HomeMy WebLinkAbout20070521 - VI-04e
VI-4
Bonestnw
Owner. C of Hast' , 1014th Street East, Hastin , MN 55033 Date: M 7, 2007
For Period: 4/7/Z007 to 5/7/2007 R oast No: 11
Contractor: Ma Constn~ction Inc, 1401 Park Road, Chanhassen, MN 55317
CONTRACTOR'S REQUEST FOR PAYMENT
CONSTRUCTION OF WELL PUMPHOUSE N0.8
BONESTR00 FILE N0.000222-06107-1
SUMMARY
1 Original Contract Amount
2 Change Order -Addition
3 Change Order -Deduction
4 Revised Contract Amount
5 Value Completed to Date
6 Material on Hand
7 Amount Eamed
8 Less Retainage 1 %
9 Subtotal
10 Less Amount Paid Previously
11 Liquidated damages -
12 AMOUNT DUE THIS REQUEST-FOR PAYMENT NO.
Recommended for Approval by:
BONESTR00
Approved by Contractor:
MAGNEY CONSTRUCTION INC.
See attached for signature
Specified Contrail Completion Date:
April 30, 2007
S 657,400.00
$ 9,155.13
S 0.00
$ 666,555.13
S 666,555.13
S o.00
$ 666,555.13
S 6,665.55
$ 659,889.58
S 645,297.48
S 0.00
11 S 14,592.10
Approved by Owner:
CITY OF HASTINGS
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Date: c ' q - 6~
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Application for Payment No. 11
To: City of Hastings (OWNER)
From: MaP,ueY Construction, Inc. 1401 Park Road Chanhassen, MN 55317 (CONTRACTOR)
Contracts General Constritctlon __ .
Prof eel Construction of Well Pumphouse # 8
Owtuis Contract No. l3agituer's Project No. 00022-06107-0
For work accomplished through the date of 5/1/2007
2) Net Change by Change Order/Written AmmdmpNs (_/+) 54,155.13
3) Current Contract Price (1+2): 5666,555.13
4) Total Completed and stored to date: 5666,SSS.I3
5) Retaimge (pa Agteemwt):
1.00% of completed work 56,665,55
5.00% of stored matrrial: $O,Op
Total rdaina8e~ 56,66555
6) Total Completed siid stored to date less retainage (4-5) $659,884.58
7) Less Provious Application for Paymems: 5645,297.48
8) DUE THIS APPLICATION f 14,592.10
Aocam~laoyblg Docu»rataNae:
~N1RAC1'OR'S Cettificadm:
7be ®deisignad CON7RKCItOR certifies curt (1) an pmvious progress payments ropdved 5om OWNER m aoco®t ~'wodc
_ ___ am6+>sAaabD~ennaot~edme~~u>~ayuaveeranapplies.an-aocu~oaGOrrtRACPOIt's umda _.____
incurred in c®xtian w1~ wads comes by prig Applicatlam far Pa ~ o6Ggatiaoa - ....-_ .
wadi, metl:iats and iacasparated in said Wodt otlaawise listed grip epvaed I livoltgh 9 rive; (2) title of all
to Owlvffit rt time d by APp~m for Paymtat win
i1°~ paY~ see and clear aian lima, aemdty>oamrst ar malm6tame (expect such as m mcovaed
by a Barad aooephbk to OWNI~t mdemmFylog OwN13t agaitut my such Imp. seauity iataeet a mwmbtaoce); and (3)
a1I Walk coveted by dtb Appllcabm far payment is in aoooedmce by the tAatlact Dawmmts sad sot defective.
.. a1'~idil'gGl~l
' rJ'"_, ~'` PAMELA M BRUEGGEMEIER Coneh7lctiOn,Ine. (Coutra~ctor)
NOTARY pllgl,IC ~ nINNESOTA ~ ~/
. ~~ • tlr Comm. Expires Jan. Jl. 2010 /// ~~
geV1II Vranicar - Project Manager
State of ~~~_ County of_~~.
Subscribed and sworn to before me this ~_ day of , 2007.
Notary Public
My CommissionF.xpires: __ _~,_
PaY~t dthe above AMOUNI'I' DUB THLS APPLICATION D
Owner
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By: By:
Da[e: I>rt~