Loading...
HomeMy WebLinkAbout2025-07-21 I01F_01 Waukee Public Safety Building_Pmt Est 19AGENDA ITEM: CITY OF WAUKEE, IOWA CITY COUNCIL MEETING COMMUNICATION MEETING DATE: July 21, 2025 AGENDA ITEM:Consideration of approval of Payment Estimate No. 19 (Combined) for the Waukee Public Safety Building Project in the amount of $1,198,214.89. FORMAT:Consent Agenda SYNOPSIS INCLUDING PRO & CON: The new Public Safety Building (Station 92) is substantially completed and the building is now fully occupied by both the Police and Fire Departments. Pay Estimate 19 for the Waukee Public Safety Building project covers general construction costs, framing and drywall, mechanical and plumbing, electrical, earthwork and landscaping as well as several other smaller items associated with the project. The building is considered 99.17% complete and approximately $245,000 remains to be paid out on the project. FISCAL IMPACT INCLUDING COST/BENEFIT ANALYSIS: Payment Estimate No. 19 is in the amount of $1,198,214.89. COMMISSION/BOARD/COMMITTEE COMMENT: STAFF REVIEW AND COMMENT: RECOMMENDATION: Approve Pay Estimate No. 19 ATTACHMENTS: I. Pay Estimate No. 19 PREPARED BY:Brad Deets, City Administrator REVIEWED BY: PUBLIC NOTICE INFORMATION – NAME OF PUBLICATION: DATE OF PUBLICATION: I1F1 Document G736™ – 2009 Project Application and Project Certificate for Payment, Construction Manager as Adviser Edition AIA Document G736 – 2009 (formerly G722™CMa – 1992). Copyright © 1981, 1992 and 2009. All rights reserved. “The American Institute of Architects,” “American Institute of Architects,” “AIA,” the AIA Logo, and “AIA Contract Documents” are trademarks of The American Institute of Architects. This document was produced at 13:52:16 ET on 07/16/2025 under Order No.4104251064 which expires on 08/13/2025, is not for resale, is licensed for one-time use only, and may only be used in accordance with the AIA Contract Documents® Terms of Service. To report copyright violations, e-mail docinfo@aiacontracts.com. User Notes: (3B9ADA4E) 1 APPLICATION NO:19 Distribution to:TO OWNER:City of Waukee 230 W. Hickman Road Waukee, IA 50263????? PROJECT: Waukee Public Safety Building 815 NW 20th Street Waukee, IA 50263????? PERIOD TO: June 30, 2025 ATTENTION:Brad Deets VIA CONSTRUCTION MANAGER:Ryan Companies US, Inc.PROJECT NOS:6173-000 / 21841001 OWNER: CONSTRUCTION MANAGER: ARCHITECT: OTHER : PROJECT APPLICATION FOR PAYMENT PROJECT CERTIFICATE FOR PAYMENT Application is made for Payment, as shown below, in connection with the Project. AIA Document G737™–2009, Summary of Contractors' Applications for Payment, is attached. 1. TOTAL CONTRACT SUMS (Item A Totals)28,868,514.50 2. TOTAL NET CHANGES BY CHANGE ORDERS (Item B Totals)406,141.96 3. TOTAL CONTRACT SUM TO DATE (Item C Totals)29,274,656.46 In accordance with the Contract Documents, based on evaluation of the Work and the data comprising this Application, the Construction Manager certifies to the Owner that to the best of its knowledge, information and belief the Work has progressed as indicated; the quality of the Work is in accordance with the Contract Documents; and the Construction Manager recommends to the Owner and Architect that the Contractors be paid the AMOUNTS set forth in the attached Summary of Contractors' Applications for Payment. 4. TOTAL COMPLETED & STORED TO DATE (Item F Totals)29,029,183.08 5. RETAINAGE (Item H Totals)1,026,044.92 6. LESS PREVIOUS TOTAL PAYMENTS (Item I Totals)26,804,923.27 TOTAL OF AMOUNTS CERTIFIED ...........................................................1,198,214.89 7. CURRENT PAYMENT DUE (Item J Totals)1,198,214.89 CONSTRUCTION MANAGER: By:Date: The undersigned Construction Manager certifies that to the best of its knowledge, information and belief this Project Application for Payment is an accurate compilation of the Contractors' Applications for Payment, attached hereto. CONSTRUCTION MANAGER: By:Date: State of: In accordance with the Contract Documents, based on evaluation of the Work, the data comprising this Application, and the Construction Manager's recommendation, the Architect certifies to the Owner that to the best of its knowledge, information and belief the Work has progressed as indicated; the quality of the Work is in accordance with the Contract Documents; and the Contractors are entitled to payments of the AMOUNTS set forth in the attached Summary of Contractors' Applications for Payment. County of: ARCHITECT: Subscribed and sworn to before me this day of By:Date: Notary Public: My Commission expires: Document G737™ – 2009 Summary of Contractors' Applications for Payment, Construction Manager as Adviser Edition AIA Document G737 – 2009(formerly G723™CMa – 1992). Copyright © 1992 and 2009. All rights reserved. “The American Institute of Architects,” “American Institute of Architects,” “AIA,” the AIA Logo, and “AIA Contract Documents” are trademarks of The American Institute of Architects. This document was produced at 13:52:01 ET on 07/16/2025 under Order No.4104251064 which expires on 08/13/2025, is not for resale, is licensed for one-time use only, and may only be used in accordance with the AIA Contract Documents® Terms of Service. To report copyright violations, e-mail docinfo@aiacontracts.com. User Notes: (3B9ADAA6) 1 APPLICATION NO.:19 APPLICATION DATE:July 16, 2025 AIA Document G732, Application and Certificate for Payment, has been completed by each Contractor. The content of those G732 forms is summarized below.PERIOD FROM:June 01, 2025 PERIOD TO:6/31/2025 In tabulations below, amounts are in US dollars.PROJECT NOS.:Ryan Co.: 6173-000 / OPN: 21841001 0 A B C D E F G H I J K L DESCRIPTION OF WORK CONTRACTOR'S NAME ORIGINAL CONTRACT SUM NET CHANGES IN THE WORK CONTRACT SUM TO DATE WORK IN PLACE TO DATE STORED MATERIALS (Not in D or I) TOTAL COMPLETED AND STORED TO DATE (D + E) RETAIN- AGE % RETAINAGE AMOUNT PREVIOUS PAYMENTS CURRENT PAYMENT (F – H – I) BALANCE TO FINISH (C – F) % COMPL. (F ÷ C) General Const DDVI 2,905,000.00 100,543.70 3,005,543.70 3,005,543.70 0.00 3,005,543.70 5.00%150,277.19 2,692,333.26 162,933.26 0.00 100.00% Building Concrete Jordison Const 1,271,000.00 0.00 1,271,000.00 1,271,000.00 0.00 1,271,000.00 5.00%63,550.00 1,185,954.35 21,495.65 0.00 100.00% Precast Material Enterprise Precast 1,833,316.00 -2,822.13 1,830,493.87 1,833,316.00 0.00 1,833,316.00 5.00%91,665.80 1,741,650.20 0.00 -2,822.13 100.15% Steel Material TSF Structures 1,932,100.00 6,640.00 1,938,740.00 1,938,740.00 0.00 1,938,740.00 0.00%0.00 1,938,740.00 0.00 0.00 100.00% Erection Northwest Steel 1,064,188.00 13,560.00 1,077,748.00 1,077,748.01 0.00 1,077,748.01 5.00%53,887.40 1,023,860.61 0.00 -0.01 100.00% Metal Panels Forman Ford 575,239.00 0.00 575,239.00 575,239.00 0.00 575,239.00 0.00%0.00 546,477.05 28,761.95 0.00 100.00% Roofing Academy Roofing 998,000.00 3,030.75 1,001,030.75 999,080.75 0.00 999,080.75 5.00%49,954.04 949,126.71 0.00 1,950.00 99.81% Glass & Glazing Ford Metro 1,069,100.00 2,879.33 1,071,979.33 1,071,979.33 0.00 1,071,979.33 5.00%53,598.97 1,017,616.61 763.75 0.00 100.00% Overhead Doors Skold Door 310,000.00 1,346.00 311,346.00 311,346.00 0.00 311,346.00 5.00%15,567.30 291,788.70 3,990.00 0.00 100.00% Frame & Drywall Hilsabeck Schacht 2,562,500.00 38,288.33 2,600,788.33 2,600,788.33 0.00 2,600,788.33 5.00%130,039.42 2,423,714.17 47,034.74 0.00 100.00% Fire Protection Elite Fire Sprinkler 364,700.00 0.00 364,700.00 364,700.00 0.00 364,700.00 5.00%18,235.00 346,465.00 0.00 0.00 100.00% Mech & Plumbing Kruck Plumbing 5,947,000.00 47,307.23 5,994,307.23 5,994,307.23 0.00 5,994,307.23 0.00%0.00 5,633,791.86 360,515.37 0.00 100.00% Elec & Comm Van Maanen 4,711,425.00 178,886.25 4,890,311.25 4,890,311.25 0.00 4,890,311.25 5.00%244,515.56 4,209,092.04 436,703.65 0.00 100.00% Audio-Visual TriCity Electric 602,832.00 -3,112.00 599,720.00 131,553.56 399,784.52 531,338.08 5.00%26,566.90 504,771.18 0.00 68,381.92 88.60% Earthwork Wenthold 803,330.50 720.00 804,050.50 804,050.10 0.00 804,050.10 5.00%40,202.51 738,202.35 25,645.25 0.40 100.00% SWPPP Absolute 155,000.00 0.00 155,000.00 41,975.00 0.00 41,975.00 5.00%2,098.75 38,213.75 1,662.50 113,025.00 27.08% Site Concrete Jordison Const 1,110,000.00 22,784.50 1,132,784.50 1,132,784.50 0.00 1,132,784.50 5.00%56,639.30 1,074,862.70 1,282.50 0.00 100.00% Landscape & Irrig Alpha Landscapes 653,784.00 -3,910.00 649,874.00 584,935.80 0.00 584,935.80 5.00%29,246.79 448,262.73 107,426.28 64,938.20 90.01% 0.00 0.00 0.00 0.00 0.00 0.00 0.00%0.00 0.00 0.00 0.00 0.00% 0.00 0.00 0.00 0.00 0.00 0.00 0.00%0.00 0.00 0.00 0.00 0.00% TOTALS $28,868,514.50 $406,141.96 $29,274,656.46 $28,629,398.56 $399,784.52 $29,029,183.08 3.53%$1,026,044.92 $26,804,923.27 $1,198,214.89 $245,473.38 99.16% Waukee Public Safety Building: Pay Application No. 19 Pay Apps Due to Ryan Co: 06/23/2025 Pay Apps Due to OPN: 6/27/2025 Council Packet Info to Waukee: 7/02/2025 by midnight Council Approval: 7/03/2025 Payment Due to Prime Contractors no later than: 7/7/2025 Prime Contractors Current (less retainage) Bid Package #1: General Construction (DDVI)162,933.26 Bid Package #2: Building Concrete (Jordison Construction)21,495.65 Bid Package #3: Precast Material (Enterprise Precast) Bid Package #4: Steel Material & Misc. Metals (TSF Structures) Bid Package #5: Precast & Steel Erection (Northwest Steel) Bid Package #6: Metal Panels (Forman Ford)28,761.95 Bid Package #7: Roofing (Academy Roofing) Bid Package #8: Glass & Glazing (Ford Metro)763.75 Bid Package #9: Overhead Doors (Skold Door)3,990.00 Bid Package #10: Framing, Drywall & Ceilings (Hilsabeck Schacht) 47,034.74 Bid Package #11: Fire Protection (Elite Fire Sprinkler) Bid Package #12: Mechanical & Plumbing (Kruck Plumbing & Heating) 360,515.37 Bid Package #13: Electrical & Communications (Van Maanen Electric) 436,703.65 Bid Package #14: Audio-Visual (Tri-City Electric) Bid Package #15: Earthwork & Utilities (Wenthold Excavating) 25,645.25 Bid Package #16: SWPPP (Absolute Group)1,662.50 Bid Package #17: Site Concrete (Jordison Construction)1,282.50 Bid Package #18: Landscaping & Irrigation (Alpha Landscapes) 107,426.28 Pay Application Subtotal 1,198,214.90 APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF TWO PAGES TO OWNER:APPLICATION NO:3 Distribution to: City of Waukee Waukee Public Safety Bldg INVOICE NO:3249 OWNER 230 W Hickman Rd Intersection of T Ave & Douglas Pkwy ARCHITECT Waukee, IA 50263 Waukee, IA 50263 PERIOD TO: 6/30/2025 CONTRACTOR FROM CONTRACTOR: Alpha Landscapes LLC 5145 NW Beaver Drive PROJECT NO: Johnston, IA 50131 CONTRACT FOR: Landscaping CONTRACT DATE: 12/18/2023 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 connection 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 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. 1. ORIGINAL CONTRACT SUM $653,784.00 2. Net change by Change Orders $(3,910.00)CONTRACTOR: 3. CONTRACT SUM TO DATE (Line 1 ± 2) $649,874.00 4. TOTAL COMPLETED & STORED TO $584,935.80 DATE (Column G on G703)By: Date:6/23/2025 5. RETAINAGE: a.a.5 % of Completed Work $29,246.79 State of: Iowa County of: Polk (Column D + E on G703) b.b.0 % of Stored Material $ (Column F on G703) Total Retainage (Lines 5a + 5b or Total in Column I of G703) $29,246.79 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $555,689.01 In accordance with the Contract Documents, based on on-site observations and the data (Line 4 Less Line 5 Total)comprising the application, the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR Architect's knowledge, information and belief the Work has progressed as indicated, PAYMENT (Line 6 from prior Certificate) $448,262.73 the quality of the Work is in accordance with the Contract Documents, and the Contractor 8. CURRENT PAYMENT DUE $107,426.28 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH, INCLUDING RETAINAGE $94,184.99 (Line 3 less Line 6)AMOUNT CERTIFIED . . . . . . . . . . . $107,426.28 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount certified differs from the amount applied. Initial all figures on this Total changes approved Application and onthe Continuation Sheet that are changed to conform with the amount certified.) in previous months by Owner $0.00 ($11,860.00)ARCHITECT: Total approved this Month $7,950.00 $0.00 By: Date: TOTALS $7,950.00 ($11,860.00)This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without NET CHANGES by Change Order ($3,910.00)prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702 · APPLICATION AND CERTIFICATION FOR PAYMENT · 1992 EDITION · AIA · ©1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006-5292 Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee. My Commission expires: 2/28/26 Notary Public: Taylor Fitzsimmons Subscribed and sworn to me this 23rd day of June, 2025. PROJECT: VIA ARCHITECT: AIA DOCUMENT G703 PAGE TWO OF TWO PAGES AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing APPLICATION NO: 3 Contractor's signed certification is attached.APPLICATION DATE:6/23/2025 In tabulations below, amounts are stated to the nearest dollar.PERIOD TO: 6/30/2025 Use Column I on Contracts where variable retainage for line items may apply.PROJECT NO: A B 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 (IF VARIABLE APPLICATION STORED AND STORED (C - G)RATE) (D + E)(NOT IN TO DATE D OR E)(D+E+F)5% 1 Planting $307,470.00 $296,338.50 $11,131.50 $0.00 $307,470.00 100%$0.00 $15,373.50 2 Biocell Excavation $11,880.00 $11,880.00 $0.00 $0.00 $11,880.00 100%$0.00 $594.00 3 Geotextile Fabric $1,260.00 $1,260.00 $0.00 $0.00 $1,260.00 100%$0.00 $63.00 4 Choker Layer 3"$2,250.00 $0.00 $2,250.00 $0.00 $2,250.00 100%$0.00 $112.50 5 Biocell Soil 42" $19,475.00 $19,475.00 $0.00 $0.00 $19,475.00 100%$0.00 $973.75 6 Weed Barrier $4,500.00 $4,500.00 $0.00 $0.00 $4,500.00 100%$0.00 $225.00 7 Trap Rock $2,160.00 $2,160.00 $0.00 $0.00 $2,160.00 100%$0.00 $108.00 8 Steel Edging $24,200.00 $24,200.00 $0.00 $0.00 $24,200.00 100%$0.00 $1,210.00 9 Hardwood Mulch $25,920.00 $21,600.00 $4,320.00 $0.00 $25,920.00 100%$0.00 $1,296.00 10 Rubber Mulch $20,370.00 $20,370.00 $0.00 $0.00 $20,370.00 100%$0.00 $1,018.50 11 Sod $47,310.00 $9,405.00 $37,905.00 $0.00 $47,310.00 100%$0.00 $2,365.50 12 Low-grow Turf Seed $9,300.00 $0.00 $5,734.80 $0.00 $5,734.80 62%$3,565.20 $286.74 13 Native Tall Grass Prairie Seed $29,150.00 $0.00 $8,990.95 $0.00 $8,990.95 31%$20,159.05 $449.55 PAGE TOTALS $505,245.00 $411,188.50 $70,332.25 $0.00 $481,520.75 95%$23,724.25 $24,076.04 Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity AIA DOCUMENT G703 · CONTINUATION SHEET FOR G702 · 1992 EDITION · AIA · ©1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W. WASHINGTON, D.C. 20006-5232 G703-1992 AIA DOCUMENT G703 PAGE TWO OF TWO PAGES AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing APPLICATION NO: 3 Contractor's signed certification is attached.APPLICATION DATE:6/23/2025 In tabulations below, amounts are stated to the nearest dollar.PERIOD TO: 6/30/2025 Use Column I on Contracts where variable retainage for line items may apply.PROJECT NO: A B 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 (IF VARIABLE APPLICATION STORED AND STORED (C - G)RATE) (D + E)(NOT IN TO DATE D OR E)(D+E+F)5% 1 Rain Garden Seed $1,520.00 $0.00 $1,520.00 $0.00 $1,520.00 100%$0.00 $76.00 2 Hydromulch $45,444.00 $0.00 $21,680.05 $0.00 $21,680.05 48%$23,763.95 $1,084.00 3 Recp. Blanket Type 2.D $21,600.00 $4,461.00 $17,139.00 $0.00 $21,600.00 100%$0.00 $1,080.00 4 Irrigation $56,975.00 $49,606.00 $7,369.00 $0.00 $56,975.00 100%$0.00 $2,848.75 5 Change Order 1 - Insurance Change $0.00 $0.00 $0.00 $0.00 $0.00 0%$0.00 $0.00 6 Temp. Irrigation for 30 Days $23,000.00 $6,600.00 $6,900.00 $0.00 $13,500.00 59%$9,500.00 $675.00 7 Change Order 2 ($11,860.00)$0.00 ($11,860.00)$0.00 ($11,860.00)100%$0.00 ($593.00) 8 Change Order 3 $7,950.00 $0.00 $0.00 $0.00 $0.00 0%$7,950.00 $0.00 9 10 11 12 13 PAGE TOTALS $144,629.00 $60,667.00 $42,748.05 $0.00 $103,415.05 72%$41,213.95 $5,170.75 GRAND TOTALS $649,874.00 $471,855.50 $113,080.30 $0.00 $584,935.80 90%$64,938.20 $29,246.79 Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity AIA DOCUMENT G703 · CONTINUATION SHEET FOR G702 · 1992 EDITION · AIA · ©1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W. WASHINGTON, D.C. 20006-5232 G703-1992 PO Box 692, Cedar Rapids, IA 52406 4200 C Street SW • Cedar Rapids, IA 52404 3057 99th Street • Urbandale, IA 50322 4427 S 139th Street • Omaha, NE 68137 ELECTRONIC MAIL:angie@sidekickdevelopment.com July 11, 2025 Our Reference: T10015-002 City of Waukee Iowa 230 W. Hickman Rd. Waukee, IA 50263 Attention: Angie Pfannkuch, Owner’s Representative – Sidekick Development Reference: Waukee Public Safety Facility, Intersection of T Avenue & Douglas Parkway New Public Safety Building for Police & Fire Departments (the “Project”) Subject: Early Release of Retainage Dear Ms. Pfannkuch: The purpose of this letter of to request release of retained funds on the above-referenced Project and to provide the sworn statement below: “Ten calendar days prior to filing this request, notice was given as required by paragraphs “f” and “g” of Section 573.28 of the Iowa Code to all known subcontractors, sub-subcontractors, and suppliers.” If you have any questions, or if I can be of any assistance, please contact me at (319) 893-2944 via e-mail at ed.boyle@forman-ford.com. Yours truly, For and On Behalf Of, Cable Glass, LLC d/b/a Forman Ford Edward M. Boyle III Executive Vice President cc: J. Boetger ) Ryan Companies R. Pigneri ) Ryan Companies S. Shanahan ) FormanFord Project Folder Chicago, Illinois 60606Chicago, Illinois 60606Chicago, Illinois 60606 24th June 2025 KRUCK Plumbing & Heating Company Inc. Mechanical Contractors Since 1941 ________________________________________________________________________________________________ OFFICE . 615 Story Street TELEPHONE: 515-432-2210 615 Story Street SHEET METAL DEPT. – 1810 217th Road BOONE, IOWA 50036 WAREHOUSE – 1810 217th Road July 7th, 2025 Danielle Hermann OPN Architects 100 Court Ave Suite 100 Des Moines, IA 50309 City of Waukee- Waukee Public Safety Building Dear Danielle, The purpose of this letter is to request release of retained funds on the above listed project and to provide the sworn statement below. “Ten calendar days prior to filling this request, notice was given as required by paragraphs “f” and “g” of section 26.13 of the Iowa Code to all known subcontractors, sub-subcontractors and suppliers”. If you have any questions, please call my cell phone at 515-236-0111. Sincerely, Kruck Plumbing & Heating Chad Houston President COMMERCIAL – INDUSTRIAL – RESIDENTAIL – PLUMBING – HEATING – SHEET METAL – AIR CONDITIONING - VENTILATION Chad Houston APPLICATION AND CERTIFICATE FOR PAYMENT TO OWNER:City of Waukee Iowa PROJECT:Waukee Public Safety Facility APPLICATION NO.:234428-JUN25 Distribution to: 230 W Hickman Road PERIOD TO:6/30/2025 OWNER Waukee, IA 50263 VIA CONSTR MANGER: Ryan Companies, US Inc.PROJECT NOS.:ARCHITECT 111 E Grand Ave., Suite 200 CONTRACTOR FROM CONTRACTOR:SKOLD DOOR & FLOOR COMPANY Des Moines, IA 50309 5730 NE 17th Street Procore CONTRACT DATE:12/18/2023 Des Moines, IA 50313 VIA ARCHITECT: OPN Architects CONTRACT FOR:Sectional Overhead 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……………...…………………..$310,000.00 2. Net changed by Change Orders ……………………...…….$1,346.00 CONTRACTOR: 3. CONTRACT SUM TO DATE (Line 1 + 2) …………...……………$311,346.00 4. TOTAL COMPLETED & STORED TO DATE ……...…………$311,346.00 By:_________________________________Date:__________________June 17, 2025 (Column G on G703) 5.5.RETAINAGE:State of: IOWA a. _5_ % of Completed Work $15,567.30 County of: POLK (Column D + E on G703)Subscribed and Sworn to before b. _5_% of Stored Material $0.00 me this day: (Column F on G703) Total Retainage (Line 5a + 5b or Total in Column I of G703)$15,567.30 6. TOTAL EARNED LESS RETAINAGE………………………..$295,778.70 (Line 6 less Line 5 Total)Notary Public: 7.7.LESS PREVIOUS CERTIFICATES FOR PAYMENT CERTIFICATE FOR PAYMENT (Line 6 from prior Certificates)……………………………………………………$291,788.70 8. CURRENT PAYMENT DUE …………………………………….$3,990.00 In accordance with the Contract Documents, based on on-site observation and the data 9.9.BALANCE TO FINISH, INCLUDING RETAINAGE comprising this application, the Construction Manager and Architect certifies to the Owner (Line 3 less Line 6)$15,567.30 that to the best of their knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS AMOUNT CERTIFIED…………………...……………..$______________ Total changes approved in previous months by Owner $1,346.00 $0.00 Total approved this Month $0.00 to the amount certified.) TOTALS $1,346.00 $0.00 CONSTRUCTION MANAGER: NET CHANGES by Change Order $1,346.00 By:_________________________________Date:__________________ ARCHITECT: 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 conform June 17, 2025 CONTINUATION SHEET AIA DOCUMENT G703 PAGE 1 OF 1 PAGE APPLICATION NO: 234428-JUN25 Skold Door & Floor Company, Inc.APPLICATION DATE: 6/17/2025 5730 NE 17th Street PERIOD TO: 6/30/2025 Des Moines, IA 50313 PROJECT NO: CONTRACT FOR: CONTRACT DATE: 12/18/2023 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) Spec Section 08 3613 Sectional Overhead Doors 1 Shop Drawings 5,000.00 5,000.00 5,000.00 100%0.00 250.00 2 Material 110,000.00 110,000.00 110,000.00 100%0.00 5,500.00 3 Installation 8,200.00 6,000.00 2,200.00 8,200.00 100%0.00 410.00 Spec Section 08 4333 Four-Fold Doors 4 Shop Drawings 5,000.00 5 ,000.00 5,000.00 100%0.00 250.00 5 Material 166,900.00 166,900.00 166,900.00 100%0.00 8,345.00 6 Installation 8,800.00 6,800.00 2,000.00 8,800.00 100%0.00 440.00 7 P&P Bond 6,100.00 6,100.00 6,100.00 100%0.00 305.00 8 CR036 1,346.00 1,346.00 1,346.00 100%0.00 67.30 GRAND TOTALS 311,346.00 307,146.00 4,200.00 0.00 311,346.00 100%0.00 15,567.30