The URL can be used to link to this page

SW0801-CN110203 APPLICATION AND CERTIFICATE FOR PAYMENT PAGE ONE OF 2 PAGES TO OWNER: PROJECT: Denton Tap Sidewalk Infill. APPLICATION #: 3 Distribution to: City of Coppell PERIOD TO: 01/28/11 255 Parkway PROJECT NOS: SW08 -01 X Owner Coppell, Tx. 75019 Const. Mgr FROM CONTRACTOR: VIA ARCHITECT: City of Coppell CONTRACT DATE: 11/08/10 Architect 3D Paving and Contracting LLC Contractor PO Box 1698 Coppell, Tx. 75019 CONTRACT FOR: 155 Cal. Days -77 Days- 78 Days remain CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment, as shown below, in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Continuation Sheet is attached. Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown therein is now due. 1. ORIGINAL CONTRACT SUM $ 231,754.00 CONTRA 2. Net change by Change Orders $ $ 16.44 3. CONTRACT SUM TO DATE (Line 1 +/- 2) $ 231,770.44 By: - i .-- - /Z. _ Date: // f �> % / / 4. TOTAL COMPLETED & STORED TO DATE -$ 122,255.69 / As. AN, s ® r — — — s a (Column G on Continuation Sheet) State of: Tee 5. RETAINAGE: County of: d 7•i�� MELONY D SCHASTEEN II a. 10.0% of Completed Work $ 12,225.57 Subscribed and sworn to before My Commission Expires • (Columns D +E on Continuation Sheet) I me this 31 day of b I i , , � March 30, 2013 F b. of Stored Material $l ' , r£ of'TO ". (Column F on Continuation Sheet) Notary Public: q Di ,t tu.(Q r k Total Retainage (Line 5a + 5b or My Commission expires: ii ! n t9 O( Total in Column 1 of Continuation Sheet $ 12,225.571 CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 110,030.12 In accordance with Contract Documents, based on on -site observations and the data comprising (Line 4 less Line 5 Total) apn, the Architect certifies to the Owner that to the best of the Architect's knowledge, 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT it ati ©n and belief the Work has progressed as indicated. the quality of the Work is in accordance i th,`CoriiraciDociimAnts, andithe Contractor is entitled to payment of the AMOUNT CERTIFIED. (Line 6 from prior Certificate) $ 70,2832 -•, •} 1 � CC i ' ‘: 8. CURRENT PAYMENT DUE $ r „---- 746.87 ,% ` 9. BALANCE TO FINISH, INCLUDING RETAINAGE � �,- j r AMOUNT CERTIFIED $ (Line 3 less Line 6) $ 121,740.32 ��-- (Attach explanation if amount certified differs from the amount applied for. Initial all figures on this . - --r r application and on the Continuation Sheet that are changed to conform to the amount certified.) CHANGE ORDER SUMMARY ADDITIONS DEdaUcTIONS ARCHI Total changes approved in previous months by Owner By: Date: Total approved this Month This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named TOTALS herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the NET CHANGES by Change Order Owner of Contractor under this Contract. i= / if p e r 1 ,---"1." t '� 2.3, .11 SCHEDULE OF VALUES Company: 3D Paving and Contracting,LLC Project: Denton Tap Sidewalk Infill PO Box 1698 Application # 3 Coppeli, Tx. 75019 Date: 1/31/2011 Period 12/27/2010 TO 1/28/2011 P CONTRACT _T PREVIOUS QUANTITY TOTAL AMOUNT THIS XT EENDED ITEM i DESCRIPTION OF WORK QUANTITY UNIT ( QUANTITY THIS PERIOD QUANTITY UNIT PRICE PERIOD I AMOUNT 1 Mobilization 1 LS 20% 20% 40% $10,000.00 $2,000.00 $4,000.00 4" Thick Reinforced Concrete 2 Sidewalk 30725 SF 13475 2675 16150 $3.60 $9,630.00 $58,140.00 4" Thick Reinforced Concrete 3 Sidewalk in DART ROW 1335 SF 0 0 0 $3.60 4" Thick Reinforced Concrete 4 Sidewalk in Atmos Gas ROW 290 SF 290 0 290 $3.60 $1,044.00 5 Reinforced Concrete Driveway 8560 SF 3874 3367 7241 $4.25 $14,308.75 $30,774.25 — Reinforced Concrete Driveway with — — — 6 Integral Color 310 SF 0 0 $6.00 Remove & Dispose of Concrete 7 Waste Material 9335 SF 3924 3407 7331 $1.00 $3,407.00 $7,331.00 8 Barrier Free Ramp 6 EA 2 2 $450.00 $900.00 Regrade & Adjust Existing 9 Landscaping at 580 S. Denton Tap 1 LS 0 1 1 $1,200.00 $1,200.00 $1,200.00 10 TxDOT PR1 Railing 70 LF 0 0 0 $100.00 11 Erosion Control 1 LS 0 0 0 $2,000.00 12 Traffic Control 1 LS 40% 10% 50% $5,000.00_ $500.00 $2,500.00 13 Retaining Wall- Stacked Block o‘h- ..770 SF 0 115 115 $20.00 $2,300.00 $2,300.00 14 Reset Valve Stack to proper Height 7 EA 2 2 $150.00 $300.00 15 Relocate Water Meter Box 9 EA 4 5 9 $500.00 $2,500.00 $4,500.00 Water Vault & Faucet @ 890 S. 16 Denton Tap 1 EA 0 0 0 $750.00 17 Railroad Pedestrian Signs 4 EA 0 0 0 $150.00 1 18 Sod 12000 SF 0 2000 2000 $0.50 $1,000.00 $1,000.00 19 Concrete Flume at Dairy Queen 1 LS 0 0 $950.00 Concrete Flume at 150 S. Denton 20 Tap 1 LS 1 0 1 $950.00 $950.00 21 Modified Curb Inlet 1 EA 0 1 1 $2,800.00 $2,800.00 $2,800.00 Remove & Replace Metal Beam 22 Guardrail 110 LF 0 0 $45.00 CO#1 Grading and Sod at 120S Denton Tap 1 LS 0 1 1.00 $4,516.44 $4,516.44 $4,516.44 TOTAL Amount Billed $122,255.69 $44,159..19 $122,255.69 Less Retainage: 10% $12,225.57 Less Previous Applications $70,283.25 Net Amount Due This Application $39,746.87