1,782,196.90$ -$ 1,782,196.90$ 105% (76,766.04)$ PROJECT TOTALBASE BID + ALTERNATE 1 + CHANGE ORDER 1 + CHANGE ORDER 2PROJECT TOTALFLUSHING HYDRANTSEDIMENT CONTROL LOG WOOD FIBERCHANGE ORDER 2REMOVE AND REPLACE 29" SPAN RC PIPE-ARCHRECONSTRUCT SANITARY MANHOLE36” STORM JETTING AND TELEVISINGCONSTRUCTION ENTRANCESILT FENCECHANGE ORDER 2 TOTALUnit PriceEJCDC C-620 Contractor's Application for Payment(c) 2018 National Society of Professional Engineers for EJCDC. All rights reserved.4 of 4DocuSign Envelope ID: B31C83B0-1048-4B11-A7D0-B663BF480C36
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