HomeMy WebLinkAboutRESOLUTION NO. 2017-27 RESOLUTION NO. 2017-27
RESOLUTION TO APPROVE PAY APPLICATION NO. 5 (FINAL) FROM
RICKLEFS EXCAVATING, LTD FOR THE 2016 UV DISINFECTION SYSTEM
PROJECT IN THE CITY OF FAIRFAX, LINN COUNTY, IOWA
WHEREAS, the City Council of Fairfax, Iowa has contracted with Ricklefs
Excavating, Ltd. for the 2016 UV Disinfection System Project within the corporate limits;
and
WHEREAS, Hall and Hall Engineers, Inc., has recommended approval of Pay
Application No. 5 (Final) from Ricklefs Excavating, Ltd. for a current payment due of
$12,017.72.
NOW, THEREFORE, BE IT RESOLVED, by the City Council of the City of
Fairfax, Iowa,to approve Pay Application No. 5 (Final) from Ricklefs Excavating, Ltd. for
the 2016 UV Disinfection System Project and issue a check for$12,017.72 after 30 (thirty)
days have elapsed from this date.
BE IT FURTHER RESOLVED, by the Fairfax City Council of the City of
Fairfax, Iowa, that the Mayor and City Clerk/Treasurer are hereby authorized and directed
to execute said resolution.
Passed and approved this 11th day of April, 2017.
AYES: Beer, Kell, and Wainwright
NAYS: None
ABSENT: Daly and Volk
eon--� -�---
Burnell G. Frieden, Mayor
ATTEST:
Cynt is Stimson, City Clerk/Treasurer
s
''oa
APPLICATION FOR PAYMENT
APPLICATION NO. 45 (FINAL)
Project: 2016 UV Disinfection System
City of Fairfax, Iowa Wastewater Treatment Plant
Contractor: Ricklefs Excavating, Ltd.
12536 Buffalo Road
Anamosa, Iowa 52205
Owner: City of Fairfax, Iowa
Original Contract
Amount: $243,500.00
Revised Contract
Amount: $243,500.00
Date: April 4, 2017
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 $ 240,354.36
Materials Stored On Site $ -
Change Orders:
Change Order No. Date Approved Amount
1 May 10, 2016 $ -
Total Change In Contract Amount from Change Orders $ -
Total Change Order Work Completed $ -
Total Complete and Stored to Date $ 240,354.36
Retainage 0% $ -
Total Complete and Stored to Date Less Retainage $ 240,354.36
Less Previous Payments $ 228,336.64
Current Payment Due $ 12,017.72
Distribution: Owner Engineer Contractor Other
Page 1 of 3
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.
Author�reO Representative:
By: Date: c
ENGINEER'S/ARCHITECT'S RECOMMENDATION:
|naccordance with the provisions mf 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 Payrnent 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 iahereby recommended.
Engineer's/Archite:cti's AZuthoZrizeep;ese ive:
By: Date: ly
CITY OF FAYRFAX PAYMENT RECOMMENDATION:
Payment to the Contractor is hereby recommended based on the Application for Payment submitted by
the Contractor and the Enginee/m/Aochitwoyorecommendation.
City ofFairfax Authorized Representative:
By: Date:
ATTACHMENTS REQUIRED:
1. Line Item Schedule of Contract Values Summary, Amounts Completed This Period, and Amounts
Completed ToDate, Recommend use ufAIA Document Q783.
2, Line Item Schedule of Contract Materials Stored and Values(if applicable).
ACCOUNTING USE ONLY:
- -
------------------'---------
' -
- -
- '
- '
Page 2 of
APPLICATION FOR PAYMENT
APPLICATION NO.05(FINAL)
Project: City of Fairfax,Iowa Wastewater Treatment Plant
Contractor: Ricklefs Excavating,Ltd.
Engineer: Hall&Hall Engineers,Inc.
Revised Contract Amount: $243,500.00
Date: April 4,2017
Item Item Description Units Qu
Bid Bid Prices This Period To Date
antltles Unit Price Total Quantity Amount quantity Amount %Complete
1 Mobilization LS 1 $ 39,000.00 $39,000.00 0.000 $0.00 1.00 $39,000.00 100.00%
2 Tem ora Erosion and Sediment Controls LS 1 $ 500.00 $500.00 0.000 $0.00 0.00 $0.00 0.00%
3 In-Channel,Non-Contact UV Disinfection S ste LS 1 $ 120,000.00 $120,000.00 0.000 $0.00 1.00 $120,000.00 100.00%
Eleddcai Connection from Blower Building h
4 Proposed UV Disinfection Building 1 $ 20,000.00
LS $20,000.00 9.000 $0.00 1.00 $20,000.00 100.00
5 UV Building LS 1 $ 36,000.00 $36,000.00 0.000 $0.00 1.00 $36,000.00 100.00%
6 Gravel Resurfacin Iowa Gradation No.11 TN 250 $ 18.00 $4,500.00 0.000 $0.00 103.02 $1,864.36 41.21
7 Hc SI me 0150 Sempler LS 1 $ 12,000.00 $12,000.00 0.000 $0.00 1.00 $12,000.00 100.00%
D YSI DO end UVT Monitor with Display LS 1 1$ 8,000.00 1 $8,000.00 0.000 $0.00 1 1.00 $8,000.00 100.00%
Siemens Hydro Ranger 200 with Transducer and LS 1 $ 3,500.00 $3,500.00 0.000 $0.00 1.00 $3,500.00 100.00%
9 50'Ceble
$240,364.36
MATERIALS STORED ON SITE
ITEM i DESCRIPTION UNITS QUANTITY PRICE PER UNIT 1 TOTAL
TOTAL MATERIALS STORED ON SITE 50.00
CHANGE ORDERS This Period To Date
NO. Description Unit Total Unit Price Total quantity Amount Quantity Amount %Complete
Quantity
I Change in Lan ue a for Enequa Sampler 1.00 1 $0.00 $0.00
TOTALS $0.00 $0.00 S0.00
REVISED CONTRACT TOTAL AFTER ALL C.O.(IF ANY) $240 354.36 ORIGINAL CONTRACT WORK COMPLETED
50.00 MATERIALS STORED ON SITE
$0.00 TOTAL CHANGE ORDER WORK COMPLETED
$240 354.36 TOTAL
0.00% 50.00 RETAINAGE
$240 356.36 TOTAL LESS RETAINAGE
$228.336.64 LESS PREVIOUS PAYMENTS
Page 3 of 3
RECEIPT AND WAIVER OF MECHANICS' LIEN RIGHTS
Dated: - /b--1-?-
The Undersigned hereby ackhowiedge receipt of the sum of $17,000.00
CHECK ONLY ONE
1) Flas partial payment for labor, skill and material furnished
2) F1 as payment for all labor, skill and material furnished or to be furnished (except the sum of
$ retainage or holdback)
3) ❑ upon receipt by the undersigned of a check in the amount of$ payable
to and when the check has been properly endorsed and has
been paid by the bank upon which it is drawn this document shall become effective.
4) 1 X] as full and final payment for all labor skill and material furnished or to be furnished to the
following described real property: (legal description, street address, or project name)
PROPERTY ADDRESS: Fairfax, Iowa
PROJECT NAME: Fairfax UV Disinfection System Project
LEGAL DESCRIPTION:
For value received hereby waives all rights acquired by the undersigned to file or record mechanic's liens,against said
real property for labor,skill or material furnished to said real property(only for the amount paid if Box 1 is checked,and
except for retainage shown if Box 2 is checked). The undersigned affirms that all material furnished by the undersigned
has been paid for and all subcontractors employed by the undersigned have been paid in full, EXCEPT:
SUB/SUPPLIER: BAL OWED: SUB/SUPPLIER: BAL OWED:
Nate: If this instrument is executed by Company Name Bert Gurney&Associates Inc.
a corporation, it must be signed by an
officer, and if executed by a By
partnership, it must be signed by a
partner. Title
Address 2g
Please Return To:
Ricklefs Excavating, Ltd. Are you a corporation? Yes No
12536 Buffalo Road If"No", provide Federal ID Number: 4-1-0¢46705
Anamosa, IA 52205 or Social Security Number:
RECEIPT AND WAIVER OF MECHANICS' LIEN RIGHTS
Dated:
The Undersigned hereby ackhowledge receipt of the sum of $2,709.47
CHECK ONLY ONE
1) as partial payment for labor, skill and material furnished
2) as payment for all labor, skill and material furnished or to be furnished (except the sum of
$ retainage or holdback)
3) upon receipt by the undersigned of a check in the amount of$ payable
to and when the check has been properly endorsed and has
been paid by the bank upon which it is drawn this document shall become effective,
4) H as full and final payment for all labor skill and material furnished or to be furnished to the
following described real property: (legal description, street address, or project name)
PROPERTY ADDRESS: Fairfax, Iowa
PROJECT NAME: Fairfax UV Disinfection System Project
LEGAL DESCRIPTION:
For value received hereby waives all rights acquired by the undersigned to file or record mechanic's liens,against said
real property for labor, skill or material furnished to said real property(only for the amount paid if Box 1 is checked,and
except for retainage shown if Box 2 is checked). The undersigned affirms that all material furnished by the undersigned
has been paid for and all subcontractors employed by the undersigned have been paid in full, EXCEPT:
SUB/SUPPLIER: BAL OWED: SUB/SUPPLIER: BAL OWED:
Note: If this instrument is executed by Company Name Schimberg Company
a corporation, it must be signed by q
officer, and if executed 1*% ARICq. Sy
9
partnership, it Must be signed' ,
partner. 4-2
AdAress L L
Lu
COO
0
—1.0 04
Please Return To:
1*r�you a corporation? Yes No
Ricklefs Excavating, L t d. "", ---*�o %
1 10) �%%
12536 Buffalo Road If"No", provide Federal ID Number:
Anamosa, IA 52205 or Social Security Number:
RECEIPT AND WAIVER OF MECHANICS' LIEN RIGHTS
Dated: WJCCV� 1L,_jL()CT
The Undersigned hereby ackhowledge receipt of the sum of $2,989.52
CHECK ONLY ONE
1) as partial payment for labor, skill and material furnished
2) as payment for all labor, skill and material furnished or to be furnished (except the sum of
$ retainage or holdback)
3) F1 upon receipt by the undersigned of a check in the amount of payable
to and when the check has been properly endorsed and has
been paid by the bank upon which it is drawn this document shall become effective,
4) Fx] as full and final payment for all labor skill and material furnished or to be furnished to the
following described real property: (legal description, street address, or project name)
PROPERTY ADDRESS: Fairfax, Iowa
PROJECT NAME: Fairfax UV Disinfection System Project
LEGAL DESCRIPTION:
For Value received hereby waives all rights acquired by the undersigned to file or record mechanic's liens,against said
real property for labor, skill or material furnished to said real property(only for the arnount paid if Box I is checked,and
except for retainage shown if Box 2 is checked). The undersigned affirms that all material furnished by the undersigned
has been paid for and all subcontractors employed by the undersigned have been paid in full, EXCEPT:
SUB/SUPPLIER: BAL OWED: SUB/SUPPLIER: BAL OWED:
Note: If this instrument is executed by Company Name Doors Inc,
a corporation, it must be signed by an
officer, and if executed by a By
partnership, it Must be signed by a
partner. Title Ni A
Address _L,4Z W'+V,
11 I-A 514L)
Please Return To:
Ricklefs Excavating, Ltd. "U a corporation? Yes No
12536 Buffalo Road If"No", provide Federal ID Number:
Anamosa, IA 52205 MAR 0 9 Mocial Security Number:
Doors Inc,
Codar Rapids, IA
RECEIPT
AND WAIVER —' —'---^ ^^ ^~~^~~S °~"~~." RoGouoS
Dated:
The Undersigned hereby ackhowledge receipt of the sum 0f
CHECK ONLY ONE
11 [--laspartial payment for labor, skill and material furnished
2) 1-1
as payDoa[d�raU labor, skilland material fU[Mished orbo ba fuDlished (e%oept Wle sUN of
retainage u[ holdback)
3\ / | upon receipt b» the undersigned qfGcheck iDthe mN0oUntof y
p� ah|B
`—� to DdVYhenthe check has been pR)p8dand ndhas
been paid bythe bank upon which itiGdrawn this document shall become effective,
4) Fx1
aa fu|| aDd fiVal payment fq[aU |obV[skU| ond 0@tgria| furnished o[tP bofW[Diohed tV the
following described real property: (legal description, street address, ¢rproject DaUle)
PROPERTY ADDRESS: Fairfax, Iowa
PROJECT NAME: Fairfax UV Disinfection System Project
LEGAL DESCRIPTION:
For value received hereby waives all rights acquired by the undersigned to file or record mechanic's liens, against said
real property for labor, skill or material furnished to said real property(only for the amount paid if Box 1 is checked, and
except for retainage shown ifBox 2isuhockno). The undersigned affirms that all material furnished bythe undersigned
has been paid for and all subcontractors employed by the undersigned have been paid in full, EXCEPT:
SUB/SUPPLIER: BAL OWED: SUB/SUPPLIER: 8AL OWED:
Note: If this instrument is a«euut*U by Company N
ame Stetson Building Products 11fle- LLC
m oorpuraUon, it must be signed by an
otUour, and if executed by a By
padneruh|p, it must be signed by a
partner. Title WLk\ ,ore
Address
Please Return To:
Ricklefs Excavating, Ltd,[Anarnosa, IA 52205
Are You G corporation? Yes KJO
12536 Buffalo Road /f"No", D[¢Vid8 Federal /[) KJVO1he[
or Social Security NUOlb0[: ' —
MAX/I (/LUI Ile X1 11 : 4� AM LUM15KK W. NAA Ro, bMdbujuj r. UUL
RECEIPT AND WAIVER OF MECHANICS" LIEN RIGHTS
Dated:
The Undersigned hereby ackhowledge receipt of the sum of $11,659.64
CHECK ONLY ONE
1) Flas partial payment for labor, skill and material furnished
2) F1 as payment for all labor, skIIJ and material furnished or to be furnished (except the sum of
$ retainage or holdback)
3) upon receipt by the undersigned of a check in the amount of$ payable
to and when the check has been properly endorsed and has
been paid by the bank upon which it is drawn this document shall become effective,
4) n as full and final payment for all labor skill and material furnished or to be furnished to the
Ii�-I1 following described real property: (legal description, street address, or project game)
PROPERTY ADDRESS: Fairfax, Iowa
PROJECT NAME: Fairfax UV Disinfection System Project
LEGAL DESCRIPTION;
For value received hereby waives all rights acquired by the undersigned to file or record mechin(do liens,against said
real property for labor, skill or material furnished to said real property(only for the amount paid if Box 1 is checked,and
except for retainage shown If Sox 2 is checked). The undersigned affirms that all material furnished by the undersigned
has been paid for and all subcontractors employed by the undersigned have been paid in full,EXCEPT-
SUB/SUPPLIER, BAL OWED: SUB/SUPPL.II=R; BAL OWED:
$ $
Note: If this Instrument is executed by
Company Name Beisser Lumber Com an
a corporation, it roust be signed by an
officer, and if executed by a By
partnership, it must be signed by a
partner. Title P
Address PS �c Ute°
Ste+ (._
Please Return To:
Ricklefs Excavating, Ltd. Are you a corporation? Yes No
12536 Buffalo Road If"No", provide Federal ID Number:
Anamosa, IA 52205 or Social Security Number:
RECEIPT AND WAIVER OF MECHANICS" LIEN RIGHTS
Dated: ' } L - -
The Undersigned hereby ackhowledge receipt of the sum of $3,378.00
CHECK ONLY ONE
1) F-1aspartial payment for labor, skill and material furnished
2) as payment for all labor, skill and material furnished or to be furnished (except the sum of
$ retainage or holdback)
3) upon receipt by the undersigned of a check in the amount of$ payable
to and when the check has been properly endorsed and has
been paid by the bank upon which it is drawn this document shall become effective.
4) o as full and final payment for all labor skill and material furnished or to be furnished to the
following described real property: (legal description, street address, or project name)
PROPERTY ADDRESS: Fairfax, Iowa
PROJECT NAME: Fairfax UV Disinfection System Project
LEGAL DESCRIPTION:
For value received hereby waives all rights acquired by the undersigned to file or record mechanic's liens,against said
real property for labor, skill or material furnished to said real property(only for the amount paid if Box 1 is checked, and
except for retainage shown if Box 2 is checked). The undersigned affirms that all material furnished by the undersigned
has been paid for and all subcontractors employed by the undersigned have been paid in full, EXCEPT:
SUB/SUPPLIER: BAL OWED: SUB/SUPPLIER: BAL OWED:
Note: If this instrument is executed by
Company Name Croell Redi-Mix Inc.
a corporation, it must be signed by an
officer, and if executed by a By k1k oafv�
partnership, it must be signed by a
partner. Title
Address
\vow01�....,(A 5tU
Please Return To:
Ricklefs Excavating, Ltd. Are you a corporation? ✓ Yes No
12536 Buffalo Road If"No", provide Federal ID Number:
Anamosa, IA 52205 or Social Security Number:
RECEIPT AND WAIVER OF MECHANICS' LIEN RIGHTS
Dated: 3//3
The Undersigned hereby ackhowledge receipt of the sum of $18,981.60
CHECK ONLY ONE
1) as partial payment for labor, skill and material furnished
2) as payment for all labor, skill and material furnished or to be furnished (except the sum of
$ 982.40 retainage or holdback)
3) upon receipt by the undersigned of a check in the amount of$ payable
to and when the check has been properly endorsed and has
been paid by the bank upon which it is drawn this document shall become effective.
4) as full and final payment for all labor skill and material furnished or to be furnished to the
following described real property: (legal description, street address, or project name)
PROPERTY ADDRESS: Fairfax, Iowa
PROJECT NAME: Fairfax UV Disinfection System Project
LEGAL DESCRIPTION:
For value received hereby waives all rights acquired by the undersigned to file or record mechanic's liens,against said
real property for labor, skill or material furnished to said real property(only for the amount paid if Box 1 is checked,and
except for retainage shown if Box 2 is checked). The undersigned affirms that all material furnished by the undersigned
has been paid for and all subcontractors employed by the undersigned have been paid in full, EXCEPT:
SUB/SUPPLIER: BAL OWED: SUB/SUPPLIER: BAL OWED:
Note: if this instrument is executed by Company Name Reece Electric
a corporation, it must be signed by an
officer, and if executed by a By
partnership, it must be signed by a
partner. Title (��-• r�� res r
Address _ Sa 91 32,,4/ ALL
C,tikr Po,,v-f :Zo
Please Return To:
Ricklefs Excavating, Ltd. Are you a corporation? Yes No
12536 Buffalo Road If"No", provide Federal ID Number:
Anamosa, IA 52205 or Social Security Number:
3 ALLIANT STREET LIGHTING RESOLUTION
ENERGY
The following Resolution L2 V was adopted by the City Council of the City of
� s
at a meeting held on � 20
"
Be it resolved by the City Council of the City of that Alliant Energy Inc.
is hereby directed to make the following changes to the existing system, at the locations described below (or shown on an
attached map made a part of this Resolution) according to the terms expressed in the existing street light contract:
NEW INSTALLATION OR CHANGES IN EXISTING SYSTEM
TYPE AND HEIGHT
ADD NUMBER DELETE NUMBER WATTAGE STYLE OF LUMINAIRE OF POLE WIRING(check one)
1. 5 80w Roadview 80w LED 35'Wood ® OH ❑ UG
2. ❑ OH ❑ UG
3. ❑ OH ❑ UG
LOCATION OF NEW INSTALLATION OR CHANGES
1. 5 locations along E Cemetery Rd Trail
2.
3.
Mayo & -..__e e,e,'1 P-
��y�l
declared said Resolution duly passed and adopted the
day of t 20 _
\ V
yyjl ✓
Attest
Title 1 )II&OZI
x
Wit; Audra rroaaa•®`"»
75-1261-A 02/07