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Home My WebLink About4N, Pay App #3 & #4 for A.J. Spanjers ~ ~ILLS Request for Council Action ~ Prepared By: Dave Scherbel, Building Official Council Meeting Date: December 8, 2008 Pay Application #3 and #4 from A.J. Spanjers Budgeted Amount: $296,577.50 (amended) Actual Amount: $58,983.12 Funding Source: Equipment Building and Replacement Fund Recommendation: Approve the November 13th, 2008, pay application #3, and November 20th, pay application #4, from A.J. Spanjers, for the total amount of $58,983.12. Supporting Documents: 1. December 8,2008, Memo to the City Council 2. Pay application #3 and #4, along with WJE's approval letter, and a partial waiver of lien for both pay applications. xii ...IIIS MEMORANDUM DATE: December 8, 2008 TO: Mayor and City Council FROM: Dave Scherbel, Building Official SUBJECT: Masonry Fa9ade Repairs, Pay Application # 3 and #4 Back2round On March 31st, 2008, the City Council approved the contract for A.I. Spanjers to make masonry repairs to the City Hall Buildings fa9ade, for an amount not to exceed $203,090.00. On October 7, 2008, the City Council approved a change order for the masonry fa9ade project for A.I. Spanjers to bring the total amount to $296,577.50, for repairs to the City Hall building. The contractor has requested $58,983.12 per pay application # 3 and #4 on November 13,2008. Wiss, Janey, Elstner (WJE) Associates, the project engineers, have reviewed and accepted A.I. Spanjers pay application #3 and #4 in their November 25, 2008, letter. The contractor was previously paid a total of $161,015.50 in pay application number one and two. Recommendation Staff recommends approval of the November 13, 2008, pay application #3 and the November 20th pay application #4 from A.I. Spanjers, for the total amount of$58,983.12. Attachments Pay application #3 and #4, WIE's approval letter for each Partial waiver of liens totaling $58,983.12 \\Metro-inet.us\ardenhills\Building\City Hall\Masonry Facade repairs\120808 - CC Report - AJ Spanjers pay application 3 and 4,DOC WJE ENGINEERS ARCHITECTS MATERIALS SCIENTISTS Wiss, Janney, Elstner Associates, Inc. 600 Highway 169 South, Suite 1520 Minneapolis, Minnesota 55426 952.545.0295 tell 952.544.6954 fax www.wje.com Via: US Postal Service Received DEe - 2 2008 November 25, 2008 Mr. Dave Scherbel Building Official City of Arden Hills 1245 West Highway 96 Arden Hills, MN 55112-5743 City of Arden Hill~ Re: Contractor Payment Application AH-00003 Masonry Fa;a<fe Repairs Project Arden Hills City Hall Arden Hills, MN WJE No. 2005.5144.6 Dear Mr. Scherbel: We have reviewed the Application and Certificate for Payment No. AH-00003 prepared by A.J. Spanjers (dated November 13, 2008). It was received by WJE on November 14, 2008. Our comments are as follows: 1. Based on our observations made to date and the data comprising the Application and Certificate for Payment No. AH-00003, it is our opinion that the work has progressed to the point indicated on the attached application. 2. To the best of our knowledge, the work is in accordance with the Contract Documents. 3. A lien waiver was received by WJE on November 14, 2008, to accompany the payment application per Subparagraph 9.3.4 of Article 9 in Section 00800 of the Project Manual. A copy of this is attached. 4. It is our belief that the contractor is entitled to payment for the amount indicated on the attached. WJE's review of the Application and Certificate for Payment is subject to the limitations listed in Section 4.2.2 of AlA Document A201 referenced in Section 00700 in the Project Manual. One original signed copy of the Application and Certificate for Payment, submitted by A.J. Spanjers is enclosed for your payment. Headquarters & Laboratories-Northbrook, Illinois Atlanta I Austin I Boston I Chicago I Cleveland I Dallas I Denver I Detroit I Honolulu I Houston Los Angeles I Minneapolis I New Haven I New York I Princeton I San Francisco I Seattle I Washington, DC WJE ENGINEERS ARCHITECTS MATERIALS SCIENTISTS Mr. Dave Scherbel City of Arden Hills November 25, 2008 Page 2 Very truly yours, WISS, JANNEY, ELSTNER ASSOCIATES, INC. Digital Signature Brian J. Pashina, P.E. Proj ect Manager Enclosures: Payment Application AH-00003 (2 pages) Lien Waiver (1 page) cc: Bob Spanjers, Jr. (faxed and mailed) A.J. Spanjers, Co. Project File 0 0 0 0 0 0 ... c 0 0:: f- 0:: 0 0::: ;:: w u 0 --I W ~ Z ill I- W I .a S f- U u.: f- -i:: I ~ 0 (j) 0 u C 0:: I- <( Z 0 U c: .g ro l-. B en Q) ("f') ~ 0 C 00 0 0 0 t:: 0 ~ 0 00 0 N N ~ 0 en ............. <::> ro ....... t :; ............. 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E~g- ~ ~;: ~E& ~.~~ .~o~ ~g-o -:;:2 ~[~ .~ >- ~ E~o <(I..C Q)o~ x ~i3: .! ~4)c (f) ~ g E ~ ~ g ~ .s::. ; c -8 ~ c@ (/) .s::. <0 ~ E ~ (") <( .::: c ~.!!1 ~ o ~::.~ E :e a g- (j) s;: () E """: 0 5' ::J ;:: 5 ~ (J (j).c c 8 ,.- 'i: 2 g~~ (3 (j) "0 :::J ~ """: 0 -g c ~ g 0.. o (j)._ ~ o r:g.9 <( iri "0 -0 > e:;-g ~ z ~E~8 o UCU~_- i= 8:S~~ ~ =!-g~g o <trac.o tJ) <J.) ~ :::s tJ) tJ) <<J <<i s:::: .0, -i: o C <( ci w a: E (f) (ij <J.) c- o. co ~, ,I ~AIA ~, ..~ .~. Document G702™ - 1992 Instructions and Certificate for Payment GE.NERAL INFORMATION :::~tpose and Related Documents AlA Document G707, Application and Certificate for Payment, is to be used in conjunction with AlA Document .:u.;,r703, Co~tinuation~~tet. These documents are designed to be used on a Project where a Contractor has a direct ~greemeI1-~"fith th~~~?er. Procedures for their use are covered in AlA Document A201, General Conditions of the :nn:)~ontractft])rConstm~ion. Persons executing the document should indicate the capacity in which they are acting (i.e., president, secretary, partIler,etc.}and the authority under which they are executing the document. Where appropriate, a copy of the resolutioJ.!1authorizing the individual to act on behalf of the firm or entity should be attached. AlA Document G702™ - 1992. Copyright @ 1953, 1963, 1965, 1971, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA@Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA@Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten (10) copies of this document when completed, To report copyright violations of AlA Contract Documents, e-mail The American Institute of Architects' fegat counsel, copyright@aia.org. 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AlA Document G702, Application and Certificate for Payment, is to be used in conjunction with AlA Document G703, Continuation Sheet. These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AlA Document A201, General Conditions of the Contract for Construction, Use of Current Documents. Prior to using any AlA Contract Document, users should consult www.aia,org or a local AlA component to verify the most recent edition~ Reproductions. This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AlA, There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AlA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703, but only for use in connection with a particular projecLThe AlA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission from the AlA. Rights to reproduce the document may vary for users of AlA software. Licensed AlA software users should consult the End User license Agreement (EULA), To report copyright violations of AlA Contract Documents, e-mail The American Institute of Architects' legal counsel, copyright@aia.org. COMPLETING THE G703 FORM Heading: This information should be completed in a manner consistent with similar information on AlA Document G702, Application and Certificate for Payment. Columns A, B & C: These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted, The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required, Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially, this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D: Enter in this column the amount of completed Work covered by the previous applicaUon (columns D & E from the previous application). Values from column F (Materials Presently Stored) from the previous application should not be entered in this column. Column E: Enter here the value of Work completed at the time of this application, including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored (column F), Column F: Enter here the value of Materials Presently Stored for which payment is sought. The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stored materials does not result in a deduction from this column, Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E (Work Completed-This Period.) Column G: Enter here the total of columns D, E and F, Calculate the percentage completed by dividing column G by column C, Column H: Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date), Column I: This column is normally used only for contracts where variable retain age is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done. Usually, Change Orders are listed separately, either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form. Construction Change Directives: Amounts not in dispute that have been induded in Construction Change Directives should be incorporated into one or more Change Orders, Amounts remaining in dispute should be dealt with according to Section 7.3 in A201, The following is an example of a Continuation Sheet for work in progress, Please note that dollar amounts shown below are for illustrative purposes only, and are not intended to reflect actual construction costs. A B C D E F G H ) WORK COMPLETED MATERIALS TOTAL BALANCE ITEM SCHEDULED FROM PREVIOUS PRESENTL Y COMPLETED % TO RET AINAGE NO. DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED (G-:-C) FINISH (IF VARIABLE (NOT IN TO DATE RATE) (D +E) D OR E) (D+E+F) (C - G) 1 MOBILIZA nON 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10 ,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10 ,000 0 5,000 0 5,000 50 5,000 5 CURBS & MISC. CONe. 5,000 0 0 0 0 0 5,000 6 PAVING, UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING, LOWER DRIVE 20,000 0 0 0 0 0 20,000 8 PAVERS 20,000 0 0 10,000 10 .000 50 10 ,000 9 BRICK WORK 5,000 0 0 0 0- 0 5,000 10 11 105,000 20,000 10 ,000 10,000 40,000 65,000 AlA Document G703™ - 1992. Copyright @ 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The Amerjcan Institute of Architects. All rights reserved. WARNING: This AIA@Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA@Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AlA Contract Documents, e-mail The American Institute of Architects' legal counsel, copyright@aia.org. PARTIAL WAIVER OF ll.EN To All Whom It May'Concern: "\lHEREAS, the undersigned has been employed'by City of Arden Hills to'furnish rabor and materials for(B} Exteri6r Masonry Restoration work, under a contract Tqt the improvement of the premises described as City of Arden Hills City Hall in the City fCity-\,Iillage) of Arden Hills , County of Ramsey Minnesota ofwhich is the owner. NOW, TH.E'REFORE, th'is 13 day. of November . f~ 2008 , -, for and in consideration of the ~um oHE} $31 ,920. 00. . Dollars paidsimultaneouslyherewi1th, the receipt whereof is hereby acknowledged by the undersigned, the under:: sigr)eddoes hereby wa~ive a'nd rel.ease. to the. extent .onlyofthe. afore~aid:-amount,'-any Hen rights :to,or claim of. lien- with respect to and on said above'':'described premises, and the 'im;provements. thereon, and onthe .monies or other considerations due or to become due from' the owner, by virtue of said contract, on account of labof, services, materials, fixtures, apparatus or machinery furnisheqby the undersigned to or for the above-described premises, but only to the extent of the payment'aforesaid. fr.-j - A. sear here} (SEft~l) (A'ffix corporate TITLE: President F()R. tA) Name person or firm with whom you agreed to:furnish either labor, Of services, or materials; or both. (8") Ril in nature and extent of work; strike the word labor or the word materials jf not in your contract. . ..-(-e}AfYQu.have more.than one,contract on the same premises, describe the.cibritrac"t:by .n~fn6er'jfavailabk:!, dat~ and extent of 'work. (D).Fumish an.accurate enough description of the improvement and location of the premises so that it can be distinguished':fromany other property. fE) Amount shown should be the amount actually received on that date. (Flit waiver is for'acorporation, corporate name should be used, corporate seal affixed and title.of officer s.igning waiver should be set forth;. if waiver is fora partnership, the partnership name should be used, p:i3rtnei should sign 'and designate himself as partner. . Designed By The Construction Industry Affairs Committee (C'IAC) TOPS 3459 LITHO IN u. S. A. @ COPYRIGHT 1973, TOPS BUSINESS FORMS. CHICAGO. ILL. WJE ENGINEERS ARCHITECTS MATERIALS SCI ENTISTS Wiss, Janney, Elstner Associates, Inc. 600 Highway 169 South, Suite 1520 Minneapolis, Minnesota 55426 952.545.0295 tell 952.544.6954 fax www.wje.com Via: US Postal Service Mr. Dave Scherbel Building Official City of Arden Hills 1245 West Highway 96 Arden Hills, MN 55112-5743 Received DEe - 2 2008 November 25, 2008 City of Arden Hill~ Re: Contractor Payment Application AH-00004 Masonry F~e Repairs Project Arden Hills City Hall Arden Hills, MN WJE No. 2005.5144.6 Dear Mr. Scherbel: We have reviewed the Application and Certificate for Payment No. AH-00004 prepared by A.J. Spanjers (dated November 20, 2008). It was received by WJE on November 21, 2008. Our comments are as follows: 1. Based on our observations made to date and the data comprising the Application and Certificate for Payment No. AH-00004, it is our opinion that the work has progressed to the point indicated on the attached application. 2. To the best of our knowledge, the work is in accordance with the Contract Documents. 3. A lien waiver was received by WJE on November 21, 2008, to accompany the payment application per Subparagraph 9.3.4 of Article 9 in Section 00800 of the Project Manual. A copy of this is attached. 4. It is our belief that the contractor is entitled to payment for the amount indicated on the attached. WJE's review of the Application and Certificate for Payment is subject to the limitations listed in Section 4.2.2 of AlA Document A201 referenced in Section 00700 in the Project Manual. One original signed copy of the Application and Certificate for Payment, submitted by A.J. Spanjers is enclosed for your payment. Headquarters & Laboratories-Northbrook, Illinois Atlanta I Austin I Boston I Chicago I Cleveland I Dallas I Denver I Detroit I Honolulu I Houston Los Angeles I Minneapolis I New Haven I New York I Princeton I San Francisco I Seattle I Washington, DC WJE ENGINEERS ARCHITECTS MATERIALS SCIENTISTS Mr. Dave Scherbel City of Arden Hills November 25, 2008 Page 2 Very truly yours, WISS, JANNEY, ELSTNER ASSOCIATES, INC. Digital Signature Brian J. Pashina, P.E. Proj ect Manager Enclosures: Payment Application AH-00004 (2 pages) Lien Waiver (1 page) cc: Bob Spanjers, Jr. (faxed and mailed) A.J. Spanjers, Co. Project File N en en ~ I ::E l- N CO r--- .C) ... 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C ~ ~ C:~ )( t='ES .! ~(l)c tI) ~ g E ~ ~ g B -5 ;0-8 :E ~~ ~ 3: C') <( .... c ~.!!~ o ~:S CD E ;e 0 -g. CD m c: () E ~_Oo :::J ;:: 5 :::. o m,O c ~ ~.;: CD g.!! ; '0 mOO g f! ~o-g ~ ~.~ 2- o ~_ O::s ~ <( (Y) .... <C ~-g-g ~ c..E @fE l:-g~ .~.~ ~ ~o~ 85~ N~~ O):Jo ~ui~ci> I.~ . 0 :;: m ~ <ci ~ f!! .~ ~!:~~ Oca-..c E g Z o i= ::> <C o <F _ *AIA:@ ......~.. - Document G702™ - 1992 Instructions Application and Certificate for Payment GENERAL INFORMATION Purpose and Related Documents AlA Document G702, Application and Certificate for Payment, is to be used in conjunction with AlA Document G703, Continuation Sheet. These documents are designed to be used on a Project where a Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AlA Document A201, General Conditions of the Contract for Construction. Use of Current Documents Prior to using any AlA Contract Document, users should consult www ~aia~org or a local AlA component to verify the most recent edition. Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AlA. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AlA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702, but only for use in connection with a particular project. The AlA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission from the AlA. Rights to reproduce the document may vary for users of .LA1.J\ soft\vare. Licensed .LJ\I.LJ\ software users should consult the End User License Agreement (EULA). To report copyright violations of AlA Contract Documents, e-mail The American Institute of Architects' legal counsel, copyright@ aia.org. COMPLETING THE G702 FORM After the Contractor has completed AlA Document G703, Continuation Sheet, summary information~should Be transferred to AlA Document G702, Application and Certificate for Payment. ,:~ .. The Contractor should sign G702, have it notarized, and submit it, together with G703, to the Architect. The Architect should review G702 and G703 and, if they are acceptable, complete the Architect's Certificate for Payment on G702. The Architect may certify a different amount than that applied for, pursuant to Sections 9.5 and 9.6 of A20l'. The Architect should then initial all figures on G702 and G703 that have been changed to conform to the amount certified and attach an explanation. The completed G702 and G703 should be forwarded to the Owner. MAKING PAYMENT The Owner should make payment directly to the Contractor based on the amount certified by the Architect on AlA Document G702, Application and Certificate for Payment. The completed form contains the name and address of the Contractor. Payment should not be made to any other party unless specifically indicated on G702. EXECUTION OF THE DOCUMENT Persons executing the document should indicate the capacity in which they are acting (i.e., president, secretary, partner, etc.) and the authority under which they are executing the document. Where appropriate, a copy of the resolution authorizing the individual to act on behalf of the firm or entity should be attached. AlA Document G702™ - 1992. Copyright @ 1953, 1963, 1965, 1971, 1978, 1983 and 1992 by The AmericanlnstitutEf qf Architects. All rights reserved. WARNING: This AIA@Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA@ Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AlA Contract Documents, e-mail The American Institute of Architects' legal counsel, copyright@aia.org. N en en ~ I :E I- M <:) ,...... C) ... c:: CD E ::J U o C ~ I I -< .. ~. ~..., , - ~ 00 00 o g g ~ g~~~:t o 0 0 . · N <'t 00 ~:: = ~ o :z: z o .i= <(' o ::::i Q.. 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C\3 r"\ It: C5 ~ o en ~ ~ M ..c: o 0 N :i: ~ s::: o o to r--.: f'- to co 0'> N E Q) E ::3 o o C '0 C\3 '- E o o <( <C (J) (ij (5 f- ,f.~ j-, ~.AIA .#'"6_,",. - Document G703™ - 1992 Instructions Continuation Sheet GENERALINFORMA TION Purpose and Related Documents. AlA Document G702, Application and Certificate for Payment, is to be used in conjunction with AlA Document G703, Continuation Sheet. These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AlA Document A201, General Conditions of the Contract for Construction. Use of Current Documents. Prior to using any AlA Contract Document, users should consult www.aia.org or a local AlA component to verify the most recent edition. Reproductions. This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AlA. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AlA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703, but only for use in connection with a particular project. The AlA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of . written,permiss,on from the AlA. Rights to reproduce the document may vary for users of AlA software, Licensed AlA software users should consult the End User License Agreement (EULA). To report copyright violations of AlA Contract Documents, e-mart The American Institute of Architects. legal counsel, copyright@aia.org. COMPLETING THE G703 FORM Heading: This information should be completed in a manner consistent with simjfar information on AlA Document G702, Application and Certificate for Payment. Columns A, B & C: These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted, The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required. Column C should be subtotaJed at the bottom when more than one page is used and totaled on the last page, Initialfy, this total should equal the original Contract Sum. The total of column Cmay be adjusted by Change Orders during the Project. Column D: Enter in this column the amount of completed Work covered by the previous application (columns 0 & E from the previous application), Values from column F (Materials Presently Stored) from the previous application should not be entered in this column, Col~mn E: Enter here the value of Work completed at the time of this application, including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored (column F), Column F: ~nter here the value of Materials Presently Stored for which payment is sought. The total of the column must be recalculated at the end of each pay period, This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stored materials does not result in a deduction from this column. Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E (Work Completed-This Period,) Column G: Enter here the total of columns OJ E and F. Calculate the percentage completed by dividing column G by column C, Column H: Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date), Column I: This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overaU contract amount. Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done, Usualfy, Change Orders are listed separately, either on their own G703 form or at the end of the basic schedule, The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form, Construction Change Directives: Amounts not in dispute that have been included in Constructton Change Directives should be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201. The following is an example of a Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illustrative purposes only, and are not intended to ref/ect actual construction costs. A B C D E F G H I WORK COMPLETED MATERIALS TOT AL BALANCE ITEM SCHEDULED FROM PREVIOUS PRESENTL Y COMPLETED % TO RET AINAGE NO. DESCRIPTION OF WORK V ALlIE APPLICATION TillS PERIOD STORED AND STORED (G -::-C) FINISH (IF VARIABLE (NOT IN TO DATE RA TE) (D + E) D OR E) (D+E+F) (C - G) 1 MOBILIZA TION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10 ,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS & MISC. CONC. 5,000 0 0 0 0 0 5,000 6 PAVING, UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING, LOWER DRIVE 20,000 0 0 0 0 0 20,000 8 PAVERS 20,000 0 0 10,000 10 ,000 50 10 ,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 105,000 20,000 10,000 10 ,000 40,000 65,000 AlA Document G703™ -1992. Copyright@ 1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA@ Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA@ Document, or any portion of it, may result in severe civil and criminal penalties, and wm be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AlA Contract Documents, e-mail The American Institute of Architects' legal counsel, copyright@aia.org. PARTIAL WAIVER OF liEN , To All Whom It.May'Concern':, WHEREAS$ the undersigned has been employed by City 0 f 'A r d' en. Hills to 'furnish labor and materials for Ext er io'r Mas onry Res t ora tion work, under a contract for the im,provement of the premisE~sdesc.ribedas Arden HiI,ls Ci ty Hall in the. city . (City-'VilJage) of Arden Hills , County of Ram.sey , State of Minnesota ofwhich City of A.rdenHil'ls is the owner. NOW, THER.EFOR.E, this 20 daYhof Novetnb'er . ,X1B. 2098 for and inconsidera.tionQfthE~~umof{EJ $27, 06'3 . 1 2 Dollars paidsimultaneouslyherewith, the receipt whereof is hereby aCknowledgedby the undersigned, the under:.: signed does hereby waive and release to the extent only ofthe aforesaidamount,any lien rights.to,or claim of lien. with respect toandonsaid above-described premises, and the improvements thereon, and on the monies or other considerations due orto become due from the owner, by virtue of said contract on account of labor, services, materials, fixtiJres, apparatus or machinery furnished by the undertsigned to or for the above-described premises, but only to the extent of the payrnent aforesaid. ff.:} . A. J. Spanjers Co., Inc. (Nameofsol~ ownership, corporation or partnership) {;3EALJ corporate seaJ here} ...~ TITLE: President \fV'J~~.I~~~f Eli (A) Name person :or firm with whom you agreed. to. furnish either labor, or services, or materials; or both. (BJ Fill in nature and extent of work; strike the word labor or the word materials if not in your contract. (CJ-Jf-YQu have more.thanone,contract on the same premises, describe theeOAtr-8ct-by nurnber-ifavailable, dat~ and extent of work. (O) Furnish an,accurate enough description of the improvement and location of the premises so that itcanbe distinguished';from 'any other property. tEl Amount shown should be the amount actually. received on that date. iF) If waiver is f~r a corporation. corporate name should be used, corporate seal affixed and title .of officer signing waiver should be set forth; if waiver is for a partnership, tlle partnership name should be used, . - PBnner;should sign and designate himself as partneJ'~ Designed By'The Construction Industry Affairs Committee: (C'IA(:) TOPS 34,59 LITHO IN U, S. A, @ COPYRIGHT 1973. TOPS BUSINESS. FORMs. CHICAG,O.ILL~