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2022-10-17 I01F_03 Public Works Site Expansion Phase 1_Pmt Est 9
AGENDA ITEM: CITY OF WAUKEE, IOWA CITY COUNCIL MEETING COMMUNICATION MEETING DATE: October 17, 2022 AGENDA ITEM:Consideration of approval of Payment Estimate No. 9 to Core Construction Services, LLC for the Waukee Public Works Site Expansion Phase 1 project, in the amount of $1,101,997.14. FORMAT:Consent Agenda SYNOPSIS INCLUDING PRO & CON: Core Construction Services, LLC requested Payment Estimate No. 9 for the work completed on the Waukee Public Works Site Expansion Phase 1, in the amount of $1,101,997.14. Farnsworth Group has reviewed the pay estimate and recommends payment. The partial payment is for the pay period ending September 30, 2022. This pay estimate is for general conditions, precast walls, joist deck, stair railing, glazing and site utilities. FISCAL IMPACT INCLUDING COST/BENEFIT ANALYSIS: $1,101,997.14 COMMISSION/BOARD/COMMITTEE COMMENT: STAFF REVIEW AND COMMENT: RECOMMENDATION: Approve Payment Estimate No. 9 ATTACHMENTS: I. Payment Estimate No. 9 II. Letter of Recommendation PREPARED BY:Beth Richardson REVIEWED BY:Sara Kappos SKK PUBLIC NOTICE INFORMATION – NAME OF PUBLICATION: DATE OF PUBLICATION: I1F3 ENGINEERS | ARCHITECTS | SURVEYORS | SCIENTISTS 14225 University Avenue, Suite 110 Waukee, Iowa 50263 p 515.225.3469 www.f-w.com October 7, 2022 City of Waukee 805 University Avenue Waukee, Iowa 50263 Attn: Rudy Koester, PE – Public Works Director Re: Waukee Public Works Site Expansion Phase 1 – Waukee, Iowa Application and Certificate for Payment No. 09 Dear Rudy, We are enclosing (1) electronic copy of Core Construction Services, LLC’s Application and Certificate for Payment No. 09, period ending 09/30/2022, requesting payment in the amount of $1,101,997.14 for the above referenced project. Based on our onsite observations and data submitted; including the Schedule of Values & the following: 1. Boone Glass’ Pay Application showing stored shop assembled Aluminum Storefront material with Certificate of Insurance & Photographs. 2. Coreslab Structures (Omaha) Inc.’s Pay Application showing balance of stored Precast Concrete Insulated Wall Panel material with Certificate of Insurance & Photographs. 3. Skold Door & Floor Company’s Invoice, Pay App showing stored Clopay and Arm-R-Lite Sectional Overhead Door material with Certificate of Insurance & Photographs. We certify payment in the amount noted above. Please send payment directly to the Contractor, Core Construction Services, LLC. Sincerely, FARNSWORTH GROUP, INC. Kristofer J. Orth, AIA Architecture Principal Cc: Sara Kappos, City of Waukee Tracy Lovetinsky, City of Waukee Beth Richardson, City of Waukee Tim Royer, City of Waukee Becky Schuett, City of Waukee Jeremy Roush, Core Construction Services, LLC Enclosures 10/07/2022 $1,101,997.14 APPLICATION NUMBER:09 APPLICATION DATE:9/25/22 PERIOD TO:9/30/22 ARCHITECT'S PROJECT NO: A B C D E F G % H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE NO VALUE From Previous This Period PRESENTLY COMPLETED (G /C) TO FINISH Application STORED AND STORED (C-G) (D+E) (not in D or E) TO DATE 1 01 GC's $ 337,243.00 113,577.00 18,638.83 132,215.83 39.20% 205,027.17 6,610.79 2 01B Bonds $ 44,680.00 44,680.00 44,680.00 100.00% - 2,234.00 3 032 Rebar I $ 26,224.00 23,000.00 23,000.00 87.71% 3,224.00 1,150.00 4 032 Rebar M $ 25,671.00 25,295.00 25,295.00 98.54% 376.00 1,264.75 5 033A Sealer L $ 1,983.00 - - 0.00% 1,983.00 - 6 033A Sealer M $ 522.00 - - 0.00% 522.00 - 7 033B Densifier L $ 10,399.00 - - 0.00% 10,399.00 - 8 033B Densifier M $ 5,713.00 - - 0.00% 5,713.00 - 9 033C Fluid Apply L $ 21,196.00 - - 0.00% 21,196.00 - 10 033C Fluid Apply M $ 20,139.00 - - 0.00% 20,139.00 - 11 036 Grout I $ 14,339.00 - - 0.00% 14,339.00 - 12 036 Grout M $ 1,173.00 - - 0.00% 1,173.00 - 13 03A Footing L $ 75,159.00 59,136.00 59,136.00 78.68% 16,023.00 2,956.80 14 03A Footing M $ 88,846.00 84,369.00 84,369.00 94.96% 4,477.00 4,218.45 15 03A SOD L $ 12,482.00 - - 0.00% 12,482.00 - 16 03A SOD M $ 11,434.00 - - 0.00% 11,434.00 - 17 03A SOG L $ 65,110.00 3,062.00 3,062.00 4.70% 62,048.00 153.10 18 03A SOG M $ 150,235.00 24,277.00 24,277.00 16.16% 125,958.00 1,213.85 19 03D Precast Embed M $ 35,682.00 7,137.00 7,137.00 20.00% 28,545.00 356.85 20 03D Precast Shops $ 136,531.00 123,221.00 123,221.00 90.25% 13,310.00 6,161.05 21 03D Precast Wall M $ 1,259,745.00 18,484.82 3,109.00 1,059,366.00 1,080,959.82 85.81% 178,785.18 54,047.99 22 04A Masonry I $ 4,357.00 - - 0.00% 4,357.00 - 23 04A Masonry M $ 6,534.00 - - 0.00% 6,534.00 - 24 05A Erect Precast $ 133,676.00 - - 0.00% 133,676.00 - 25 05B Erect Joists $ 101,618.00 - - 0.00% 101,618.00 - 26 05C Install Decking $ 32,249.00 - - 0.00% 32,249.00 - 27 05D Misc metals - I $ 15,643.00 - - 0.00% 15,643.00 - 28 05E SS Material $ 138,094.00 - 138,094.00 138,094.00 100.00% - 6,904.70 29 05F Joist Deck M $ 693,860.00 - 693,860.00 693,860.00 100.00% - 34,693.00 30 05G Stair Railing M $ 3,296.00 - 3,296.00 3,296.00 100.00% - 164.80 31 05H SS Plate I $ 1,888.00 - - 0.00% 1,888.00 - 32 05H SS Plate M $ 23,979.00 - - 0.00% 23,979.00 - 33 06A Rough Carp M $ 10,204.00 - - 0.00% 10,204.00 - 34 07A Roof M Foam $ 102,038.00 - - 0.00% 102,038.00 - 35 07A Roof Material $ 270,401.00 - - 0.00% 270,401.00 - 36 07A Waterproofing L $ 21,675.00 - - 0.00% 21,675.00 - 37 07B Roof Labor $ 120,711.00 - - 0.00% 120,711.00 - 38 07C Sheet Metal -M $ 48,978.00 - - 0.00% 48,978.00 - 39 07D Air Barrier L $ 2,857.00 - - 0.00% 2,857.00 - 40 07D Air Barrier M $ 2,041.00 - - 0.00% 2,041.00 - G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification is attached. In tabulations below, amounts are stated to the nearest penny. Use Column I on Contracts where variable retainage for line items may apply. CONTINUATION SHEET (G703) G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification is attached. In tabulations below, amounts are stated to the nearest penny. Use Column I on Contracts where variable retainage for line items may apply. CONTINUATION SHEET (G703) Core Construction 21114 Waukee Public Works Phase 1 1 of 3 A B C D E F G % H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE NO VALUE From Previous This Period PRESENTLY COMPLETED (G /C) TO FINISH Application STORED AND STORED (C-G) (D+E) (not in D or E) TO DATE 41 07D Sheet Metal - I $ 35,713.00 - - 0.00% 35,713.00 - 42 07E. Fibercement I $ 3,592.00 - - 0.00% 3,592.00 - 43 07E. Fibercement M $ 15,306.00 - - 0.00% 15,306.00 - 44 07I Joint Seal L $ 31,622.00 - - 0.00% 31,622.00 - 45 07I Joint Seal M $ 13,646.00 - - 0.00% 13,646.00 - 46 08A Doors Hardware I $ 2,653.00 - - 0.00% 2,653.00 - 47 08A Doors Hardware M $ 20,573.00 - - 0.00% 20,573.00 - 48 08C Access DR M $ 2,551.00 - - 0.00% 2,551.00 - 49 08D Sectional DR I $ 17,551.00 - - 0.00% 17,551.00 - 50 08D Sectional DR M $ 81,427.00 - 1,627.00 79,800.00 81,427.00 100.00% - 4,071.35 51 08E StoreFront I $ 16,546.00 - 4,235.00 4,235.00 25.60% 12,311.00 211.75 52 08E StoreFront M $ 9,867.00 197.00 9,670.00 9,867.00 100.00% - 493.35 53 08G Glazing I $ 5,170.00 - 4,235.00 4,235.00 81.91% 935.00 211.75 54 08G Glazing M $ 1,682.00 34.00 1,648.00 1,682.00 100.00% - 84.10 55 09A CFMF L $ 17,060.00 - - 0.00% 17,060.00 - 56 09A CFMF M $ 15,510.00 - - 0.00% 15,510.00 - 57 09A Gypsum L $ 11,087.00 - - 0.00% 11,087.00 - 58 09A Gypsum M $ 1,378.00 - - 0.00% 1,378.00 - 59 09C. Int. Paint I $ 24,336.00 - - 0.00% 24,336.00 - 60 09C. Int. Paint M $ 20,641.00 - - 0.00% 20,641.00 - 61 09D HP Paint I $ 39,642.00 - - 0.00% 39,642.00 - 62 09D HP Paint M $ 41,689.00 - - 0.00% 41,689.00 - 63 10A Sign I $ 1,701.00 - - 0.00% 1,701.00 - 64 10A Sign M $ 1,678.00 - - 0.00% 1,678.00 - 65 10B Project Sign M $ 917.00 - - 0.00% 917.00 - 66 10C Specialities I $ 898.00 - - 0.00% 898.00 - 67 10C Specialities M $ 2,488.00 1,867.00 621.00 2,488.00 100.00% - 124.40 68 21A Sprinker I $ 25,747.00 - - 0.00% 25,747.00 - 69 21A Sprinker M $ 40,815.00 - - 0.00% 40,815.00 - 70 21A Sprinker Shops $ 8,163.00 8,163.00 8,163.00 100.00% - 408.15 71 22A Plumb Fixtures L $ 20,408.00 10,204.00 10,204.00 50.00% 10,204.00 510.20 72 22A Plumb Fixtures M $ 73,468.00 63,265.00 63,265.00 86.11% 10,203.00 3,163.25 73 22B UG Plumbing L $ 8,163.00 7,143.00 7,143.00 87.50% 1,020.00 357.15 74 22B UG Plumbing M $ 4,082.00 3,062.00 3,062.00 75.01% 1,020.00 153.10 75 22C AG Plumbing L $ 4,082.00 2,041.00 2,041.00 50.00% 2,041.00 102.05 76 22C AG Plumbing M $ 3,061.00 1,021.00 1,021.00 33.36% 2,040.00 51.05 77 23A Fans louvers L $ 2,041.00 - - 0.00% 2,041.00 - 78 23A Fans louvers M $ 9,183.00 9,183.00 9,183.00 100.00% - 459.15 79 23B Toxalert Syst. L $ 3,061.00 - - 0.00% 3,061.00 - 80 23B Toxalert Syst. M $ 12,245.00 12,245.00 12,245.00 100.00% - 612.25 81 26A Temp Elect I $ 4,592.00 - - 0.00% 4,592.00 - 82 26A Temp Elect M $ 3,367.00 - - 0.00% 3,367.00 - 83 26B Power Equip I $ 18,517.00 - - 0.00% 18,517.00 - 84 26B Power Equip M $ 22,638.00 8,919.00 8,919.00 39.40% 13,719.00 445.95 85 26C Eletric UG I $ 15,570.00 13,776.00 13,776.00 88.48% 1,794.00 688.80 86 26C Eletric UG M $ 28,831.00 17,235.00 17,235.00 59.78% 11,596.00 861.75 87 26D Electric RI - I $ 45,638.00 - - 0.00% 45,638.00 - Core Construction 21114 Waukee Public Works Phase 1 2 of 3 A B C D E F G % H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE NO VALUE From Previous This Period PRESENTLY COMPLETED (G /C) TO FINISH Application STORED AND STORED (C-G) (D+E) (not in D or E) TO DATE 88 26D Electric RI - M $ 42,907.00 - - 0.00% 42,907.00 - 89 26E Electric Light I $ 18,661.00 - - 0.00% 18,661.00 - 90 26E Electric Light M $ 96,625.00 32,949.00 32,949.00 34.10% 63,676.00 1,647.45 91 31A Site Demo Labor $ 54,386.00 36,736.00 36,736.00 67.55% 17,650.00 1,836.80 92 31C Site Grading L $ 131,119.00 118,468.00 118,468.00 90.35% 12,651.00 5,923.40 93 31D Site Backfill L $ 9,285.00 2,057.00 2,057.00 22.15% 7,228.00 102.85 94 31E SWPPP $ 34,324.00 10,147.00 281.00 10,428.00 30.38% 23,896.00 521.40 95 32A Paving I $ 91,008.00 9,101.00 9,101.00 10.00% 81,907.00 455.05 96 32A Paving M $ 228,406.00 22,862.00 22,862.00 10.01% 205,544.00 1,143.10 97 32B Walks I $ 7,410.00 7,410.00 7,410.00 100.00% - 370.50 98 32B Walks M $ 6,842.00 6,842.00 6,842.00 100.00% - 342.10 99 32D Paving Mark I $ 1,525.00 1,525.00 1,525.00 100.00% - 76.25 100 32D Paving Mark M $ 510.00 - - 0.00% 510.00 - 101 32E Paving Signs I $ 582.00 - - 0.00% 582.00 - 102 32E Paving Signs M $ 872.00 720.00 720.00 82.57% 152.00 36.00 103 32F Ext. Jt Seal I $ 357.00 - - 0.00% 357.00 - 104 32F Ext. Jt Seal M $ 536.00 - - 0.00% 536.00 - 105 32G Landscape I $ 52,891.00 - - 0.00% 52,891.00 - 106 32G Landscape M $ 52,890.00 - - 0.00% 52,890.00 - 107 32H Splash Block L $ 11,694.00 - - 0.00% 11,694.00 - 108 32H Splash Block M $ 11,694.00 - - 0.00% 11,694.00 - 109 33A Utilities M $ 65,480.00 65,480.00 65,480.00 100.00% - 3,274.00 110 33B Utilities I $ 133,495.00 85,388.00 39,119.00 124,507.00 93.27% 8,988.00 6,225.35 Change Order 1 $ 15,712.16 - 15,712.16 15,712.16 100.00% - 785.61 Change Order 2 $ 9,154.89 926.00 5,500.00 6,426.00 70.19% 2,728.89 321.30 - - - TOTAL Scheduled Values 5,947,567.05$ 1,085,204.82$ 927,706.99$ 1,151,105.00$ 3,164,016.81$ 53.20% 2,783,550.24$ 158,200.84$ Core Construction 21114 Waukee Public Works Phase 1 3 of 3 APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 2 PAGES CONTRACTOR:Core Construction Services PROJECT:APPLICATION NUMBER:3 Distribution to: 3093 NW Prairie Lane Waukee Public Works Site Expansion PERIOD TO:09/19/22 OWNER Des Moines, IA 50313 Phase 1 PROJECT NOS.:21114 CONSTRUCTION 805 University Ave.MANAGER SUBCONTRACTOR: Boone Glass Company Waukee, IA 50263 CONTRACT DATE:12/23/21 ARCHITECT PO Box 4 X CONTRACTOR Boone, Iowa 50036 VIA CONSTRUCTION MANAGER CONTRACT FOR: Aluminum & Glazing VIA ARCHITECT:Farnsworth Group CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment, as shown below, in accordance with the Contract.information and belief, the Work covered by this Application for Payment has been Continuation Sheet, AIA Document G703, is attached.completed in accordance with the Contract Documents, that all amounts have been 1.ORIGINAL CONTRACT SUM $32,600.00 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 herein is now due. 2.Net Change By Change Orders……………………….$2,885.00 CONTRACTOR: 3.CONTRACT SUM TO DATE (Line 1 +2)……35,485.00$ BY: _____________________________________________________ DATE___________ 4.TOTAL COMPLETED & STORED TO DATE…………..$22,503.00 (Column G on G703) State of:___________________________________ County of : __________________ 5.RETAINAGE:Subscribed and sworn before me this day of 20 a. 5% % of Completed Work $415.00 Notary Public: (Columns D & E on G703)My Commission Expires: b. 5% % of Stored Material $710.15 (Column F on G703)CERTIFICATE FOR PAYMENT Total Retainage (Line 5a + 5b or Total in Column 1 of G703)$1,125.15 In accordance with the Contract Documents, based on on-site observations and the data comprising the above application, the Construction Manager 6.TOTAL EARNED LESS RETAINAGE……………………$21,377.85 certifies that to the best of his knowledge, information and belief the Work (Line 4 less Line 5 Total)has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT AMOUNT CERTIFIED. (Line 6 from prior Certificate)$13,492.85 AMOUNT CERTIFIED…………………….7,885.00$ 8.CURRENT PAYMENT DUE $7,885.00 (Attach explanation if amount certified differs from the amount applied for. Initial all figures on this Application and on the Continuation Sheet that changed to conform to the amount certified.). 9.BALANCE TO FINISH, INCLUDING RETAINAGE CONSTRUCTION MGR: (Line 3 less Line 6)14,107.15$ By:___________________________________________Date:__________________ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: Total changes approved in By:____________________________________________ Date: _________________ previous months by Owner $2,885.00 $0.00 This certificate is not negotiable. The AMOUNT CERTIFIED is payable only Total Approved this Month $0.00 to the Contractor named herein. Issuance, payment and acceptance of TOTALS $2,885.00 $0.00 payment are without prejudice to any rights of the Owner or Contractor under NET CHANGES by Change Order $2,885.00 this Contract. 9/19/2022 CONTINUATION SHEET AIA DOCUMENT G703 PAGE - 2 OF 2 AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT APPLICATION NO:3 containing Contractor's signed Certification is attached.APPLICATION DATE 09/19/22 In tabulations below, amounts are stated to the nearest dollar.PERIOD TO: 09/19/22 Use column 1 on Contracts where variable retainage for line items may apply.ARCHITECT'S PROJECT NO:21114 AB CDEFG H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G/C) TO FINISH APPLICATION STORED AND STORED (C-G) (D+E) (NOT IN TO DATE D OR E) (D+E+F) 1 Storefront/Doors $0.00 $0.00 $0.00 $0.00 $0.00 2 Material $9,670.00 $0.00 $0.00 $9,670.00 $9,670.00 100% $0.00 $483.50 3 Labor $16,215.00 $0.00 $4,150.00 $4,150.00 25% $12,065.00 $207.50 4 $0.00 $0.00 $0.00 $0.00 $0.00 5 Glazing $0.00 $0.00 $0.00 $0.00 $0.00 6 Material $1,648.00 $0.00 $0.00 $1,648.00 $1,648.00 100% $0.00 $82.40 7 Labor $5,067.00 $0.00 $4,150.00 $4,150.00 82% $917.00 $207.50 8 $0.00 $0.00 $0.00 $0.00 $0.00 9 CO #1 (Material Cost Increase) $2,885.00 $0.00 $0.00 $2,885.00 $2,885.00 100% $0.00 $144.25 10 $0.00 $0.00 $0.00 $0.00 $0.00 11 $0.00 $0.00 $0.00 $0.00 $0.00 12 $0.00 $0.00 $0.00 $0.00 $0.00 13 $0.00 $0.00 $0.00 $0.00 $0.00 14 $0.00 $0.00 $0.00 $0.00 $0.00 15 $0.00 $0.00 $0.00 $0.00 $0.00 17 $0.00 $0.00 $0.00 $0.00 $0.00 18 $0.00 $0.00 $0.00 $0.00 $0.00 20 $0.00 $0.00 $0.00 $0.00 $0.00 21 $0.00 $0.00 $0.00 $0.00 $0.00 22 $0.00 $0.00 $0.00 $0.00 $0.00 23 $0.00 $0.00 $0.00 $0.00 $0.00 24 $0.00 $0.00 $0.00 $0.00 $0.00 25 $0.00 $0.00 $0.00 $0.00 $0.00 26 $0.00 $0.00 $0.00 $0.00 $0.00 27 $0.00 $0.00 $0.00 $0.00 $0.00 28 $0.00 $0.00 $0.00 $0.00 $0.00 29 $0.00 $0.00 $0.00 $0.00 $0.00 30 $0.00 $0.00 $0.00 $0.00 $0.00 31 $0.00 $0.00 $0.00 $0.00 $0.00 32 $0.00 $0.00 $0.00 $0.00 $0.00 34 $0.00 $0.00 $0.00 $0.00 $0.00 35 $0.00 $0.00 $0.00 $0.00 $0.00 36 $0.00 $0.00 $0.00 $0.00 $0.00 37 $0.00 $0.00 $0.00 $0.00 $0.00 38 $0.00 $0.00 $0.00 $0.00 $0.00 39 $0.00 $0.00 $0.00 $0.00 $0.00 40 $0.00 $0.00 $0.00 $0.00 $0.00 41 $0.00 $0.00 $0.00 $0.00 $0.00 42 $0.00 $0.00 $0.00 $0.00 $0.00 43 $0.00 $0.00 $0.00 $0.00 $0.00 44 $0.00 $0.00 $0.00 $0.00 $0.00 45 $0.00 $0.00 $0.00 $0.00 $0.00 46 $0.00 $0.00 $0.00 $0.00 $0.00 47 $0.00 $0.00 $0.00 $0.00 $0.00 48 $0.00 $0.00 $0.00 $0.00 $0.00 49 $0.00 $0.00 $0.00 $0.00 $0.00 TOTALS $35,485.00 $0.00 $8,300.00 $14,203.00 $22,503.00 63% $12,982.00 $1,125.15 TM DATE INSURED POLICY EFFECTIVE POLICY EXPIRATIONCOTYPE OF INSURANCE POLICY NUMBER COVERED PROPERTY LIMITSLTRDATE (MM/DD/YY) DATE (MM/DD/YY) INLAND MARINE BOILER & MACHINERY OTHER AUTHORIZED REPRESENTATIVE COMPANY COMPANY COMPANY COMPANY BUILDING $ CAUSES OF LOSS PERSONAL PROPERTY $ BASIC BUSINESS INCOME $ BROAD EXTRA EXPENSE $ SPECIAL BLANKET BUILDING $ EARTHQUAKE BLANKET PERS PROP $ FLOOD BLANKET BLDG & PP $ $ $ $ TYPE OF POLICY $ $ $ NAMED PERILS $ OTHER $ $ $ $ $ $$ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE A B C D COVERAGES CERTIFICATE HOLDER CANCELLATION ACORD 24 (1/95)ACORD CORPORATION 1995cO ACORD CERTIFICATE OF PROPERTY INSURANCE PRODUCER LOCATION OF PREMISES/DESCRIPTION OF PROPERTY TYPE OF POLICY SPECIAL CONDITIONS/OTHER COVERAGES PROPERTY CAUSES OF LOSS CRIME 7/27/2022 Hub International Northeast Limited 980 Jolly Road Suite 100 Blue Bell PA 19422 Lexington Insurance Company Coreslab Structures (Omaha)Inc. 802 Allied Rd. LaPlatte NE 68123-4107 Axis Surplus Insurance Company Endurance American Specialty Insurance Company Starstone Specialty Insurance Company THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. A B C D Bldrs Risk/Installa 011144509 EAF643746-22 IMP10014853702 H84824210CSP 1/1/2022 1/1/2022 1/1/2022 1/1/2022 1/1/2023 1/1/2023 1/1/2023 1/1/2023 X Limit 5,000,000 X Deductible 50,000 Job Name and Location:Waukee Public Works Materials being stored at Coreslab Structures (OMAHA)Inc.,802 Allied Road,LaPlatte,NE 68123 valued at $1,059,366.00 Core Construction Svc is included as Loss Payee. See Attached... Core Construction Svc 3093 NW Prairie Lane Des Moines IA 50313 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. LOCATION OF PREMISES /DESCR.OF PROP./SPECIAL CONDITIONS /OTHER COVS. SPECIAL CONDITIONS: Insurance Companies A B C &D -Contractors Equip.Leased or Rented from others: Policy #'s:011144509;EAF64374622;IMP10014853702 &H84824210CSP Eff.Date:01/01/2022 Exp.Date:01/01/2023 Limit:$2,500,000 Insurance Companies A B C &D -Stored property @ jobsite or at Insured’s Premises Policy #'s:011144509;EAF64374622;IMP10014853702 &H84824210CSP Eff.Date:01/01/2022 Exp.Date:01/01/2023 Limit:$5,000,000 Ded.:$50,000 Skold Door & Floor Company, Inc 5730 NE 17th Street Des Moines IA 50313 515-264-8420 Contract Invoice 214443-SEP22 Project: Billed To: Thank you for your prompt payment! Invoice Total: Retention: Amount Due Due Date: Te rms: License: Waukee Public Works 805 University Ave Waukee IA 50263 Core Structural Services 3093 NW Prairie Lane Des Moines IA 50313 C093541 Order# 10/14/2022 2111 4.26 0.00 79,800.00 3,990.00 75,810.00 30DY 09/14/2022 Invoice#: Date: Amount Paid: 0.00 Description Amount September Billing Sectional Overhead Doors Material 79,800.00 Stored Materials Clopay - Delivered 9/13 - Please see attached pictures Arm-R-Lite - Prepaid materials - Delivering 9/22 Notes: REMIT TO: 5730 NE 17TH STREET DES MOINES, IA 50313 Excise Tax: 9/15/2022 To Katie O APPLICATION AND CERTIFICATE FOR PAYMENT TO CONTRACTOR:Core Construction Services PROJECT:Waukee Public Works APPLICATION NO.:214443-SEPT22 Distribution to: 3093 NW Prairie Lane PERIOD TO:9/30/2022 OWNER Des Moines, IA 50313 PROJECT NOS.:21114 ARCHITECT EMAIL ONLY TO :katieo@coreconstructionia.com COST CODE:CONTRACTOR FROM CONTRACTOR:Skold Door & Floor Company 5730 NE 17th Street VIA ARCHITECT:Farnsworth Group Des Moines, IA 50313-1618 CONTRACT DATE:1/19/2022 CONTRACT FOR:Overhead Sectional Doors The undersigned Contractor certifies that to the best of the Contractor's knowledge, infor- CONTRACTOR'S APPLICATION FOR PAYMENT mation and belief the Work covered by this Application for Payment has been completed Application is made for payment, as shown below, in connection with the Contract.in accordance with the Contract Documents, that all amounts have been paid by the Continuation Sheet, AIA Document G703, is attached.Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. 1. ORIGINAL CONTRACT SUM……………...…………………..$97,000.00 2. Net changed by Change Orders ……………………...…….$0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE (Line 1 + 2) …………...……………$97,000.00 4. TOTAL COMPLETED & STORED TO DATE ……...…………$79,800.00 By:_________________________________Date: (Column G on G703) 5. RETAINAGE:State of: IOWA a. _5_ % of Completed Work $0.00 County of: POLK (Column F on G703)Subscribed and Sworn to before b. _5__% of Stored Material $3,990.00 me this day: (Column F on G703) Total Retainage (Line 5a + 5b or Total in Column I of G703)$3,990.00 6. TOTAL EARNED LESS RETAINAGE………………………..$75,810.00 (Line 6 less Line 5 Total)Notary Public: 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 6 from prior Certificates)……………………………………………………$0.00 8. CURRENT PAYMENT DUE …………………………………….$75,810.00 In accordance with the Contract Documents, based on on-site observation and the data 9. BALANCE TO FINISH, INCLUDING RETAINAGE comprising this application, the Architect certifies to the Owner that to the best of the (Line 3 less Line 6)$21,190.00 Architect's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS AMOUNT CERTIFIED…………………...……………..$______________ Total changes approved in previous months by Owner $0.00 $0.00 Total approved this Month $0.00 $0.00 conform to the amount certified.) TOTALS $0.00 $0.00 ARCHITECT: NET CHANGES by Change Order $0.00 By:_________________________________Date:__________________ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Con- tractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. (Attach explanation if amount certified differs from the amount applied for Initial all figures on this Application and on the Continuation Sheet that are changed to September 15, 2022 September 15, 2022 10/30/2024 CONTINUATION SHEET AIA DOCUMENT G703 PAGE 1 OF 1 PAGE APPLICATION NO:214443-SEPT22 Skold Door & Floor Company, Inc.APPLICATION DATE:9/15/2022 5730 NE 17th Street PERIOD TO:9/30/2022 Des Moines, IA 50313 ARCHITECT'S PROJECT NO: CONTRACT FOR:Waukee Public Works CONTRACT DATE:1/19/2022 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL %BALANCE RETAINAGE NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G/C)TO FINISH APPLICATION STORED AND STORED (C-G) (D+E)(NOT IN TO DATE 5% D OR E)(D+E+F) 1 Spec Section 08 36 13 Sectional Overhead Doors 2 Material 79,800.00 79,800.00 79,800.00 100%0.00 3,990.00 3 Installation 17,200.00 0.00 0%17,200.00 0.00 GRAND TOTALS 97,000.00 0.00 0.00 79,800.00 79,800.00 82%17,200.00 3,990.00 CERTIFICATE HOLDER © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECT PRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY GENERAL LIABILITY PREMISES (Ea occurrence)$ DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $ UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY)LIMITS WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNED AUTOS AUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). The ACORD name and logo are registered marks of ACORD COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: INSURED PHONE (A/C, No, Ext): PRODUCER ADDRESS: E-MAIL FAX (A/C, No): CONTACT NAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. X 1-800-247-7756 1,000,000 07/01/22 X 31325 5,000,000 X 5730 NE 17th Street, Ste. 2 3,000,000 1,000,000 ACADIA INS CO X X 1,000,000 XCU Coverage Per Project/Loc. Agg. X 66573793 66573793 07/01/22 07/01/23 PO Box 9207 10,000 X 07/01/22 07/01/23 A 3093 NW Prairie Lane Core Structural Services 3,000,000 X Skold Door Co. Holmes Murphy & Associates - WDM 07/01/22 07/01/23 X 1,000,000 Jake Robertson 300,000 Des Moines, IA 50313 5,000,000 USA Certificate Holder and Owner are included as additional insured. Stored at Skold Door?s warehouse located at 5730 NE 17th Street, Des Moines, IA Stored Materials: Clopay and Arm-R Lite Sectional Doors on pay application 214443-SEPT22, in the amount of 79,800.00. RE: Waukee Public Works SDC 214443 N Des Moines, IA 50313 X CPA3278524-21 0 WCA3279046-22 X A 09/15/2022 1,000,000 A 07/01/23 CPA3278524-21 A Des Moines, IA 50306-9207 CPA3278524-21 1,000,000 eclarkdsm SUPP (10/00) SUPPLEMENT TO CERTIFICATE OF INSURANCE DATE NAME OF INSURED: 09/15/2022 *FIRST NAMED INSURED ON ALL POLICIES: Skold Companies, Inc.* Skold Door Co.