03-11-24-R - Laserfiche WebLink

Home Browse Search

Contractor's Application for Payment No. 1 Application to 12/31/2023 Application Date: 12/31/2023 Period: To (Owner): City of Arden Hills From Peterson Companies, Inc. Via (Engineer): HR Green (Contractor): Project: Arden Manor Park Floral Park Contract: Owner's Contractor's 23120 Project No: Project No: Chance Order Summary Approved Change Orders Number Additions Deductions Change Order 01 $115,649.89 TOTALS NET CHANGE BY CHANGE ORDERS $115,649.89 -$115,649.89 Contractor's Certification The undersigned Contractor certifies, to the best of its knowledge, the following: (1) All previous progress payments received from Owner on account of Work done under the Contract have been applied on account to discharge Contractor's legitimate obligations incurred in connection with the Work covered by prior Applications for Payment; (2) Title to all Work, materials and equipment incorporated in said Work, or otherwise listed in or covered by this Application for Payment, will pass to Owner at time of payment free and clear of all Liens, security interests, and encumbrances (except such as are covered by a bond acceptable to Owner indemnifying Owner against any such Liens, security interest, or encumbrances); and Contractor Signature By: Date: 12/31/2023 L ORIGINAL CONTRACT PRICE................................................................... $ $816,523.35 t. Net change by Change Orders......................................................................... $-$115,649.89 L Current Contract Price (Line 1 f 2)................................................................ $ $700,873.46 t. TOTAL COMPLETED AND STORED TO DATE (Column F total on Progress Estimates).......................................................... $ $690,004.09 i. RETAINAGE: a. 5% X $690,004.09 Work Completed............ $ $34,500.20 b. 5% X Stored Material .............. $ c. Total Retainage (Line 5.a + Line 5.b)................................... $ $34,500.20 5. AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5.c).................................... $ $655,503.89 7. LESS PREVIOUS PAYMENTS (Line 6 from prior Application) ............... $ 3. AMOUNT DUE THIS APPLICATION.......................................................... $ $655,503.89 1. BALANCE TO FINISH, PLUS RETAINAGE (Column G total on Progress Estimates + Line 5.c above) ............................. $ $45,369.57 Payment of. $ $655,503.89 (Line 8 or other - attach explanation of the other amount) is recommended by: 41 y"'� 3/1 /2024 (Engineer) (Date) Payment of: $ $655,503.89 (Line 8 or other - attach explanation of the other amount) is approved by: (Owner) (Date) Approved by: Funding or Financing Entity (if applicable) (Date)