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ST8502-CS 870430PAYMENT REQUEST NO. FOR WORK COMPLETED Application for Payment Fi£teen SHEET One OF Six THROUGH THE DATE OF: 04/30/87 PROJECT TITLE: LOCATION: DESCRIPTION: MOORE ROAD IMPROVEMENTS DATE: 05/13/87 Coppell, Texas - Sand?' l.akc l(uad to Belt IAne Road 5,300 1.£. of 37' widc cuucretc l)aVe~nt, store se~er, r~val of existing bridge ~ constn~ction of new concrete bridge 0 Grapevine Creek. OWNER/ENGINEER INFORMATION: OWNER: CItY OF COPPELL ADDRE~: P- O. ~ox 478 CITY/STATE: Coppell, Texas 75019 CQ44TACT P~J~ON: ~ Po~11. P.E.. City Eng,,NONE NO.: I~iONE #O.: 462-0022 'II'IN, INC., ENGINEER: CONSULTING ENGINEER8 AIN~IE&S: 1· 1·· PRESTON ROAD, ~UITE CITY/STATE: DALLAS, TEXAS CONTACT P'ER$ON: Kevin Peiffer P#ONE NO.: (2~4) CONTRACTOR INFORMATION: CONTRACTOR: ADDRESS: CITY/STATE: Lewisville ~ Texas CONTACT PERSON: ~ ,,~.'.~1 436-5S09 ASIILAR CONTRACTING CC~IPANY P. O. Box 713 75067 INI4JRANCE Co.: ADDRE~S: CITY/STATE: BONDING AGENT: ADDRESS: CITY/STATE: I~tPLOYERS OF TEXAS }.~. Clem Lesch, R~sident Sm SEAP~RD SUREqY COMPANY 206 Elm Street, Ste. 106 l,ewisville~ Texas 75067 CONTRACT NO.: CONTRACT DATE: 12/16/85 PROJECT NO.: J254 TOTAL ORIGINAL CONTRACT AMOUNT: TOTAL CHANGE ORDERS: AMOUNT: TOTAL CONTRACT AMOUNT TO DATE: 11938~351.95 - 72.038.48 1,866,3~3.a7 NOTICE TO PROCEED DATE: 01/06/86 COMPLETION TIME: CONTRACT COMPLETION DATE: November 1~ 1P86 PERCENT TIME ELAPSED: 300 CALENDAR DAYS PERCENT WORK COMPLETED: ~g II, JlJjOjjCT; I'1¢}1.)1,11': lll)^l! IHI'JIIJVI.;HI'.N'I':; .... ~,HEET ? DF I, PAYMENT NO. 15 PAY QUANTITY AMOUNT ITEM DESCRIPTION PLAN UNIT TO UNIT TO NO. QUANTITY DATE PRICE DATE 100,1 Prepare right-of-way 53.7 S'l~ 99 7~ 1~100.00 ~Qn?n nn 102,1 Clear & Grub .5 AC .50 2,000.00 1000.00 104.1 Sawcut Concrete 889 I.F 979.00 1.50 146R.~0 104,2 Sawcut Aephalt 1,',', l.l.' 455.00 1.50 682.50 104.31 Remove Old Concrete 270 SY ~cc cc 9.00 ~loo o~ 105.1 'Remove Old Bridge 1 LS 3 An {2,000.0( l?nAn AA 110.1 Rosdway Excavation 7,1~04 ely 7.?A3 AA 4.75 Z~?IQ Oh 120.1 Channel Excavation 447 CY 447 hh 4.75 212~.25 131.1 Borrow (Dens. Cont.) 4,902 CY 4,q~ h~ 10.00 49020_80 162.1 Soddtn~ (Block) 1,084 HY 4.20 164.1 H~dromulchin~ 11~335 SY .50 166.1 Fertilizer 440 LB .20 168.1 Sprinkle Irri§ation 107 HG 8.00 248.1 Flex Base 697 CY q?t 8~ 50.00 &~l~h Ah 252.1 Salvase & Rep. Base 20{) CY ~,~ 3).00 7000.80 260.1 L~e Trea;men; 24,584 SY ~4.~R& AA 1.50 t6R76 hA 264.1 Lime Slurry, 4~ 221 TN ~h ~A 86.00 1Rg63_hO 340.1 ~ACP, Type D 142 TN 142.00 115.00 16330.00 340.2 }~{ACP, Type B 617 TN 617_00 60.00 zTA?A Ah 360.1, 6" Concrete Pavement 22,928 SY ?].~tq A0 17.60 z?h?R6 dh 360.2 ~nolt;htc Curb 8~424 LF 7.?~ ~8 1.70 ]z3~ nA 360.3 Concrete Street Header 127 LF l~7,~ 7.00 ~RQ hh 360.4 Concrete Railroad Header 1OO LF 10O,0Q 11.00 1100.00 421.1 Class A Concrete 49.8 CY 5]_80 1~150.001 qoK7n hn 450.2 Railing (Culvert) 45 LF 46 D0 150.00 ~nn nh 450.3 Handrail 135 ].F 135.00 45.00 §07S.00 464.1 18" RCP, Class III 1,743 LF ] 74~_00 25.00 4~75.00 464.2 21" RCP, Class III 628 LF R3~ nn 27.00 ]6OKR hh 464.3 24" RCP~ Class III 816 LF 786.00 34.00 26724.00 INIOJEOT: ~oI~£ .nAn T~Rnv£~n~'~'~ SHEET leAYMENT PAY QUANTITY AMOUNT ITEM DESCRIPTION PLAN UNIT TO UNIT TO NO. QUANTITY DATE PRICE DATE 464.4 27" RCP, Ciass lI! 286 LF 286.00 38.00 10868.00 464.5 30" RCP, Class III 499 LF 499,0( 40.00 19960.00 464.6 36" RCP, Class Ill 728 LF 728.00 50.00 36400.00 464.7 48" RCP, Class III 94 1,F q4.aO 76.00 7144 464.8 4'x2' RCBC, C-850 228 L~' 228,00 100.00 22800,0Q 464.9 5'x2' RCBCt C-850 197 LF 191,00 115.00 464.~ 7'x5' RCBC~ C-850 60 ~.i; ~n nn 700.00 a?nnn nn 470.1 Type B Headwall 5 Ii^ R Nfl 6,000.00 XNNNN nn 470.2 Type C Headwall 4 In ann 3,ooo.oo l?nnn nn 470.3 Junction Box, Type "A" I EA l_00 6,000.00 470.4 T~pe A Hsadwall (Modified} 2 EA 2.00 9,000.00 18000.00 470.5 Drop Inlet (Modified} .1 FA 1.0D 2,100.00 ?lon fin 470.6 6' Curb Inlets 9 EA 9.00 2,500.00 22S00.00 470.7 6' Recessed Inlet 17 EA 17.00 2~500.00 42500.00 470.8 10' Recessed Inlet Ii EA l~ ~0 3~000.00 ~q~a~ 470.9 10' Curb Inlets 2 EA 2.00 2,800.00 5600.00 470.~ 14' Curb Inlets 1 FA ],00 4,000.00 4000.00 470~1 Storm Manhole~ Type B 3 EA 3,00 2.~00.00 7800.00 470~2 4'x5' San. Swr. Manhole 2 EA ? hO 2,300.00 476 Railroad Bore~ (c.i.p.} 101 LF 103,00 115.O0 11845.00 479.1 Adjust Manhole 4 EA 4 O0 300.00 ]?Dh 00 504.1 Field Office 1 LS 1.00 .2~000.0~ 12000.00 530.1 6" DrivewaY/Alley (~nnr.~ 1.036 SY I 27R 2X 21.50 530.2 4" Sidewalks (conc.} 3,894 SY 2.767.00 16.10 '44548t70 530.3 Brick Pavers 1~159 SY 631.7~ 8.40 5306.62 530.4 6" Curb & Gutter (cont.) 297 LF 91.~0 5.00 455.00 530.5 6" Slope 8.i SY 55.00 544.1 Replace Wood Fence 55 I,F 192.50 15.00 2887.50 582.1 Relocate/Lower 8" Main 190 I.F ~ol ?a 84.00 MOORE ROAI~ IMPROVEMENTS SHS=~T & DF 6 PAYMENT NO~ ] ,~ PAY QUANTITY AMOUNT ITEM DESCRIPTION PLAN UNIT TO UNIT TO NO. QUANTITY DATE PRICE DATE 582.2 Relocate R20 Service 4 .FA 4,00 3IS~QQ 1260.00 582.3 Install H20 Service ] I~ I tiff aNn_nn ANN nn 582.4 30" DI San. Swr. Hain 152 I,F 152.00 90.00 13680.00 582.5 Adjust M~O Valve 20 EA 2fi_tiff 55.00 11fid fin 582.6 Relocate/Adjust S.Swr.Matr 1 EA 400.00 582.7 12" DI, Class 51 662 LF 662.00 34.00 22508.00 582.8 12" Gate Vslve 2 EA 2.00 800.O6 1600.00 582.9 Relocate Fire Hydrant 1 .EA ] 00 700.00 700 nn 582.10 6" DI Gate Valve 1 EA ~00.00 591.1 Stone Facing 1,256 S¥ 1~768.60 1.00 1768.60 618.1 3" PVC Conduit 387 LF 587.00 10.50 4~63.50 674.1 4" Yellow Dbl Refl. Button 509 EA 6.00 676.1 8" ~ntte Refl. Button 22 EA 34.00 676.2 8" Yellow Refl.' Button 99 EA 36.00 666 Thermo Markings 335 I.l: 8.00 ..... No Pay Item 0 416 18" Drill Shafts 80 LF 80,00 43.00 3440.00 416 30" Drill Shafts 482.5 LF 483.62 75.00 56271.50 421 Class C Cont. Abut. 50.6 CY gfi ?n 370.00 ?fiTqd no 421 Class C Cont. Bends 43 CY 43.00 370.00 15910.00 421 Class C Cont. Slab 257.2 CY 259.70 310.00 80507.00 425 Type C B~- 1~183 LF 1~183.00 6I-QQ 72163.00 ~32.1 Concrete Rtprap 1,020 SY ].065.90 ~. '35.00 ~7~06 ~O ~40 Reinforced Steel 67,367 I.B 72~956.00 .47 34289.32 ~42 Structural Steel 2,250 LB 1,980.00 1.40 2772.00 392 17~.00 ~50.2 Brid~e Untlin~ LF 392.00 69776.00 546 Class A Appr. Slab 48.3 cY 48.30 260.00 l?g~R no $11.1 Bridge Electrical 1 LS 1.00 23,000.00 23000.00 I~OJECT: MOORE ROAD II~PROVEI TS SHL f 5 I)P 6 · PAYMFAdT NO, 15 PAY QUANTITY AMOUNT ITEM DESCRIPTION PLAN UNIT TO UNIT TO NO. QUANTITY DATE PRICE 0ATE FIELD EXTRAS 6" PVC S S EXTEN .211 LF 211.00 26.00 5486.00 16" H20 LOWERING 1 LS 1 .NO 8500.fl0 ~na_nn 8" It20 SERVICE 90 LF 90.00 46.00 4140.00 8" x 8" TAPPING ~ ~ V 1 EA 1.00 1850.00 1850.00 'GRADING K~N LEE'S PROP. 1 Lq l _Off gila nO gan no RI PUC' TUTI::'P 1 EA 1.00 2750.00 27~i0.00 MATERIALS ON HAND GROSS AMOUNT DUE 1~826.791.94 SHgET 6 ., .O.F~ PAYMEHT NO. Accompanyin$ Docu~entetion: GROSS AMOUNT DUE ......... $ 1~826~791.94 ., LESS 05 [ RETAiN*GE ..... $ 9[.339.60 ' AMOUNT DUE TO DATE ....... $~ LESS PREVIOUS PA~'fl~NTS... $~_ ANOUNT DUE THIS A~PLIC~TIC)N $ ~R:630.42 NEVIEWED IY: CHECKED BY: DATE: ~-~DATE: GOffTRA CTO~'$ CB~'rlFICAlI~ The tmdereLsned CONTRACTOR cert/fteJ ~t (1) all prevLou, prosress pa~nt~ received f~om ~R on iccoun~ of ~rk d~e ~der ~he ~a~rac~ referred to ~bove have ~ln ~ppl~ to d~ocharge in full ill oblL~cLon8 of C~R incurred la co~ection ~th ~rk c~ere~ by pr~or Appl~ce~ions for P~t .... ~red I ~hroush ~ ~clus~vo; ~ (2) ~t~o t~ '411 liens, cllt~, ~c~r~cy h~ocl md ~c~r~ce. (e~epC ~ch as csr~ ~ b · lJited 7 ASHLAR CONTRACTINC COMPANY // correCTeR BN4idE~I'8 II~COMPJiDATIO~: This Application (with accou~nying docun~nterion) ~eta the requir~nt~ 'of the Contrac~ ~c~ento ~ paint of the above ~UNT ~E ~lS ~PLI~TION. is recomndsd. Title Dated GINN, INC., Consulting Engineers OWNER'8 AI, PROVAL: Pay raquast racaived Approved for payment on .By CITY OF COPPELL day of TITLE by , 19