Loading...
HomeMy WebLinkAboutRESOLUTION NO. 2014-66 APPLICATION FOR PAYMENT APPLICATION NO. 02 Pro ect: Phase 2 East Cemetery Road Street Reconstruction,Trail. and Drainage Improvements in Fairfax, Linn County, Iowa Contractor: Rathje Construction Co. P.O. Box 408 Marion, Iowa 52302 Owner: City of Fairfax, iowa Original Contract Amount: $973,267,26 Revised Contract Amount: $974,440.60 Date: June 5, 2014 The Contractor noted above, in accordance with the provisions of the contract documents, hereby requests -approval of this application for payment on the following estimates of contract work completed, Original Contract Work Completed $ 53,158.60 Materials Stored On Site $ - Change Orders: Change Order�No. Date Approved Amount No, 1 June 10,2014 $1,173-34 Total Change In Contract Amount from Change Orders l $ 1,173.34 Total Change Order Work Completed $ 376,00_ Total Complete and Stored to Date $ 53,534.60_ Retainage 5% $ 2,676.73 Total Complete and Stored to Date Less Retainage $ 50,857.87 Less Previous Payments $ 7,918.95 Current Payment Due $ 42,938.91_ Distribution: Owner__11,-,-1._Engineer_—Contractor--,I-,-.--Other— Page 1 of 4 CONTRACTOR'S CERTIFICATION - The undersigned Contractor certifies,to the best of the Contractor's knowledge, that the above information and estimated values of completed work covered on this Application for Payment have been completed in accordance with the provisions of the Contract Documents, that all amounts have been paid by the Contractor for work for which previous Applications for Payment have been made and payments received from the Owner, and that the current payment billing requested is now due. Contractor's Authorized Repres ative, Z By: AL14,-Z ENGINEER'S/ARCHITECT'S RECOMMENDATION: In accordance with the provisions of the Contract Documents and based on the Engineer's/Architect's on- site observations of the work included in this Application for Payment and based on the Engineer's/Architect's review of this Application for Payment including the accompanying supporting data, and to the best of the Engineer's knowledge, information and belief, the work included in this Application for Payment is completed substantially in conformance with the Contract Documents and payment by the Owner is hereby recommended. Engineer's/Architect's Authorized Representative: By: r Date; CITY OF FAIRFAX PAYMENT RECOMMENDATION: Payment to the Contractor is hereby recommended based on the Application for Payment submitted by the Contractor and the Engineer's/Architect's recommendation. City of Fairfax Authorized Representative: iv By: 7 Date: ATTACHMENTS REQUIRED: 1. Line Item Schedule of Contract Values Summary, Amounts Completed This Period, and Amounts Completed To Date. Recommend use of AIA Document G703. 2. Line Item Schedule of Contract Materials Stored and Values (if applicable). ACCOUNTING USE ONLY: Page 2 of 4 mWA 7rov_wfQtrOPA»D7 HEFZw NOOG<OPOOo00OOo O A"A?7m33`mw°w3GHnnh4 D].-:::':'.::W-:'�W:.wNOO-:-...:'..rv'<�-3mm3wm°hofEi_-wOpJrOPOOOOOO..:.iAA L l.f.'..:;:':`:..:.':._'�eN.aOtlO�n.fdHmmASO OpOpa D R NwmNm�mCim--n'7_..mHw^mDN-mWVWAOa rrOmOppODOo-�O M_n:Y'N1row.try3pNAWpOOpO0O0pO©OOoA.7�_.:"�t'-Na.NVO0o:.:._:».'®y.'.E'..Op�.OC(Or6OO'''�../f..aww�a3YDv❑noL3-'N❑':'-..'-'.'.ffmwm_moAwmOOpOCOvCAO0OPARO i 7ro�m�Wn_POp_0D-]fF:.TW�poVr.0A.-_,.A.:Aa��..3a❑!rFmnm�m23-I.p.'''..',.-:--�r6S:N�Pe(VxpOo��5hv"s]`°moOOO0C0'flJ»'ai7lfl'fr=ma��NCA0P00ti3.-`�NO0p..n`Al+..+rIfHO.Wp❑m❑mxopt0p00a-UnUA+W]i-etEGW0POoSm¢�nvWmL�OptlOOJa00A»o-::-HOfEmOsNO0O00a33m-❑=u!SODAA»i'.e(fom�m�v,mNGp0P0003rwam3WVppOrR_�A»l'6fFuWm0pr33�snJJWNC00TqmOAAvi+)J r.r-NO_¢m���mNN:n';:--EVW--WUSiO�WwWNmW::,-...9-:!.':"m'm.�its-Wmq❑»cmm.''a..wfmtsowNOA(mNNNO'p0`cnA46°RoV��s 6[mmr(NNpO0eim,mmm=mcaOppo7�OJd!noD9'l ficlWeN0OOp00ammmamymOtlOFTrg r-:vcCtl(Is��N''.Tn.n..:v!bW:.(�OOOQt.p.'pp'.'?{'..:...::-�.`..-farn:°¢h.ym_-,- Ebmv❑NoonCrow'mWOOpppoo0p0amSW4A�a 7 1,'-.::m »'-''.:'--.:nmNmJO�Np5HbIpOa q 99i(m'PE i.'nOWc'-NO6V-:�»'&st_ACpo-:..:._.J,.:i.:(mm3�-'vw-.:.]pOsi�OOPD9Ef6OOpCOoOo pA9a°mvg❑❑i'.d.N0op0'f`�mTr�OOOSaO:»�9 f{�c❑4OOoO0wnmOtlPcAp�r fW0c❑���nmN6OpO0J-A°.,v4NWcW03`[mm{W�0co09�aP?�'-<g1OO0O..n'....dbpCpa..-..':�']di/v�ro-:wN`_A�'.::-'.p-Wta❑(OQPon&COobO F.lma❑°ov{_cODNfOP_-nD�'&Lf`OOoO'.A.0'.''.'�--f N>qcogap'n_:''. 6rN->v'aD>aN4OPflff1TOO0�Afl. _�vmpQ'2fe❑OO0O:O A.A../N'a>c.-_A.x.�. yfOfav4rO0OoOcaO0D4U�AnAi"i,�ffpe3�ND�O0pOd0OmDO�O46-A'n>:-!--Sw'mrD00po0�O0O0'nhp. damvf0p0�p60-p6C4h�]_.i fW6�p❑d4W0O00�0NJSA»9 ffm❑as�V0oOt0dWouoO6PR'i9v f4mnmme❑-W0ao0RRn'.mfVfmavmNNa0o000/n4.-#Tbmn❑'cm�edPS00o00oa9�. N6uc��4WWOcvOo0ANpO_nA 9 uFN-c�r9uNONoONA0ONaW0pOP fla 9 f6-cawh.�wt�W{0oaO0tlAoT4.'--4Wc0w'�pbTv0o0JVd0O fl's9,-.'s�_pENd0d'.-ni4f:OOP.-AR:ca2mh❑ro"m� crWVam�O0NpO0nooDA- Rst fe WNmONwWppWNcOdOdO onIUVNpNNV`:.x Hs.PO0O:❑N,aOmf._.-`'wbNoHOfNOO0O A[i❑N-a❑n.bLf'.vuW-A wO00O.4OCP.A�9.a 1+mSwmacNOO00pAVNA'�m�mNc'ayWWS[[Vo0ppm b ryryo}vwnoUcm'I1-.13:wWTFwNO»4<uuCmpIm'aOO 6--aNwa�❑auN-tNrp(m.[N�WIJ0lSn'9'ri 1!AE(uHBxwaamWS<N0pp6rnA»fl,..wwO0<Ntnp<4mOOOpOO 9mjvn3❑c❑S" .tr�afmw6my<-OS.0<vNVrUOWOOUNVn,oD�D o,,I mymnaE3�AmOcpo0oOOO1pOn9r,�7 7'e wm:n..`�pO--"DW':-OppOO:�.',H:m-❑Nw2��t..w-wbN-�tl's T•fVTNO0OoaAbLL Am3mNNaCZm 1 t•{mm❑m{SdWOmWa'VQAwD�GlnH y!.-' fifmv'mx'9amNWTNPa0OOOOD00PooF D .HffNQtmWV.OC00OOGOmCO0A.P❑aSJl 6.-�OO_opaOp.ppcOr4O�N0a-:-41.., Nd£�omm0N_C❑$.c0pO000pNo0A.n!)w9,:'_.<fffm�_No0VmppoQcNmdpOp.::'R.:nD9 A:I- fhmE=�mmah"m3OoO0O0OoNOQO.sAas3 HH6� 0 v D � m T N o < _ w w Cv Ov h hh3 3. cso ° . mo nm ¢ o �� ac � C �a3 mc coN vi N oNo . ❑ om mmmo3owvmwo ° h0mmovH�1moopO0D0OpNLLGfP6n9] ++ 0 mm m v m ❑❑ aa a G v N v amm3Q °3 3 emox ocN N 0 0 FCm:h mh h 3 m � mro m v o ❑n -_; m m ah pWN 3W W h h e. mav d G= mo ro ' o��❑ ' mm ❑w N'N 3 m 60 �vwpo0aOVWopaO`O-6NO'�OPL]• �. y�mmCmm7GaCoTa��7an3.°$}" �-163a❑oCa � ® 'm(gy1m�Om 0p c�Na m 3 o o ❑ 0 ca ° 000 3 ¢ m m bN x m y rn o m D DA cn <{ { < < { N { T a DR ➢ Dm A< { mm to � N N W N 6 m t D b DD ➢ DAr 0 7mm[°❑dmAop77 mwfw��wnm 3�� a anmwh?O7(T7 f�wa❑m-ONmmm�n -N 7 0 ?ZNNmNcN�aZ vn »as - ry n Re- r0Po 60 P 0 Sp -: AEh COE - 'N Cy ° �9 OOn pO lopO V 4 pp ONO O 0 0 S pO OO 0 O O O p Pp pO 00 I Ay6 o0Oym P O p CP. p O 0 OOO O0p O-P - 0 OS V00 a O O O OO O 0D O mNW n 1)3 o p 0 Opo 0 coo 0 w 's Q o NNO O p 1 p O O 00 D p p 000 o p O O O o0x000 p O 0 OO- a a000Cta ' ppp 511 51 a aO P a OO p O0 0 0 W O 0 M 0 0 p p O 0 0 p pO Q 0 O0 0 00 0p h01 W r H Hmw6yOOO Op ppppp 0 0 ob0 oO O O O OOOa s O O a 00 0 00000 0 0V o p0 0 oa oo 000pppp 0 000ao p p 000 oopp p 0pp o ODp s ou 0 0 O p 0 O O O ppQ pp'oonop-GApp p PPO p OONO8 O a ©0 pNp 000O 0 0 OO O O O p pap O pPOp, O O OO a o oxo 0 -� '. a m m pgggp g _2 g p p p p , g ;m 7 . \\\ § ; C-) 0 \ \ _ tn m §$ (G 7 < - ! (\§ƒ 2 m \| [% | § � 3 �3 \ § � G ! k 2 2 :f-- F R o p U)ea 00 2. 40 07 ; mAft ) k §9 / --® o ; § § ) § - j rri . �o� - ,mom - E § \ coo ! G \ ) + r § RM883 2 : ■/�»_mg o _ r§�G5> §rn ; � § §§ 9 E§(>�§ M2 J ■ 40 n oma_ . )t § § q §� k�m0 mm[ - 7 m 0 \ 0 |