HomeMy WebLinkAbout#07 - CH-PW Pay requestSTAFF REPORT
DATE: May 16, 2023
CONSENT
AGENDA ITEM: City Center-Public Works Addition Pay Request #16
SUBMITTED BY: Kristina Handt, City Administrator
BACKGROUND: At the November 3, 2021 meeting, Council awarded bids for the new city center and public works addition. Also established at that time was Guaranteed Maximum Price (GMP) with H+U for construction costs. The GMP was $13,402,788. ISSUE BEFORE COUNCIL: Should Council approve Pay Request #16 for the City Center and Public Works Addition project? PROPOSAL: Pay request #16 is for $686,643.35. A copy is included in your packet.
FISCAL IMPACT: With this pay request, the project remains within budget. OPTION: 1) Approve pay request #16
2) Don’t approve pay request #16 RECOMMENDATION: “Motion to approve Pay Request #16 for the New City Center and Public Works Addition.” ATTACHMENTS:
• Pay Request #16
APPLICATION AND CERTIFICATE FOR PAYMENTTO (OWNER): PROJECT:LAKE ELMO CITY HALL, FIRE DEPARTMENT APPLICATION NO: 16Distribution to:City of Lake Elmo & PUBLIC WORKS FACILITIES REMODELXOWNER3880 Laverne Ave N PERIOD TO:4/30/2023Lake Elmo, MN 55042ARCHITECT FROM (CM): OVERALLCONST. MANAGERHOFFMANN + UHLHORN CONSTRUCTION, INC.5555 W 78TH ST, SUITE AXFILEMINNEAPOLIS, MN 55439CONTRACT DATE:APPLICATION FOR PAYMENTApplication is made for Payment, as shown below,CHANGE ORDER SUMMARYContinuation Sheet, AIA Document G703, is attached.Change Orders Approved inADDITIONSDEDUCTIONS1. COMMITTED COST$13,402,788.00previous months by Owner2. Net Change by Change Orders$0.00TOTAL$0.00$0.003. SUM TO DATE (Line 1+2)$13,402,788.00Approved this Month4. TOTAL COMPLETED & STORED TO DATE $11,531,409.77NumberDate Approved (Column G on G703) 5. RETAINAGE:$0.00$0.00 a. _5_ % of Completed Work$576,570.57 (Column D+E on G703) b. ___ % of Stored Material$0.00 (Column F on G703)Total Retainage (Line 5a + 5b or Total in Column I of G703)$576,570.57TOTALS$0.00$0.006. TOTAL EARNED LESS RETAINAGE$10,954,839.20Net change by Change Orders$0.00 (Line 4 less Line 5 Total)The undersigned Construction Manager certifies that to the best of his 7. LESS PREVIOUS CERTIFICATES FORknowledge, information and belief the Work covered by this Application for PAYMENT (Line 6 from prior Certificate)$10,268,195.85Payment has been completed in accordance with the Contract Documents, 8. CURRENT PAYMENT DUE$686,643.35and that current payments shown herein are now due.9. BALANCE TO FINISH, PLUS RETAINAGE $2,447,948.80 (Line 3 less Line 6)CONSTRUCTION MANAGER:HOFFMANN + UHLHORN CONSTRUCTION, INC.State of: MINNESOTACounty of:Anoka County Subscribed and sworn to before me this 5/9/2023Notary Public:By:Date:5/9/2023My Commission expires:31-Jan-28ARCHITECT'S CERTIFICATE FOR PAYMENTAMOUNT CERTIFIED$In Accordance with the Contract Documents, based on on-site observations and the(Attach explaination if amount certified differs from the amount applied for).data comprising the above application, the Architect certifies to the Owner that to theARCHITECT:best of the Architect's knowledge, information and belief the Work has progressed asindicated, the quality of the Work is in accordance with the Contract Documents, andBy:Date:the Contractors are entitled to payment of the Amounts Certified.WASHINGTON COUNTY SHERRIFF SUBSTATION2023-05-09
CITY OF LAKE ELMO - OVERALLAPPLIC. FOR PAYMENT NO.#16H+U CONSTRUCTION EDITION OF AIA DOCUMENT G703PERIOD ENDING 4/30/2023 AIA Document G723,APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification is attached.In tabulations below, amounts are stated to the nearest dollar. ABCDEF GHITEMDESCRIPTION OF WORKSCHEDULEDCHANGEREVISED WORK COMPLETEDTOTAL%BALANCERETAINAGENO.VALUEORDERSSCHEDULEFROMTHIS PERIODCOMPLETED(F/C)TO FINISHVALUEPREV. APPL.AND STORED(C-F)(A+B) TO DATE (D+E)InsuranceBuilders Risk Insurance25,000.000.0025,000.0021,204.000.0021,204.0085%3,796.001,060.200Payment and Performance Bond127,464.000.00127,464.00127,424.000.00127,424.00100%40.006,371.201General Conditions243,080.00(40,781.25)202,298.75163,393.846,784.82170,178.6684%32,120.098,508.93ReimburseConstruction Management Reimbursables488,555.0040,781.25529,336.25496,630.0032,706.25529,336.25100%0.0026,466.81FeeConstruction Management Fee82,595.000.0082,595.0069,802.364,667.7574,470.1190%8,124.893,723.51TrailerTemporary City Office Trailer53,170.000.0053,170.0050,665.942,458.8953,124.83100%45.172,656.24ContingencyConstruction Contingency588,330.00(636,068.00)(47,738.00)0.000.000.000%(47,738.00)0.00TestingTesting & Special Inspections28,000.000.0028,000.000.000.000.000%28,000.000.00#0330Cast-In-Place Concrete668,316.0056,740.00725,056.00707,706.000.00707,706.0098%17,350.0035,385.30#0341Strutctural Precast1,755,999.00580.001,756,579.001,750,054.006,525.001,756,579.00100%0.0087,828.95#0510Steel Erection93,400.0015,196.00108,596.0099,000.006,000.00105,000.0097%3,596.005,250.00#0512Steel Supply485,000.0074,767.00559,767.00532,944.6026,822.40559,767.00100%0.0027,988.35#0610Carpentry & GC1,027,000.0027,818.001,054,818.00639,927.70181,224.70821,152.4078%233,665.6041,057.62#0750Roofing & Metal Panels1,113,300.00(59,665.00)1,053,635.00784,356.00133,172.37917,528.3787%136,106.6345,876.42#0790Caulking & Firestopping72,350.007,545.0079,895.0014,690.0023,028.5037,718.5047%42,176.501,885.93#0810Doors, Frames, Hardware - Supply171,697.0026,533.00198,230.0074,764.74114,297.83189,062.5795%9,167.439,453.13#0833Coiling & Sectional Doors350,000.00(28,970.00)321,030.00321,030.000.00321,030.00100%0.0016,051.50#0840Aluminum Storefronts & Curtainwall400,410.00147,119.00547,529.00525,754.0010,295.00536,049.0098%11,480.0026,802.45#0920Drywall & Fireproofing543,770.0052,455.00596,225.00520,183.507,486.82527,670.3289%68,554.6826,383.52#0930Tile154,980.000.00154,980.0081,490.0038,750.00120,240.0078%34,740.006,012.00#0950Acoustical Ceilings & Panels126,000.000.00126,000.0060,000.0053,000.00113,000.0090%13,000.005,650.00#0965Resilient Flooring & Carpet131,940.00275.00132,215.00111,340.1012,672.90124,013.0094%8,202.006,200.65#0990Painting and Wallcovering157,727.00670.00158,397.0092,823.0028,190.00121,013.0076%37,384.006,050.65#1420Conveying Equipment82,000.000.0082,000.0021,577.000.0021,577.0026%60,423.001,078.85#2100Fire Protection112,915.000.00112,915.00110,765.000.00110,765.0098%2,150.005,538.25#2200Plumbing & Heating854,000.0057,999.00911,999.00873,283.260.00873,283.2696%38,715.7443,664.16#2300HVAC & Controls962,000.00159,675.001,121,675.001,048,206.7530,139.251,078,346.0096%43,329.0053,917.30#2600Electrical1,454,170.0077,660.001,531,830.00955,495.000.00955,495.0062%576,335.0047,774.75#3100Earthwork & Site Utilities575,790.0021,220.00597,010.00539,627.500.00539,627.5090%57,382.5026,981.38#3210Asphalt Paving317,200.00(1,549.00)315,651.0014,489.004,560.0019,049.006%296,602.00952.45#3290Landscaping & Fencing144,630.000.00144,630.000.000.000.000%144,630.000.00#TBDHoist12,000.000.0012,000.000.000.000.000%12,000.000.00TOTAL CONTRACT AMOUNTS13,402,788.000.0013,402,788.0010,808,627.29722,782.4811,531,409.7786%1,871,378.23576,570.57
APPLICATION AND CERTIFICATE FOR PAYMENTTO (OWNER): PROJECT:LAKE ELMO CITY HALL, FIRE DEPARTMENT APPLICATION NO: 16Distribution to:City of Lake Elmo & PUBLIC WORKS FACILITIES REMODELXOWNER3880 Laverne Ave N PERIOD TO:4/30/2023Lake Elmo, MN 55042ARCHITECT FROM (CM): LABORCONST. MANAGERHOFFMANN + UHLHORN CONSTRUCTION, INC.5555 W 78TH ST, SUITE AXFILEMINNEAPOLIS, MN 55439CONTRACT DATE:APPLICATION FOR PAYMENTApplication is made for Payment, as shown below,CHANGE ORDER SUMMARYContinuation Sheet, AIA Document G703, is attached.Change Orders Approved inADDITIONSDEDUCTIONS1. COMMITTED COST$6,492,541.00previous months by Owner2. Net Change by Change Orders$0.00TOTAL$0.00$0.003. SUM TO DATE (Line 1+2)$6,492,541.00Approved this Month4. TOTAL COMPLETED & STORED TO DATE $4,792,286.62NumberDate Approved (Column G on G703) 5. RETAINAGE:$0.00$0.00 a. _5_ % of Completed Work$239,614.39 (Column D+E on G703) b. ___ % of Stored Material$0.00 (Column F on G703)Total Retainage (Line 5a + 5b or Total in Column I of G703)$239,614.39TOTALS$0.00$0.006. TOTAL EARNED LESS RETAINAGE$4,552,672.23Net change by Change Orders$0.00 (Line 4 less Line 5 Total)The undersigned Construction Manager certifies that to the best of his 7. LESS PREVIOUS CERTIFICATES FORknowledge, information and belief the Work covered by this Application for PAYMENT (Line 6 from prior Certificate)$4,270,543.38Payment has been completed in accordance with the Contract Documents, 8. CURRENT PAYMENT DUE$282,128.85and that current payments shown herein are now due.9. BALANCE TO FINISH, PLUS RETAINAGE $1,939,868.77 (Line 3 less Line 6)CONSTRUCTION MANAGER:HOFFMANN + UHLHORN CONSTRUCTION, INC.State of: MINNESOTACounty of:Anoka County Subscribed and sworn to before me this 5/9/2023Notary Public:By:Date:5/9/2023My Commission expires:31-Jan-28ARCHITECT'S CERTIFICATE FOR PAYMENTAMOUNT CERTIFIED$In Accordance with the Contract Documents, based on on-site observations and the(Attach explaination if amount certified differs from the amount applied for).data comprising the above application, the Architect certifies to the Owner that to theARCHITECT:best of the Architect's knowledge, information and belief the Work has progressed asindicated, the quality of the Work is in accordance with the Contract Documents, andBy:Date:the Contractors are entitled to payment of the Amounts Certified.WASHINGTON COUNTY SHERRIFF SUBSTATION2023-05-09
CITY OF LAKE ELMO - LABOR & GENERAL CONDITIONSAPPLIC. FOR PAYMENT NO.#16H+U CONSTRUCTION EDITION OF AIA DOCUMENT G703PERIOD ENDING 4/30/2023 AIA Document G723,APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification is attached.In tabulations below, amounts are stated to the nearest dollar. ABCDEF GHITEMDESCRIPTION OF WORKSCHEDULEDCHANGEREVISED WORK COMPLETEDTOTAL%BALANCERETAINAGENO.VALUEORDERSSCHEDULEFROMTHIS PERIODCOMPLETED(F/C)TO FINISHVALUEPREV. APPL.AND STORED(C-F)(A+B) TO DATE (D+E)InsuranceBuilders Risk Insurance25,000.000.0025,000.0021,204.000.0021,204.0085%3,796.001,060.200Payment and Performance Bond127,464.000.00127,464.00127,424.000.00127,424.00100%40.006,371.201General Conditions243,080.00(40,781.25)202,298.75163,393.846,784.82170,178.6684%32,120.098,508.93ReimburseConstruction Management Reimbursables488,555.0040,781.25529,336.25496,630.0032,706.25529,336.25100%0.0026,466.81FeeConstruction Management Fee82,595.000.0082,595.0069,802.364,667.7574,470.1190%8,124.893,723.51TrailerTemporary City Office Trailer53,170.000.0053,170.0050,665.942,458.8953,124.83100%45.172,656.24ContingencyConstruction Contingency588,330.00(636,068.00)(47,738.00)0.000.000.000%(47,738.00)0.00TestingTesting & Special Inspections28,000.000.0028,000.000.000.000.000%28,000.000.00#0330Cast-In-Place Concrete428,316.0032,818.00461,134.00451,284.000.00451,284.0098%9,850.0022,564.20#0341Strutctural Precast333,704.000.00333,704.00327,179.006,525.00333,704.00100%0.0016,685.20#0510Steel Erection93,400.0015,196.00108,596.0099,000.006,000.00105,000.0097%3,596.005,250.00#0610Carpentry & GC459,000.006,684.00465,684.00304,843.0542,841.80347,684.8575%117,999.1517,384.24#0750Roofing & Metal Panels614,800.00(31,650.00)583,150.00438,466.0055,838.25494,304.2585%88,845.7524,715.21#0790Caulking & Firestopping54,050.004,324.0058,374.0013,110.0014,052.0027,162.0047%31,212.001,358.10#0833Coiling & Sectional Doors175,000.00(143,500.00)31,500.0031,500.000.0031,500.00100%0.001,575.00#0840Aluminum Storefronts & Curtainwall78,450.0047,704.00126,154.00116,259.003,235.00119,494.0095%6,660.005,974.70#0920Drywall & Fireproofing314,360.0031,715.00346,075.00295,476.005,625.82301,101.8287%44,973.1815,055.09#0930Tile86,880.000.0086,880.0030,410.0021,730.0052,140.0060%34,740.002,607.00#0950Acoustical Ceilings & Panels51,000.000.0051,000.0015,000.0033,000.0048,000.0094%3,000.002,400.00#0965Resilient Flooring & Carpet41,010.000.0041,010.0020,135.1012,672.9032,808.0080%8,202.001,640.40#0990Painting and Wallcovering128,196.00558.00128,754.0070,405.0024,200.0094,605.0073%34,149.004,730.25#1420Conveying Equipment35,260.000.0035,260.000.000.000.000%35,260.000.00#2100Fire Protection55,395.000.0055,395.0053,245.000.0053,245.0096%2,150.002,662.25#2200Plumbing & Heating363,000.0041,624.00404,624.00386,399.350.00386,399.3595%18,224.6519,319.97#2300HVAC & Controls300,000.0016,250.00316,250.00262,281.7524,639.25286,921.0091%29,329.0014,346.05#2600Electrical646,070.0024,446.00670,516.00307,745.000.00307,745.0046%362,771.0015,387.25#3100Earthwork & Site Utilities366,400.0018,676.00385,076.00341,858.500.00341,858.5089%43,217.5017,092.93#3210Asphalt Paving136,566.000.00136,566.001,592.000.001,592.001%134,974.0079.60#3290Landscaping & Fencing83,490.000.0083,490.000.000.000.000%83,490.000.00#TBDHoist12,000.000.0012,000.000.000.000.000%12,000.000.00TOTAL CONTRACT AMOUNTS6,492,541.000.005,921,318.004,495,308.89296,977.734,792,286.6281%1,129,031.38239,614.39
INVOICE SUMMARY-PAYMENT APPLICATION NO. #16CITY OF LAKE ELMO - LABOR & GENERAL CONDITIONSPERIOD ENDING 4/30/2023ITEM NO# DESCRIPTION VENDORDATENUMBERAMOUNTRETAINAGEDUE1General ConditionsH+U Construction4/30/23Applic #16$6,784.82$339.24$6,445.58ReimburseConstruction Management ReimbursablesH+U Construction4/30/23Applic #16$32,706.25$1,635.31$31,070.94FeeConstruction Management FeeH+U Construction4/30/23Applic #16$4,667.75$233.39$4,434.36TrailerTemporary City Office TrailerH+U Construction4/30/23Applic #14$2,458.89$122.94$2,335.95#0341Strutctural PrecastWells Concrete4/30/23Applic #6$6,525.00$326.25$6,198.75#0510Steel ErectionA.M.E. Construction Corp4/30/23Applic #7$6,000.00$300.00$5,700.00#0610Carpentry & GCEbert Construction4/30/23Applic #16$42,841.80$2,142.09$40,699.71#0750Roofing & Metal PanelsPalmer West Construction4/30/23Applic #4$55,838.25$2,791.91$53,046.34#0790Caulking & FirestoppingCarciofini Company4/30/23Applic #3$14,052.00$702.60$13,349.40#0840Aluminum Storefronts & CurtainwallEmpirehouse, Inc.4/30/23Applic #10$3,235.00$161.75$3,073.25#0920Drywall & FireproofingCommercial Drywall4/30/23Applic #13$5,625.82$281.29$5,344.53#0930TileAdvanced Terrazzo & Tile4/30/23Applic #3$21,730.00$1,086.50$20,643.50#0950Acoustical Ceilings & PanelsAcoustics Associates4/30/23Applic #2$33,000.00$1,650.00$31,350.00#0965Resilient Flooring & CarpetCommerical Flooring4/30/23Applic #2$12,672.90$633.65$12,039.25#0990Painting and WallcoveringSteinbrecher Painting Company4/30/23Applic #4$24,200.00$1,210.00$22,990.00#2300HVAC & ControlsSt. Cloud Refrigeration4/30/23Applic #9$24,639.25$1,231.96$23,407.29SUBTOTAL AMOUNT DUE$296,977.73$14,848.88$282,128.85 TOTAL AMOUNT DUE $282,128.85
INVOICE : 230109
PROJECT: J21001
APRIL 30, 2023
PAGE 1 OF 2
TO:CITY OF LAKE ELMO
3880 Laverne Ave N
Lake Elmo, MN 55042
ATTN:ACCOUNTING
RE:LAKE ELMO CITY CENTER &
LAKE ELMO PUBLIC WORKS ADDITION
Invoice for Construction Management services performed during the month of April, 2023
CONSTRUCTION MANAGEMENT REIMBURSABLES
Senior Project Manager 43.50 hrs. @ 125.00 $5,437.50
Project Manager 44.00 hrs. @ 105.00 $4,620.00
Project Administrator/Accountant 5.75 hrs. @ 65.00 $373.75
Project Superintendent 195.00 hrs. @ 105.00 $20,475.00
Truck, Travel, & Small Tools 1 mo. @ 1,400.00 $1,400.00
Field Office Equipment 1 mo. @ 400.00 $400.00
$32,706.25
GENERAL CONDITIONS
Temporary City Office Trailer $2,458.89
Plan Prints/Shipping $68.80
Expendable Supplies $1,136.44
Drinking Water $52.22
Temporary Toilets $489.64
Safety & OSHA $1,006.33
Xcel Energy - Utility Service $296.66
Trash Removal $414.00
Trailer $675.00
Skid Steer $2,645.73
$9,243.71
$41,949.96
Subtotal Construction Management Reimbursables
Subtotal General Conditions
Total
INVOICE : 230109
PROJECT: J21001
APRIL 30, 2023
PAGE 2 OF 2
TO:CITY OF LAKE ELMO
3880 Laverne Ave N
Lake Elmo, MN 55042
ATTN:ACCOUNTING
RE:LAKE ELMO CITY CENTER &
LAKE ELMO PUBLIC WORKS ADDITION
Contractor's Pay Applications April 30, 2023
#0341-Labor Wells Concrete $6,525.00
#0510-Labor A.M.E. Construction Corp $6,000.00
#0512-Material Construction Systems, Inc.$26,822.40
#0610-Labor Ebert Construction $42,841.80
#0610-Material Ebert Construction $138,382.90
#0750-Labor Palmer-West Construction $55,838.25
#0750-Material Palmer-West Construction $77,334.12
#0790-Labor Carciofini Company $14,052.00
#0790-Material Carciofini Company $8,976.50
#0810-Material Twin City Hardware Company $114,297.83
#0840-Labor Empirehouse Inc.$3,235.00
#0840-Material Empirehouse Inc.$7,060.00
#0920-Labor Commercial Drywall, Inc.$5,625.82
#0920-Material Commercial Drywall, Inc.$1,861.00
#0930-Labor Advanced Terrazzo & Tile Co.$21,730.00
#0930-Material Advanced Terrazzo & Tile Co.$17,020.00
#0950-Labor Acoustic Associates, Inc.$33,000.00
#0950-Material Acoustic Associates, Inc.$20,000.00
#0965-Labor Commercial Flooring Services $12,672.90
#0990-Labor Steinbrecher Painting Company $24,200.00
#0990-Material Steinbrecher Painting Company $3,990.00
#2300-Labor St.Cloud Refrigeration, Inc.$24,639.25
#2300-Material St.Cloud Refrigeration, Inc.$5,500.00
#3210-Material Ebert Construction $4,560.00
$676,164.77
$4,667.75
$722,782.48
Retainage
Current Retainge 36,139.12
Prior Retainage 540,431.45
Retainage-To-Date 576,570.57
Total Amount Due $686,643.35
CONSTRUCTION MANAGEMENT FEE
Total Contractor's Pay Applications April 1 - April 30
Total Before Retainage
Customer No.
C51148
H U Construction
5555 W78th St
Suite A
Minneapolis, MN 55439
Bill to:Ship to:City of Lake Elmo
24x60 Doublewide Office s/n 15809A/10B
Gabe 651-395-0055
3800 Laverne Ave. North
Lake Elmo, MN 55042
Satellite Quote No.
RC520567
Contract No
Matt Lawellin
Salesperson
05/11/2023
Due Date Customer PO No.
RQ152297 Lake Elmo DW Trailer
Invoice No.:
Invoice Date:04/11/2023
INV656042
Tracy DickensonA/R Account Rep:
PO Box 860700
Minneapolis, MN 55486-0700
Phone: (763) 553-1900
Rental Insurance Status:NO INS
No.Description Serial No.
Rental
From Date
Rental
To Date Qty.Unit Price Amount
Customer Project RC520567 0 0.00 0.00
FA204334 24x60 Doublewide Office w/RR s/n 15809A/10B 15809A/10B 04/11/23 05/08/23 1 2,000.00 2,000.00
RR not utilized no need to winterize.
STEPS Steps - Rental 04/11/23 05/08/23 2 45.00 90.00
44130 Damage Waiver Chg - No Insurance on File 1 200.00 200.00
Subtotal:2,290.00
Tax:168.89
Total:2,458.89
Thank You For Your Business!
20050 75th Ave N
Hamel, MN 55340-9459
Phone No.: 763-420-2001
Fax No.: 763-420-2034
Satellite Shelters, Inc - Minneapolis
InvoiceSatellite Shelters, Inc - Minneapolis
Lockbox Remit to address:Page 1 of 1
ARC DOCUMENT SOLUTIONS LLC
4730 PARK GLEN RD
SAINT LOUIS PARK MN 55416-5701 54MNI90586864/14/2023
INVOICEDATE
Page 1/1
5555 WEST 78TH STREET
SUITE AMINNEAPOLIS, MN 55439
P: (952) 837-3309
F: (952) 831-1268
H+U CONSTRUCTION
BILL TO:SHIP TO:
Lisa Knox
5555 WEST 78TH STREETSUITE A
MINNEAPOLIS, MN 55439
P: (952) 837-3309F: (952) 831-1268
H+U CONSTRUCTION
54MNO90535184/13/2023NET30ARC DELIVERY1016013PR 12
OrderOrder Due DatePayment TermsShipping MethodCustomer IDPurchase Order #
Lake ElmoJ21001Lisa Knox
Project NameProject NumberOrdered By
Extended
PricePriceDescriptionItem NumberUOM
Quantity
BO
Quantity
Shipped
Quantity
Ordered
1 set of 21 (30.00x42.00)
$20.77$0.10989Bond Prints - First Set1600SQFT0.00189.00189.00
1 set of 1
$1.93$1.92918Stapling Sets1624EACH011
$35.00$35.00Supply / Delivery Charge5201EACH011
$5.00$5.00Energy / Fuel Surcharge5205EACH011
$67.74Total Due
Amount Received
$67.74Total
$0.00Trade Discount
$0.00Freight
$5.04Tax
$0.00Misc
$62.70SubtotaltronneiBiller:
$67.744/14/202354MNI90586861016013
AMOUNT DUEDOC DATEINVOICECUSTOMER NO
ARC DOCUMENT SOLUTIONS LLC
NEW REMIT TO ADDRESS
PO BOX 645913CINCINNATI, OH 45264-5913
(216) 539-1501
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ARC DOCUMENT SOLUTIONS LLC
4730 PARK GLEN RD
SAINT LOUIS PARK MN 55416-5701 54MNI90586874/14/2023
INVOICEDATE
Page 1/1
5555 WEST 78TH STREET
SUITE AMINNEAPOLIS, MN 55439
P: (952) 837-3309
F: (952) 831-1268
H+U CONSTRUCTION
BILL TO:SHIP TO:
Luke Nelson
5555 WEST 78TH STREETSUITE A
MINNEAPOLIS, MN 55439
P: (952) 837-3309F: (952) 831-1268
H+U CONSTRUCTION
54MNO90535334/13/2023NET30ARC DELIVERY1016013ASI 33
OrderOrder Due DatePayment TermsShipping MethodCustomer IDPurchase Order #
Lake ElmoJ21001Lisa Knox
Project NameProject NumberOrdered By
Extended
PricePriceDescriptionItem NumberUOM
Quantity
BO
Quantity
Shipped
Quantity
Ordered
1 set of 1 (30.00x42.00)
$0.99$0.10989Bond Prints - First Set1600SQFT0.009.009.00
$1.06Total Due
Amount Received
$1.06Total
$0.00Trade Discount
$0.00Freight
$0.07Tax
$0.00Misc
$0.99SubtotaltronneiBiller:
$1.064/14/202354MNI90586871016013
AMOUNT DUEDOC DATEINVOICECUSTOMER NO
ARC DOCUMENT SOLUTIONS LLC
NEW REMIT TO ADDRESS
PO BOX 645913CINCINNATI, OH 45264-5913
(216) 539-1501
We accept: Visa | MasterCard | American Express | Discover
Card/Check Number:______________________ Exp. Date: __________
Signature:_______________________________ Amount: $___________
REMIT PAYMENT TO
HTTPS://PAY.ARCREMOTE.COM/P/C9DA19BB-6DD6-4195-9592-E0D32E537A8C
QuickPay Online Payment
Scan or Click
Branch:100
St. Paul
1401984
Invoice Date Page
INVOICE
3262234
ORDER NUMBER
Columbus, MN 55025
9205 Lake Drive NE
Viking Industrial Center
1 of 1651-646-6141
INVOICE
04/02/2023
Please Note New Remittance Address
Bill To:Ship To:
Lake Elmo, MN 55042
3800 Laverne Ave N
H+U Construction - Lake Elmo City CenterH+U Construction
5555 West 78th Street Suite A
Minneapolis, MN 55439
Customer ID:106629
Ordered By: Gabe .
Delivery Instructions:Contact Gabe 651.395.0055
DOUG GEIST Tracking #:Carrier:
Net Due Date Discount AmountDisc Due DateTerm DescriptionPO Number
Lake Elmo Net 30 05/02/2023 05/02/2023 0.00
Primary Salesrep NameOrder Date Pick Ticket No Taker
03/30/2023 10:52:46 2293822 Douglas P. Geist TWOODBURY
Item ID
Item DescriptionOrderedShippedRemaining
Quantities
UOM
Disp.Unit Size
Pricing
UOM Unit
PriceUnit Size PriceExtended
2.00 0.00 BOX V8H-SM302 BOX 109.582000 219.16
1.0 1.0000
2.00
CLEAN ROOM MAT - BLUE PADS 24X36
Clean Room Mat - Blue Pad of 30 Sheets 24 in X 36 in - 4 Pads/Bx
5.00 0.00 ROLL V8H-CM420 ROLL 96.294000 481.47
1.0 1.0000
5.00
CARPET MASK TINTED 36 X 200FT
Carpet Mask Tinted 36 in X 200
SUB-TOTAL:Total Lines:2 700.63
MN STATE TAX 48.72:
MN SPECIAL TAX 3.55:
TRUCK DELIVERY 8.00:
760.90AMOUNT DUE:
ORIGINAL12.17.2242 - 11/12/15
Goods may be returned within 30 days of this invoice for credit, exchange or replacement only with authoriztion, and subject to inspection
and restocking charges. ALL Respiratory, Fall Protection, Special Order and Custom Items are NON-RETURNABLE.
Interest at 1.5% per month (18% annum) will be charged on past due accounts.
Rev 2
Branch:100
St. Paul
1402986
Invoice Date Page
INVOICE
3263036
ORDER NUMBER
Columbus, MN 55025
9205 Lake Drive NE
Viking Industrial Center
1 of 1651-646-6141
INVOICE
04/12/2023
Please Note New Remittance Address
Bill To:Ship To:
Lake Elmo, MN 55042
3800 Laverne Ave N
H+U Construction - Lake Elmo City CenterH+U Construction
5555 West 78th Street Suite A
Minneapolis, MN 55439
Customer ID:106629
Ordered By: Gabe .
Delivery Instructions:Contact Gabe 651.395.0055
DOUG GEIST Tracking #:Carrier:
Net Due Date Discount AmountDisc Due DateTerm DescriptionPO Number
Lake Elmo Net 30 05/12/2023 05/12/2023 0.00
Primary Salesrep NameOrder Date Pick Ticket No Taker
04/11/2023 07:07:44 2294827 Douglas P. Geist TWOODBURY
Item ID
Item DescriptionOrderedShippedRemaining
Quantities
UOM
Disp.Unit Size
Pricing
UOM Unit
PriceUnit Size PriceExtended
1.00 0.00 ROLL GR38HDTB ROLL 141.152000 141.15
1.0 1.0000
1.00
38 X 100' 46/MIL CONSTRUCTION BOARD
100% Recyclable Heavy Duty Surface Protection
2.00 0.00 EA GR3TPTB EA 16.200000 32.40
1.0 1.0000
2.00
3 X 55 YRD/RL GRIP-RITE SEAM TAPE
Floor Board Seam Tape (16/rls/cs)
SUB-TOTAL:Total Lines:2 173.55
MN STATE TAX 11.93:
MN SPECIAL TAX 0.87:
TRUCK DELIVERY 0.00:
186.35AMOUNT DUE:
ORIGINAL12.17.2242 - 11/12/15
Goods may be returned within 30 days of this invoice for credit, exchange or replacement only with authoriztion, and subject to inspection
and restocking charges. ALL Respiratory, Fall Protection, Special Order and Custom Items are NON-RETURNABLE.
Interest at 1.5% per month (18% annum) will be charged on past due accounts.
Rev 2
Biffs, Inc6430 County Rd 101 EShakopee MN 55379-5202952.403.1221
Invoice
#W910357
4/19/2023
W910357
1 of 2
Bill To
C57180Hoffman & Uhlhorn Const Inc5555 W 78th StSte AMinneapolis MN 55439United States
Location
L136962Lake Elmo Public Facilities3800 Laverne Ave NLake Elmo MN 55042United States
Invoice Total $244.82
Balance Due $244.82
Due Date: 5/17/2023
Terms Due Date PO #Sales Rep Builders Club#
Net 28 5/17/2023 -Jeff Foley
Qty Item Days Sales Order #Service Level Rate Amount
1 RENTAL
RegHS Mar 22-Apr 18
28 386930 -$4.00 $4.00
1 SERVICEService Mar 22-Apr 18
28 386930 1X/wk $70.00 $70.00
1 SERVICEClimateSvc Mar 22 to Apr 18
28 386930 1X/wk $40.00 $40.00
1 RENTAL
zHandSani Mar 22-Apr 18
28 386930 -$0.00 $0.00
1 RENTALRegHS Mar 22-Apr 18
28 398087 -$4.00 $4.00
1 SERVICE
Service Mar 22-Apr 18
28 398087 1X/wk $70.00 $70.00
1 SERVICEClimateSvc Mar 22 to Apr 18
28 398087 1X/wk $40.00 $40.00
1 RENTAL
zHandSani Mar 22-Apr 18
28 398087 -$0.00 $0.00
0 TAX-MNTax-MN
---$0.00 $15.68
0 TAX-WASH
Tax-WASH
---$0.00 $1.14
Subtotal $244.82
Invoice Total $244.82
Credits/Payments Applied $0.00
Balance Due $244.82
Biffs, Inc6430 County Rd 101 EShakopee MN 55379-5202952.403.1221
Invoice
#W910357
4/19/2023
W910357
2 of 2
Biffs Inc.Remittance Slip
Make Checks Payable To Customer L136962 Hoffman & Uhlhorn Const Inc : Lake Elmo Public Facilities
Biffs, Inc6430 County Rd 101 EShakopee MN 55379-5202
Please return this portion with your payment.
Invoice #W910357
Amount Due $244.82
Amount Paid ______________________
Biffs, Inc6430 County Rd 101 EShakopee MN 55379-5202952.403.1221
Invoice
#W910358
4/19/2023
W910358
1 of 1
Bill To
C57180Hoffman & Uhlhorn Const Inc5555 W 78th StSte AMinneapolis MN 55439United States
Location
L141353LEPW3445 Ideal Ave NLake Elmo MN 55042United States
Invoice Total $122.41
Balance Due $122.41
Due Date: 5/17/2023
Terms Due Date PO #Sales Rep Builders Club#
Net 28 5/17/2023 LEPW Jeff Foley
Qty Item Days Sales Order #Service Level Rate Amount
1 RENTAL
RegHS Mar 22-Apr 18
28 396954 -$4.00 $4.00
1 SERVICEService Mar 22-Apr 18
28 396954 1X/wk $70.00 $70.00
1 SERVICEClimateSvc Mar 22 to Apr 18
28 396954 1X/wk $40.00 $40.00
1 RENTAL
zHandSani Mar 22-Apr 18
28 396954 -$0.00 $0.00
0 TAX-MNTax-MN
---$0.00 $7.84
0 TAX-WASH
Tax-WASH
---$0.00 $0.57
Subtotal $122.41
Invoice Total $122.41
Credits/Payments Applied $0.00
Balance Due $122.41
Biffs Inc.Remittance Slip
Make Checks Payable To Customer L141353 Hoffman & Uhlhorn Const Inc : LEPW
Biffs, Inc6430 County Rd 101 EShakopee MN 55379-5202
Please return this portion with your payment.
Invoice #W910358
Amount Due $122.41
Amount Paid ______________________
Biffs, Inc6430 County Rd 101 EShakopee MN 55379-5202952.403.1221
Invoice
#W910360
4/19/2023
W910360
1 of 1
Bill To
C57180Hoffman & Uhlhorn Const Inc5555 W 78th StSte AMinneapolis MN 55439United States
Location
L143501LECC3880 Laverne Ave NLake Elmo MN 55042United States
Invoice Total $122.41
Balance Due $122.41
Due Date: 5/17/2023
Terms Due Date PO #Sales Rep Builders Club#
Net 28 5/17/2023 -Jeff Foley
Qty Item Days Sales Order #Service Level Rate Amount
1 RENTAL
RegHS Mar 22-Apr 18
28 402272 -$4.00 $4.00
1 SERVICEService Mar 22-Apr 18
28 402272 1X/wk $70.00 $70.00
1 SERVICEClimateSvc Mar 22 to Apr 18
28 402272 1X/wk $40.00 $40.00
1 RENTAL
zHandSani Mar 22-Apr 18
28 402272 -$0.00 $0.00
0 TAX-MNTax-MN
---$0.00 $7.84
0 TAX-WASH
Tax-WASH
---$0.00 $0.57
Subtotal $122.41
Invoice Total $122.41
Credits/Payments Applied $0.00
Balance Due $122.41
Biffs Inc.Remittance Slip
Make Checks Payable To Customer L143501 Hoffman & Uhlhorn Const Inc : LECC
Biffs, Inc6430 County Rd 101 EShakopee MN 55379-5202
Please return this portion with your payment.
Invoice #W910360
Amount Due $122.41
Amount Paid ______________________
OECS
OECS - 170064 PO Box 9201
Minneapolis, MN 55480
763-417-9599
accounting@oecscomply.com
Invoice 40206
BILL TO
H+U Construction
5555 West 78th Street, Suite A
Minneapolis, MN 55439
DATE
04/15/2023
PLEASE PAY
$3,019.00
DUE DATE
05/30/2023
DATE DESCRIPTION QTY RATE AMOUNT
Monthly Safety Services 1 3,019.00 3,019.00
TOTAL DUE $3,019.00
THANK YOU.
137131555-0002
661003
4/28/23
1 of 1
SCHOER,GABE 137131555
LAKE ELMO
3 -H +U CONSTRUCTI
MINNEAPOLIS DOWNTOWN PC781
900 E HENNEPIN AVE
MINNEAPOLIS,MN 55414 1314
612-486-4111
SUNBELT RENTALS,INC.PO BOX 409211ATLANTA,GA 30384-9211
787.64
58.09
845.73
REMIT TO:
SUNBELT RENTALS,INC.NET 30
Invoices not paid within 30 days may be subject to a 1-½%
per month charge.
LAKE ELMO CITY CENTER
3880 LAVERNE AVE N
LAKE ELMO,MN 55042 9627
651-395-0055
4 WEEK BILL
PO BOX 409211
ATLANTA,GA 30384-9211
1oz -3827 -3895
H +U CONSTRUCTION
5555 WEST 78TH STREET,SUITE A
MINNEAPOLIS,MN 55439
THERESA CASBOLT theresa.casebolt@sunbeltrentals.com
Y PAGE
RECEIVED BY CONTRACT NO.
PURCHASE ORDER NO.
JOB NO.
INVOICE TO
INVOICE
SEND ALL PAYMENTS TO:
JOB ADDRESS
LOYALTY PLUS NO.
Equipment. Service. Guaranteed.
INVOICE NO.
ACCOUNT NO.
INVOICE DATE
BRANCH
SUBTOTAL
SALES TAX
INVOICE TOTAL
.QTY EQUIPMENT #Min Day Week 4 Week Amount
.
1.00 BOX BROOM 116.00 116.00 340.00 776.00 776.00
1032512 Make:BOBCAT Model:6707144 Ser #:714433206
#pick up snow bucket currently on rent
when delivering this.
Rental Sub-total:776.00
SALES ITEMS:
Qty Item number Unit Price
1 ENVIRONMENTAL EA 11.640 11.64
ENVIRONMENTAL/HAZMAT FEE 2133XXX0000
BILLED FOR FOUR WEEKS 4/13/23 THRU 5/10/23.
APPLICATION AND CERTIFICATE FOR PAYMENT
TO:FROM:APPLICATION NUMBER:6
CITY OF LAKE ELMO Wells Concrete PERIOD FROM:04/01/23
3880 LAVERNE AVE NORTH SUITE 100 P.O. Box 656 TO:04/30/23
LAKE ELMO MN 55042 Albany, Minnesota 56307 CONTRACT NUMBER:
VENDOR NUMBER:
Project Number:7509 Project Name:LAKE ELMO FIRE STATION
CONTRACTOR'S APPLICATION FOR PAYMENT
Application Is made for payment, as shown below, in connection with the Contract Continuation Sheet, G703, attached.
1. ORIGINAL CONTRACT SUM . . . . . . . . . . . . . . . . . $333,704.00
2. NET CHANGE BY CHANGE ORDERS . . . . . . . . . . .$0.00
3. CONTRACT SUM TO DATE (Line 1 + 2) . . . . . . . . .$333,704.00
Total To Date This Period
4. TOTAL COMPLETED & STORED TO DATE (Column G on G703) . . . . . . . . . . . . . . . . . . . . . .$333,704.00 $6,525.00
5. RETAINAGE 5.00% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$16,685.20 $326.25
6. TOTAL EARNED LESS RETAINAGE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $317,018.80 $6,198.75
(Line 4 Less Line 5)
7. LESS PREVIOUS CERTIFICATES FOR PAYMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$310,820.05
(Line 6 From Prior Certificate)
8. CURRENT PAYMENT DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$6,198.75 $6,198.75
9. BALANCE TO FINISH, INCLUDING RETAINAGE . . .$16,685.20
(Line 3 Less Line 6)The undersigned Subcontractor certifies that to the best of the
Subcontractor's knowledge, information and belief the Work covered by this
Application for Payment has been completed in accordance with the Contract
Documents, that all amounts have been paid by the Subcontractor for Work
for which previous Certificates for Payment were issued and payments
received from the Contractor, and that current payment shown herein is now
due.
CHANGE ORDER SUMMARY ADDITIONS/DEDUCTIONS
Previous Months Total Approved Changes $-
This Month's Total Approved Changes $-
TOTALS $-
By:Stacy Schwantz
Title:AR SPECIALIST
Date:April 6, 2023
CONTINUATION SHEET AIA DOCUMENT G703
In tabulations below, amounts are stated to the nearest dollar.INVOICE NO:040002L
APPLICATION NO:6
APPLICATION DATE:04/06/23
PERIOD ENDING:04/30/23
A B C D E F G H I
ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL %BALANCE RETAINAGE
NO.VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G/C)TO FINISH
APPLICATION STORED AND STORED (C-G)
(D+E)(NOT IN TO DATE
D OR E)(D+E+F)
1 INSTALLATION - WALLS $208,286.16 $208,286.16 $0.00 $0.00 $208,286.16 100%$0.00 $10,414.31
2 INTALLATION - DTS $77,534.40 $72,521.50 $5,012.90 $0.00 $77,534.40 100%$0.00 $3,876.72
3 INSTALLATION - PLANK $21,601.44 $20,089.34 $1,512.10 $0.00 $21,601.44 100%$0.00 $1,080.07
4 INSTALLATION - CAULK $26,282.00 $26,282.00 $0.00 $0.00 $26,282.00 100%$0.00 $1,314.10
TOTALS $333,704.00 $327,179.00 $6,525.00 $0.00 $333,704.00 100%$0.00 $16,685.20
$ 5,700.005/1/23
40,699.715/2/23
5/1/23
13,349.405/1/23
3,073.25
78,450.00
47,704.00
126,154.00
119,494.00
5,974.70
113,519.30
110,446.05
0.00
0.00
119,494.00
Page 1
Certificate of the Subcontractor:
I hereby certify that the work performed and the materials supplied to date as shown on the above represent the actual value of accomplishment under the terms of the contract (and all authorized
changes thereto) between the undersigned and H+U Construction relating to the above-referenced project.
I also certify that Payments, less applicable retention, have been made through the period covered by previous payments received from the contractor, to (1) all my subcontractors (sub-subcontractors) and (2) for all materials and labor used in connection with the performance of this contract.
I further certify I have complied with Federal, State and Local tax laws, including Social Security laws and unemployment laws and Workmen's Compensation laws insofar as applicable to the
performance of this contract.
Furthermore, in consideration of this request of the payments received and upon receipt of the amount of this request, the undersigned does hereby waive, release, and relinquish all claims or right of lien which the undersigned may now have upon the premises above described except for claims or right of lien for contract and/or change order work performed to the extent that payment is being retained or will
subsequently become due.
Original contract sum
Net change by change orders (as per attached breakdown)
Contract sum to date
Completed to date (as per attached breakdown)
Total retainage (5.0%)
Total earned less retainage
Less previous certificates of payment
Sales tax at 0.000% on 0.00
Amount of this request
Stored material (as per attached breakdown)
Total completed and stored to date
Subtotal 3,073.25
Empirehouse Inc.
5200 Quincy StreetMounds View, MN 55112
To:
From:
Phone:
Project:Lake Elmo City Center (L)3880 Laverne Avenue N.
Lake Elmo, MN 55042
Application No: 10 Date: 04/01/23
Period To: 04/30/23
Contract For:
Contract Date:
Contractor Job
Number:21152
Date: __________________________________
Subscribed and sworn to before me this _____ day
of ____________, _________ (year).
Notary public: _____________________________
My commission expires ____________________.
Contractor: Empirehouse Inc.
By: ____________________________________
Title: ___________________________________
(763) 535-1150
Application and Certificate For Payment
H+U Construction5555 West 78th Street
Suite A
Edina, MN 55439
April 20, 2023 20
April 2023
January 31, 2025 Kristine Hutera, CEO
010500
010600
020550
020551
020552
021050
021550
029050
029051
031050
040550
041050
042050
059000
CO #001-1
CO #001-2
CO #002-1
CO #002-2
1,115.00 1,115.00 0.00 0.00 1,115.00 100.00 55.750.00
9,260.00 9,260.00 0.00 0.00 9,260.00 100.00 463.000.00
12,085.00 10,000.00 2,085.00 0.00 12,085.00 100.00 604.250.00
6,820.00 6,820.00 0.00 0.00 6,820.00 100.00 341.000.00
2,225.00 2,225.00 0.00 0.00 2,225.00 100.00 111.250.00
18,906.00 18,906.00 0.00 0.00 18,906.00 100.00 945.300.00
5,962.00 5,962.00 0.00 0.00 5,962.00 100.00 298.100.00
6,820.00 6,820.00 0.00 0.00 6,820.00 100.00 341.000.00
2,146.00 2,146.00 0.00 0.00 2,146.00 100.00 107.300.00
2,146.00 2,146.00 0.00 0.00 2,146.00 100.00 107.300.00
1,560.00 0.00 0.00 0.00 0.00 0.00 0.001,560.00
2,340.00 0.00 1,150.00 0.00 1,150.00 49.15 57.501,190.00
195.00 0.00 0.00 0.00 0.00 0.00 0.00195.00
6,870.00 6,870.00 0.00 0.00 6,870.00 100.00 343.500.00
1,360.00 0.00 0.00 0.00 0.00 0.00 0.001,360.00
43,989.00 43,989.00 0.00 0.00 43,989.00 100.00 2,199.450.00
-3,285.00 0.00 0.00 0.00 0.00 0.00 0.00-3,285.00
5,640.00 0.00 0.00 0.00 0.00 0.00 0.005,640.00
126,154.00 116,259.00 3,235.00 0.00 119,494.00 94.72 5,974.706,660.00
To:H+U Construction
From (Subcontractor):Empirehouse Inc.
Project:Lake Elmo City Center (L)
Application and Certificate For Payment -- page 2
Application No: 10 Date: 04/01/23
Item
Number Description ScheduledValue
Work Completed
Previous Application This Period
Materials
Presently Stored
Completed and
Stored to Date
%Balance to Finish Retention Memo
Bonds
Submittals/PM/CAD/Admin
SF Installation
CW Installation
Housekeeping
Window Installation
Skylight Installation
Ballistic Window Install
Hurricane Window Install
Mock-up Installation
Borrowed Lite Installati
Heavy Wall Installation
Mirrors Installation
Equipment
All Glass Door 205A Billing Total
Add Curtainwall Billing Total
Change Vinyl Windows to SF Billing
Total
Add Type W3 windows Billing Total
Application Total
Period To: 04/30/23
Contractor's Job Number: 21152
20,643.50
$ 31,350.00
12,039.25
22,990.005/1/23
23,407.29
APPLICATION AND CERTIFICATE FOR PAYMENTTO (OWNER): PROJECT:LAKE ELMO CITY HALL, FIRE DEPARTMENT APPLICATION NO: 16Distribution to:City of Lake Elmo & PUBLIC WORKS FACILITIES REMODELXOWNER3880 Laverne Ave N PERIOD TO:4/30/2023Lake Elmo, MN 55042ARCHITECT FROM (CM): MATERIALCONST. MANAGERHOFFMANN + UHLHORN CONSTRUCTION, INC.5555 W 78TH ST, SUITE AXFILEMINNEAPOLIS, MN 55439CONTRACT DATE:APPLICATION FOR PAYMENTApplication is made for Payment, as shown below,CHANGE ORDER SUMMARYContinuation Sheet, AIA Document G703, is attached.Change Orders Approved inADDITIONSDEDUCTIONS1. COMMITTED COST$6,910,247.00previous months by Owner2. Net Change by Change Orders$0.00TOTAL$0.00$0.003. SUM TO DATE (Line 1+2)$6,910,247.00Approved this Month4. TOTAL COMPLETED & STORED TO DATE $6,739,123.15NumberDate Approved (Column G on G703) 5. RETAINAGE:$0.00$0.00 a. _5_ % of Completed Work$336,956.20 (Column D+E on G703) b. ___ % of Stored Material$0.00 (Column F on G703)Total Retainage (Line 5a + 5b or Total in Column I of G703)$336,956.20TOTALS$0.00$0.006. TOTAL EARNED LESS RETAINAGE$6,402,166.95Net change by Change Orders$0.00 (Line 4 less Line 5 Total)The undersigned Construction Manager certifies that to the best of his 7. LESS PREVIOUS CERTIFICATES FORknowledge, information and belief the Work covered by this Application for PAYMENT (Line 6 from prior Certificate)$5,997,652.45Payment has been completed in accordance with the Contract Documents, 8. CURRENT PAYMENT DUE$404,514.50and that current payments shown herein are now due.9. BALANCE TO FINISH, PLUS RETAINAGE $508,080.05 (Line 3 less Line 6)CONSTRUCTION MANAGER:HOFFMANN + UHLHORN CONSTRUCTION, INC.State of: MINNESOTACounty of:Anoka County Subscribed and sworn to before me this 5/2/2023Notary Public:By:Date:5/2/2023My Commission expires:31-Jan-28ARCHITECT'S CERTIFICATE FOR PAYMENTAMOUNT CERTIFIED$In Accordance with the Contract Documents, based on on-site observations and the(Attach explaination if amount certified differs from the amount applied for).data comprising the above application, the Architect certifies to the Owner that to theARCHITECT:best of the Architect's knowledge, information and belief the Work has progressed asindicated, the quality of the Work is in accordance with the Contract Documents, andBy:Date:the Contractors are entitled to payment of the Amounts Certified.WASHINGTON COUNTY SHERRIFF SUBSTATION2023-05-09
CITY OF LAKE ELMO - MATERIALAPPLIC. FOR PAYMENT NO.#16H+U CONSTRUCTION EDITION OF AIA DOCUMENT G703PERIOD ENDING 4/30/2023 AIA Document G723,APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification is attached.In tabulations below, amounts are stated to the nearest dollar. ABCDEF GHITEMDESCRIPTION OF WORKSCHEDULEDCHANGEREVISED WORK COMPLETEDTOTAL%BALANCERETAINAGENO.VALUEORDERSSCHEDULEFROMTHIS PERIODCOMPLETED(F/C)TO FINISHVALUEPREV. APPL.AND STORED(C-F)(A+B) TO DATE (D+E)#0330Cast-In-Place Concrete240,000.0023,922.00263,922.00256,422.000.00256,422.0097%7,500.0012,821.10#0341Strutctural Precast1,422,295.00580.001,422,875.001,422,875.000.001,422,875.00100%0.0071,143.75#0512Steel Supply485,000.0074,767.00559,767.00532,944.6026,822.40559,767.00100%0.0027,988.35#0610Carpentry & GC568,000.0021,134.00589,134.00335,084.65138,382.90473,467.5580%115,666.4523,673.38#0750Roofing & Metal Panels498,500.00(28,015.00)470,485.00345,890.0077,334.12423,224.1290%47,260.8821,161.21#0790Caulking & Firestopping18,300.003,221.0021,521.001,580.008,976.5010,556.5049%10,964.50527.83#0810Doors, Frames, Hardware - Supply171,697.0026,533.00198,230.0074,764.74114,297.83189,062.5795%9,167.439,453.13#0833Coiling & Sectional Doors175,000.00114,530.00289,530.00289,530.000.00289,530.00100%0.0014,476.50#0840Aluminum Storefronts & Curtainwall321,960.0099,415.00421,375.00409,495.007,060.00416,555.0099%4,820.0020,827.75#0920Drywall & Fireproofing229,410.0020,740.00250,150.00224,707.501,861.00226,568.5091%23,581.5011,328.43#0930Tile68,100.000.0068,100.0051,080.0017,020.0068,100.00100%0.003,405.00#0950Acoustical Ceilings & Panels75,000.000.0075,000.0045,000.0020,000.0065,000.0087%10,000.003,250.00#0965Resilient Flooring & Carpet90,930.00275.0091,205.0091,205.000.0091,205.00100%0.004,560.25#0990Painting and Wallcovering29,531.00112.0029,643.0022,418.003,990.0026,408.0089%3,235.001,320.40#1420Conveying Equipment46,740.000.0046,740.0021,577.000.0021,577.0046%25,163.001,078.85#2100Fire Protection57,520.000.0057,520.0057,520.000.0057,520.00100%0.002,876.00#2200Plumbing & Heating491,000.0016,375.00507,375.00486,883.910.00486,883.9196%20,491.0924,344.20#2300HVAC & Controls662,000.00143,425.00805,425.00785,925.005,500.00791,425.0098%14,000.0039,571.25#2600Electrical808,100.0053,214.00861,314.00647,750.000.00647,750.0075%213,564.0032,387.50#3100Earthwork & Site Utilities209,390.002,544.00211,934.00197,769.000.00197,769.0093%14,165.009,888.45#3210Asphalt Paving180,634.00(1,549.00)179,085.0012,897.004,560.0017,457.0010%161,628.00872.85#3290Landscaping & Fencing61,140.000.0061,140.000.000.000.000%61,140.000.00TOTAL CONTRACT AMOUNTS6,910,247.000.007,481,470.006,313,318.40425,804.756,739,123.1590%742,346.85336,956.20
INVOICE SUMMARY-PAYMENT APPLICATION NO. #16CITY OF LAKE ELMO - MATERIALPERIOD ENDING 4/30/2023ITEM NO# DESCRIPTION VENDORDATENUMBERAMOUNTRETAINAGEDUE#0512Steel SupplyConstruction Systems, Inc.4/30/23Applic #7$26,822.40$1,341.12$25,481.28#0610Carpentry & GCEbert Construction4/30/23Applic #12$138,382.90$6,919.15$131,463.75#0750Roofing & Metal PanelsPalmer West Construction4/30/23Applic #6$77,334.12$3,866.71$73,467.41#0790Caulking & FirestoppingCarciofini Company4/30/23Applic #2$8,976.50$448.83$8,527.67#0810Doors, Frames, Hardware - SupplyTwin City Hardware4/30/23Applic #4$114,297.83$5,714.89$108,582.94#0840Aluminum Storefronts & CurtainwallEmpirehouse, Inc.4/30/23Applic #11$7,060.00$353.00$6,707.00#0920Drywall & FireproofingCommercial Drywall4/30/23Applic #11$1,861.00$93.05$1,767.95#0930TileAdvanced Terrazzo & Tile4/30/23Applic #3$17,020.00$851.00$16,169.00#0950Acoustical Ceilings & PanelsAcoustics Associates4/30/23Applic #3$20,000.00$1,000.00$19,000.00#0990Painting and WallcoveringSteinbrecher Painting Company4/30/23Applic #4$3,990.00$199.50$3,790.50#2300HVAC & ControlsSt. Cloud Refrigeration4/30/23Applic #10$5,500.00$275.00$5,225.00#3210Asphalt PavingEbert Construction4/30/23Applic #5$4,560.00$228.00$4,332.00SUBTOTAL AMOUNT DUE$425,804.75$21,290.25$404,514.50 TOTAL AMOUNT DUE $404,514.50
25,481.285/1/23
131,463.755/1/23
5/1/23
8,527.675/1/2377
$ 108,582.94
6,707.00
321,960.00
99,415.00
421,375.00
416,555.00
20,327.75
396,227.25
389,520.25
0.00
0.00
416,555.00
Page 1
Certificate of the Subcontractor:
I hereby certify that the work performed and the materials supplied to date as shown on the above represent the actual value of accomplishment under the terms of the contract (and all authorized
changes thereto) between the undersigned and H+U Construction relating to the above-referenced project.
I also certify that Payments, less applicable retention, have been made through the period covered by previous payments received from the contractor, to (1) all my subcontractors (sub-subcontractors) and (2) for all materials and labor used in connection with the performance of this contract.
I further certify I have complied with Federal, State and Local tax laws, including Social Security laws and unemployment laws and Workmen's Compensation laws insofar as applicable to the
performance of this contract.
Furthermore, in consideration of this request of the payments received and upon receipt of the amount of this request, the undersigned does hereby waive, release, and relinquish all claims or right of lien which the undersigned may now have upon the premises above described except for claims or right of lien for contract and/or change order work performed to the extent that payment is being retained or will
subsequently become due.
Original contract sum
Net change by change orders (as per attached breakdown)
Contract sum to date
Completed to date (as per attached breakdown)
Total retainage (4.9%)
Total earned less retainage
Less previous certificates of payment
Sales tax at 0.000% on 0.00
Tax Exempt
Amount of this request
Stored material (as per attached breakdown)
Total completed and stored to date
Subtotal 6,707.00
Empirehouse Inc.
5200 Quincy StreetMounds View, MN 55112
To:
From:
Phone:
Project:Lake Elmo City Center (M)3880 Laverne Avenue N.
Lake Elmo, MN 55042
Application No: 11 Date: 04/01/23
Period To: 04/30/23
Contract For:
Contract Date:
Contractor Job
Number:21153
Date: __________________________________
Subscribed and sworn to before me this _____ day
of ____________, _________ (year).
Notary public: _____________________________
My commission expires ____________________.
Contractor: Empirehouse Inc.
By: ____________________________________
Title: ___________________________________
(763) 535-1150
Application and Certificate For Payment
H+U Construction5555 West 78th Street
Suite A
Edina, MN 55439
Date: __________________________________
Subscribed and sworn to before me this _____ day
of ____________, _________ (year).
Notary public: _____________________________
My commission expires ____________________.
Contractor: Empirehouse Inc.
By: ____________________________________
Title: ___________________________________
April 20, 2023 20
April 2023
January 31, 2025 Kristine Hutera, CEO
010500
010600
020500
020502
021000
021001
021002
030500
030501
030502
040500
041000
042000
055000
CO #001-1
CO #001-2
CO #001-3
CO #001-4
CO #002-1
CO #002-2
4,580.00 4,580.00 0.00 0.00 4,580.00 100.00 229.000.00
26,100.00 26,100.00 0.00 0.00 26,100.00 100.00 1,305.000.00
49,080.00 49,080.00 0.00 0.00 49,080.00 100.00 2,454.000.00
17,575.00 17,575.00 0.00 0.00 17,575.00 100.00 878.750.00
57,775.00 57,775.00 0.00 0.00 57,775.00 100.00 2,888.750.00
47,640.00 47,640.00 0.00 0.00 47,640.00 100.00 2,382.000.00
63,500.00 63,500.00 0.00 0.00 63,500.00 100.00 3,175.000.00
17,565.00 17,565.00 0.00 0.00 17,565.00 100.00 878.250.00
7,530.00 7,530.00 0.00 0.00 7,530.00 100.00 376.500.00
10,000.00 10,000.00 0.00 0.00 10,000.00 100.00 0.000.00
6,010.00 4,000.00 2,010.00 0.00 6,010.00 100.00 300.500.00
6,465.00 4,000.00 2,465.00 0.00 6,465.00 100.00 323.250.00
120.00 0.00 0.00 0.00 0.00 0.00 0.00120.00
8,020.00 8,020.00 0.00 0.00 8,020.00 100.00 401.000.00
648.00 648.00 0.00 0.00 648.00 100.00 32.400.00
468.00 0.00 0.00 0.00 0.00 0.00 0.00468.00
1,529.00 0.00 0.00 0.00 0.00 0.00 0.001,529.00
91,482.00 91,482.00 0.00 0.00 91,482.00 100.00 4,574.100.00
-6,826.00 0.00 -3,415.00 0.00 -3,415.00 50.03 -170.75-3,411.00
12,114.00 0.00 6,000.00 0.00 6,000.00 49.53 300.006,114.00
421,375.00 409,495.00 7,060.00 0.00 416,555.00 98.86 20,327.754,820.00
To:H+U Construction
From (Subcontractor):Empirehouse Inc.
Project:Lake Elmo City Center (M)
Application and Certificate For Payment -- page 2
Application No: 11 Date: 04/01/23
Item
Number Description ScheduledValue
Work Completed
Previous Application This Period
Materials
Presently Stored
Completed and
Stored to Date
%Balance to Finish Retention Memo
Bonds
Submittals/PM/CAD/Admin
SF Metal Materials
CW Metal Materials
Jeld-wen Vinyl Windows
StormDefend Windows
Bullet Resistant Windows
SF Glass Materials
CW Glass Materials
Skyligtht Glass Material
Interior Glass Materials
Heavy Wall Glass Materia
Mirror Materials
Testing
Precast Revisions Billing Total
Change Door 110 to All Glass Billing Total
All Glass Door 205A Billing Total
Add Curtainwall Billing Total
Change Vinyl windows to SF Billing
Total
Add Type W3 Windows Billing Total
Application Total
Period To: 04/30/23
Contractor's Job Number: 21153
16,169.0048,526.0016,169.00
$ 19,000.00
3,790.505/1/23
5,225.00
4,332.005/1/23