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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 />1 From 05/01/24 to 05/31/24 <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 />($)Description <br />Work Completed <br />Materials Currently <br />Stored (not in G) <br />($) <br />Progress Estimate - Unit Price Work <br />City of Little Canada <br />Bolton & Menk, Inc. <br />Miller Excavating, Inc. <br />2024 Street Improvements <br />Owner: <br />200-101-012 <br />0N1.125375 <br />24-PW42 <br />Engineer: <br />Contractor: <br />Project: <br />Contract: <br />Previous Estimate <br />06/03/24 <br />B <br />% of <br />Value of <br />Item <br /> (J / F) <br />(%) <br />Balance to Finish <br />(F - J) <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 />141,942.79$ -$ 15,445.50$ -$ 15,445.50$ 11% 126,497.29$ <br />1,223,880.39$ -$ 118,941.17$ 118,941.17$ 10% 1,104,939.22$ <br />CHANGE ORDERS TOTAL: <br />PROJECT TOTAL: <br />BASE BID + ALTERNATAE + CHANAGE ORDERS <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 <br />DocuSign Envelope ID: D4F0E498-3363-4DA9-9CFD-AF26210A7479