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Contractor's Application for PaymentOwner's Project No.:Engineer's Project No.:Agency's Project No.:4 From08/01/25to 11/25/25A C D E F F1 F2 G H I J K L Item 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)($)Progress Estimate - Unit Price WorkCity of Little CanadaBolton & Menk, Inc.OMG Midwest, Inc. dba Minnesota Paving & Materials2025 Street ImprovementsOwner:24X.135772Engineer:Contractor:Project:Contract:Previous EstimateBalance to Finish (F - J)($)Materials Currently Stored (not in G)($)Work Completed and Materials Stored to Date (H + I)($)DescriptionWork CompletedContract InformationBid Item No.Application Date:Application Period:Application No.:01/05/26B% of Value of Item (J / F)(%)87 180.00 SY 24.54 4,417.20 675.00 16,564.50 675.00 16,564.50 16,564.50 375% (12,147.30)88 390.00 TON 108.00 42,120.00 381.38 41,189.04 381.38 41,189.04 41,189.04 98% 930.96 89 160.00 TON 116.56 18,649.60 207.73 24,213.01 207.73 24,213.01 24,213.01 130% (5,563.41)90 260.00 TON 104.26 27,107.60 234.05 24,402.05 234.05 24,402.05 24,402.05 90% 2,705.55 91 72.00 SF 15.04 1,082.88 81.00 1,218.24 81.00 1,218.24 1,218.24 113% (135.36)92 3.00 EA 150.42 451.26 4.00 601.68 4.00 601.68 601.68 133% (150.42)93 1,400.00 LF 0.90 1,260.00 1,400.00 1,260.00 1,400.00 1,260.00 1,260.00 100% - 94 18.00 EA 382.77 6,889.86 18.00 6,889.86 19.00 7,272.63 7,272.63 106% (382.77)95 204.00 EA 88.33 18,019.32 204.00 18,019.32 204.00 18,019.32 18,019.32 100% - 96 52.00 EA 261.95 13,621.40 52.00 13,621.40 52.00 13,621.40 13,621.40 100% - 97 1,070.00 CY 36.99 39,579.30 360.00 13,316.40 443.00 16,386.57 16,386.57 41% 23,192.73 98 3,020.00 SY 1.28 3,865.60 3,189.00 4,081.92 3,189.00 4,081.92 4,081.92 106% (216.32)99 501.00 SY 2.30 1,152.30 2,022.00 4,650.60 2,022.00 4,650.60 4,650.60 404% (3,498.30)100 987.00 SY 1.79 1,766.73 987.00 1,766.73 987.00 1,766.73 1,766.73 100% - 101 1,685.00 SY 1.59 2,679.15 1,092.00 1,736.28 1,092.00 1,736.28 1,736.28 65% 942.87 102 10.00 MGAL 281.28 2,812.80 - - - - - 2,812.80 103 1.00 EA 1,431.75 1,431.75 1.00 1,431.75 1.00 1,431.75 1,431.75 100% - 104 1.00 EA 1,107.79 1,107.79 1.00 1,107.79 1.00 1,107.79 1,107.79 100% - 105 4.00 EA 1,236.54 4,946.16 4.00 4,946.16 4.00 4,946.16 4,946.16 100% - 106 1.00 EA 4,977.54 4,977.54 1.00 4,977.54 1.00 4,977.54 4,977.54 100% - 107 230.00 LF 62.94 14,476.20 222.00 13,972.68 222.00 13,972.68 13,972.68 97% 503.52 108 136.00 LF 86.55 11,770.80 136.00 11,770.80 136.00 11,770.80 11,770.80 100% - 109 3.00 SF 150.42 451.26 4.99 751.26 4.99 751.26 751.26 166% (300.00)110 10.00 SY 79.76 797.60 - - 10.00 797.60 797.60 100% - 111 2.00 EA 202.04 404.08 - - 2.00 404.08 404.08 100% - 112 8.00 EA 134.69 1,077.52 8.00 1,077.52 8.00 1,077.52 1,077.52 100% - 490,417.84 466,907.14 506,517.38 506,517.38 103% (16,099.54)796,544.75$ 698,702.75$ 744,627.56$ -$ 744,627.56$ 93% 51,917.19$ PARKING LOT PATCHINGTYPE SP 9.5 WEARING COURSE MIXTURE (2,C) - TRAILTYPE SP 9.5 WEARING COURSE MIXTURE (3,C)#3 CONT. DECIDUOUS SHRUB4' HT. B&B CONIFEROUS SHRUBCOMMON TOPSOIL BORROWSEED MIX RT, FERTILIZER, HYDRAULIC MATRIX TYPE MULCHEMERGENT ZONE SEEDINGTYPE SP 12.5 WEARING COURSE MIXTURE (3,C)CONCRETE BENCH PADPAVEMENT MESSAGE - PAINT4" SOLID LINE PAINT6' HT. B&B CONIFEROUS TREEPART 5 - PARKS TOTAL15" RC APRON4' DIA STORM SEWER CBMH, INCL CSTG AND RINGS12" RC PIPE CLASS V15" RC PIPE CLASS VSIGN TYPE CTRANSITIONAL ZONE SEEDINGUPLAND ZONE SEEDINGAPPLICATION OF WATER FOR TURF ESTABLISHMENTCONNECT TO EXISTING PIPE12" RC APRONREMOVE AND REPLACE BITUMINOUS PAVEMENTPATCH DOGHOUSEPATCH LIFT HOLEBASE BID TOTALUnit PriceEJCDC C-620 Contractor's Application for Payment(c) 2018 National Society of Professional Engineers for EJCDC. All rights reserved.3 of 4Docusign Envelope ID: F16BAAF5-ECAA-45D9-BB74-D748A6D16A7F
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