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EJCDC C-620 Contractor's Application for Payment <br />(c) 2018 National Society of Professional Engineers for EJCDC. All rights reserved. <br />Contractor's Application for Payment <br />Owner:City of Little Canada Owner's Project No.:24-PW42 <br />Engineer:Bolton & Menk, Inc.Engineer's Project No.:0N1.125375 <br />Contractor:Miller Excavating, Inc.Agency's Project No.:200-101-012 <br />Project:2024 Street Improvements <br />Contract: <br />Application No.:3 Application Date:8/7/2024 <br />Application Period:From 7/1/2024 to 7/31/2024 <br />1.Original Contract Price $1,081,937.60 <br />2.Net change by Change Orders $141,942.79 <br />3.Current Contract Price (Line 1 + Line 2)$1,223,880.39 <br />4.Total Work completed and materials stored to date <br />(Sum of Column G Lump Sum Total and Column J Unit Price Total)$949,376.75 <br />5.Retainage <br />a.5%X $949,376.75 Work Completed $47,468.84 <br />b.X $-Stored Materials $- <br />c.Total Retainage (Line 5.a + Line 5.b)$47,468.84 <br />6.Amount eligible to date (Line 4 - Line 5.c)$901,907.91 <br />7.Less previous payments $414,858.79 <br />8.Amount due this application $487,049.12 <br />9.Balance to finish, including retainage (Line 3 - Line 4)$274,503.64 <br />Contractor's Certification <br />The undersigned Contractor certifies, to the best of its knowledge, the following: <br />(1) All previous progress payments received from Owner on account of Work done under the Contract have been applied on account to <br />discharge Contractor's legitimate obligations incurred in connection with the Work covered by prior Applications for Payment; <br />(2) Title to all Work, materials and equipment incorporated in said Work, or otherwise listed in or covered by this Application for <br />Payment, will pass to Owner at time of payment free and clear of all liens, security interests, and encumbrances (except such as are <br />covered by a bond acceptable to Owner indemnifying Owner against any such liens, security interest, or encumbrances); and <br />(3) All the Work covered by this Application for Payment is in accordance with the Contract Documents and is not defective. <br />Contractor:Miller Excavating, Inc. <br />Signature:Date: <br />Name:Title: <br />Recommended by Bolton & Menk, Inc.Approved by City of Little Canada <br />By:By: <br />Name:Name: <br />Title:Title: <br />Date:Date: <br />Docusign Envelope ID: 25F6242A-B841-4DB8-A5B6-214BB7916E4D <br />Controller <br />August 7, 2024 <br />Mindy Hackett <br />Eric Seaburg <br />August 7, 2024 <br />Principal Engineer <br />August 7, 2024 <br />Bill Dircks <br />Public Works Director