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WA9801-CS 991222 T SHIMEK, JACOBS & FINKLEA, L.L.P. CONSULTING ENGINEERS 8333 Douglas Avenue, #820 Dallas, Texas 75225-5816 Fax (214) 361-0204 Phone (214) 361-7900 ROSS L. JACOB& P.E. RONALD V. CONWAY, P.E. JOHN W. BIRKHOFF, P.E. JOE R. CARTER, P.E. GARY C. HENDRICKS, P.E. PAUL A. CARLINE, P.E. MATT HICKEY, P.E. December 22, 1999 H & W Utility Contractors 305 Main S et Le~...e , 65 "State Highway 121 Water Line Affidavit of Final Payment Gentlemen: We are enclosing two copies of the Affidavit of Final Payment and Release, along with a preliminary copy of Pay Request No. 3 and Final for the City of Coppell State Highway 121 Water Line project. During the final inspection of the project we reviewed the final quantities with your project superintendent and Mr. Larry Davis of the City of Coppell. This final pay request reflects our findings in the field. Please sign and return both copies of the Affidavit to this office· ~ Upon receipt of the executed Affidavit, we will forward the final pay request to the City of Coppell for their consideration. Since · dri s, P.E. cE~.'cl°~r. Ken Griffin, P.E. Mr. Larry Davis MONTHLY PAY REQUEST ~' Page 1 of 1 City of Coppell, Texas State Highway 121 Water Line Project No. WA-98-01; Bid No. Q-0199-02 From: 1-Aug-99 To: 22-Dec-99 Pay Request No. 3 and Final Contract Date: March 23, 1999 Original Contract Amount: $ Revised Contract Amount: Contractor: H & W Utility Contractors 305 Main Street Lake Dallas, Texas 75065 Item No. Description I 12" PVC Waterline with Embedment 2 12" PVC Waterline by D~y Bore 3 12" PVC W.L in 18", 3/16" Encase. Pipe by Dry Bore 4 12" PVC Waterline w/Class "G" Cone. Encasemerit 5 8" PVC Waterline with Embedment 6 6" PVC Watedthe with Embedmerit 7 12" Gate VaNe 8 8" Gate Valve 9 6" Gate Valve 10 Standard Fire Hydrant 11 2" Air and Vacuum Release Valve 12 6" Blow-Off Valve and Assembly 13 Connecting to Existing 12" Waterline 14 Ductile Iron Fithngs 15 Remove & Replace Existing Concrete Pavement 16 Remove & Replace Existing Asphalt Pavement 17 Remove & Replace Existing Gravel Drive 18 Extra Concrete for Encasement 19 Extra Crushed Stone for Embedmere 20 Erosion Control Devices 21 Traffic Control Devices 22 Trench Safety Systems 23 Remobilization (Change Order Number 1 ) Prepared and SubmiRed by: SHIMEK, JACOBS & FINKLEA, L.L.P. Consulting Engineers, Dallas, Texas By: Date: Approved for Owner By: Date: Gary C. Hendricks, P.E. 12/22/99 ~ I~-- Quantity ~Pro~ R~vlsed Unit osal Quantity L.F. 4,137 0 L.F. 40 0 L.F. 33 0 L.F. 190 0 L.F. 60 0 L.F. 30 0 Ea. 8 0 Ea. 6 0 Ea. 6 0 Ea. 6 0 Ea. 3 0 Ea. 2 0 Ea. 2 0 Lbs. 3,370 0 L.F. 50 0 L.F. 27 0 S.Y. 24 0 C.Y. 30 0 C.Y. 30 0 L.S. 1 0 L.S. 1 0 L.F. 4,417 0 262 L.S. 0 1 1 180,217.54 $ 178,344.34 Project Start Date: 31-May-99 Completion Date: 4-Sep-99 Cal. Days Allotted: 97 Used: 206 Quantity Coraplete Tonl This omW;f~ Contract Ex~nded 257 4,177.0 $23.42 $ 97,825.34 0.0 $133.00 $ 33.0 $32.00 $ 1,056.00 15 190.0 $45.00 $ 8,550.00 60.0 $18.50 $ 1,110.00 30.0 $17.00 $ 510.00 1 7.0 $1,050.00 $ 7,350.00 6.0 $510.00 $ 3,060.00 6.0 $425.00 $ 2,550.00 6.0 $1,740.00 $ 10,440.00 3.0 $2,350.00 $ 7,050.00 2.0 $1,570.00 $ 3,140.00 2.0 $3,250.00 $ 6,500.00 3,370.0 $1.70 $ 5,729.00 50.0 $75.00 $ 3,750.00 27 27.0 $30.00 $ 810.00 24.0 $20.00 $ 480.00 28.0 $100.00 $ 2,800.00 0.0 $15.00 $ 1.0 $750.00 $ 750.00 1.0 $1,850.00 $ 1,850.00 1 $4,200.00 $ 4,200.00 $ 178,344.34 0% $ $ 178,344.34 $ 148,559.76 Total Amount L~ss Amoum Retained Total An~911nt Pa abl~. ~Ss Previous payments SHIMEK, JACOBS & FINKLEA, L.L.P. CONSULTING ENGINEERS Monthly Consulting Pay Request Status Today's Date: December 22, 1999 Client: Name of Project: Pay Request No. 1 2 3 and Final 0 0 0 Monthly Consulting Pay Request Status City of Coppell, Texas Project No. State Highway 121 Water Line Project No. WA-98-01; Bid No. Q-0199-02 Final Contract Amount: $ Date of Pay Request Total Amount 28-Jun-99 $ 70,651.20 4-Aug-99 $ 165,066.40 22-Dec-99 $ 178,344.34 0-Jan-00 $ 0-Jan-00 $ O-Jan-O0 $ Amount Due This Request $ 63,586.08 $ 84,973.68 $ 29,784.58 98167 178,344.34 % Complete I 39.62% 92.55% 100.00% 0.00% 0.00% 0.00%