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Application and Certificate for Payment
CHANGE ORDER SUMMARY Change Orders approved in previous months by Owner ADDITIONS DEDUCTIONS TOTAL $0.00 $0.00 Approved this Month Number Date Approved P &P Bonc 2/1/2010 $12,400.00 $0.00 1 4/21/2010 $6,621.25 TOTALS $19,021.25 $0.00 Net change by Change Orders $19,021.25 APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 TO: BCS Development Company PROJECT: Sonoma Phase III 4090 State HWY 6 South College Station, TX 77845 FROM (CONTRACTOR): BRAZOS VALLEY SERVICES P. O . Box 985, BRYAN, TX 77806 CONTRACT FOR: CONTRACTOR'S APPLICATION FOR PAYMENT VIA (ARCHITECT): APPLICATION ft 5 Application is made for Payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document G703, is attached. 1. ORIGINAL CONTRACT SUM 2. Net change by Change Orders 3. CONTRACT SUM TO DATE (Line 1 +2) 4. TOTAL COMPLETED & STORED TO DATE (Column G on G703) 5. RETAINAGE: a. % of Completed Work 10.00% $75,666.23 (Column D +E on G703) b. 95% of Stored Material (Column F on G703) Total Retainage (Line 5a +5b or Total in Column I of G703) The undersigned Contractor certifies that to the best of the Contractor's kr 6. TOTAL EARN LESS RETAINAGE information and belief the Work covered by this Application for Payment it (Line 4 less Line 5 Total) completed in accordance with the Contract Documents, that all amounts h 7. LESS PREVIOUS CERTIFICATES FOR paid by the Contractor for Work for which previous Certificates for Palmer PAYMENT (Line 6 from prior Certificate) issued and payments received from the Owner, and that current payment :8. CURRENT PAYMENT DUE herein is now due. 9. BALANCE TO FINISH, PLUS RETAINAGE (Line 3 less Line 6) BRAZOS A S State of: Texas County of: BRAZOS — Subscribed to before me this a3 day of Notary Public: Date: n O M Commission ex•'res: . . ► 0 Page 1 of 1 ARCHITECT'S PROJECT NO: PERIOD TO: 23 JUN 10 Distribution to: ❑ OWNER ❑ ARCHITECT ❑ CONTRACTOR 0 $746,921.04 $19,021.25 $765,942.29 $756,662.29 $75,666.23 $680,996.06 $666,614.06 $14,382.00 $84,946.23 ARCHITEC 'S CERTIFICATE FOR PAYMENT AMOUNT CERTIFIED In accordance with the Contract Documents, based on on -site observation (Attach explanation if amount certified differs from the amount applied for.) data comprising the above application, the Architect certifies to the Owner ARCHITECT: best of the Architect's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Docur By: Date: the Contractor is entitled to payment of the AMOUNT CERTIFIED. This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. p 3 a Colored Sidewalk Ramps IIfPu00 OAd ,.9 4" Reinforced Concrete Sidewalk 6' Reinforced Concrete Pavement Concrete Curb and Gutter (all types) 2" HMAC Surface Course (including Prime Coat) 8" Crushed Limestone Base 6" Crushed Limestone Base 6" Lime Stabilized Subgrade (6% by wt) Earthwork for Street Constuction ( +/- 6804 CY Excavation/ embankment) Items includes topsoil stripping and replacement in ROW and Easement Paving Construction Clearing and Grubbing Site Preparation Preformance and Payment Bond Preformance and Payment Bond DESCRIPTION OF WORK w H n y 7 8.00 865.00 10,566.00 344.00 5,353.00 8,504.00 1,009.00 7,495.00 11,395.00 1.00, OTY $ 250.00 E 12.00 $ 275 S 36.00 5 8.50 $ 8.50 $ 11.00 $ 8.50 $ 3.50 $ 28.000.00 $ 1,500.00 $ 12.400.00 PRICE S 2.000.00 5 10,380.00 $ 29.056.50 _ S 12,384.00 S 45,500.50 S 72,284.00 S 11.099.00 5 63,707.50 $ 39,882.50 $ 28,000.00 5 10.950.00 _ $ 12,400.00 SCHEDULED VALUE 0 $0.00 $10.380.00 $14,528.25 512.384.00 0S'005'SP$ _ $72,284.00 $11,099.00 $63,707.50 $39,882.50 $28,000.00 510.950.00 $12,400.00 PREVIOUS PERIOD I WORK COW VJC•■ ; _ D I E $250.00 $0.00 $14,528.25 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 I THIS PERIOD MATERIALS PRESENTLY STORED 0 a 3 r a 7 0 1.00 865.00 10.566.00 344.00 5,353.00 8.504.00 1,009.00 7,495.00 11,395.00 1.00 7.30 I.00 TOTAL OTY TO DATE 5250.00 $10.380.00 $29,056.50 $12,384.00 $45,500.50 $72.284.00 $11.099.00 $63,707.50 $39,882.50 $28,000.00 $10,950.00 N oO S TOTAL COMPLETED& STORED 0 j 51.750.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 so 001 $0.00 y«� O O O O O O BALANCE TO FINISH z $25.00 $1,038.00 $2.905.65 $1,238.40 $4.550..05 � $7,228.40 $1,109.90 $6.370.75 $3.988.25 � $0.00 1 h N RETAINAGE — ` O un N A . 2 ti ro . J O; ii; ;1 z ; ) J. Use colum oia�,uaw van......,...,.... Rock Rip Rap Channel Lining, on Filter Fabric n Cl) v a _ Cl) 2 ( L m K ° to w to a ci w D a • a O :° c oo O 01 p a = 7 -0 0 A CO o. m C w w o a -0 A O a m G m m m p 7. p 2 O . f c ] • r • a K 1 :1 F c I CO I I V n V a J1 ? N o D D c . a7 W O N a a -p Y ID K n m 0 (!1 2 El ID F m 13 m N ? N Q p a G e D w Ci co CA CO o Drainaae Construction i • I ° •AIddI AI= IweS 0141 XII 856U1I101 OIPIUTA ODIUM ItoU11Ue0 U0 I U T T C 107.01 1.01 5.0C 2.0C 1 6.00 1.00 1.00 204.00 190.00 160.00 75.001 62.00 OTY $ 40.00 S 2,000.00 )� $ 2,500.00 II $ 3,000.00 '1 S 500.00 S 2.000.00 $ 1.450,00_ $ 650.00 $ 122.00 S 35.00 I S 47.00 S 30.00 $ 43.00 PRICE $ 4,280.00 S 2.000.00 $ 1 2,5 0 0.00 S 6.000.00 $ 2,000.00 $ 12,000.00 $ 1.450.00 $ 650.00 S 24,888.00 $ 6,650.00 5 7,520.00 5 2,250.00 S 3.526.00 VALUE r A 52.000.0C $12.500.01 $9,000.00 $2,000.00 $12,000.00 51.450.00 $650.00 $24,888.00' $6,650.001 511,656.00 52.250,001 53,526.00 PREVIOUS PERIOD 0 E $0.00 I $0.00 I 50.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 1 $0.00 $0.00 $0.00 - 17 THIS I PERIOD I 80 -< I 1.00 5.00 3.00 4.00 6.00 1.00 1.00 204.00 190.00 248.00 75.00 82.00 TOTAL OTY TO DATE $0.00 $2,000.00 $12,500.00 $9.000.00 $2,000.00 512.000.00 $1,450.00 $650.00 $24,888.00 $6,650.00 $11.656.00 • $2.250.00 I $3.528.00 $0.00 COMPLETED d STORED Q x 50.01 $0.00 ($3,000.00) $0.00 $0.00 50.00 $0.00 50.00 $0.00 ($4,138.00) $0.00 $0.00 TO FINISH 1 $200.00 I $1.250.00 $900.00 5200.00 51.200.00 $145.00 $65.00 $2,488.80 $665.00 $1.165.60 $225.00 to to ! • O y� 33 D T AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing 3 /2� ITEM DESCRIPTION OF WORK NO. 8" MJ Gate Valve 8 "x6" MJ Tee 8 "x8" MJ Tee 6" Blow -off Valve 24" Butterfly Valve 24 "x45 deg bend Fire Hydrant Assembly 36" Steel Casing (Includes spacers and structural backfilq 4" PVC, C909 CI 200 Waterline, Non -Str. Backfill 6" PVC, C909 CI 200 Waterline. Str. Backfill 6" PVC, C909 CI 200 Waterline. Non -Sir. Backfill 8" PVC, C909 CI 200 Waterline, Str. Backfill 8" PVC. C909 CI 200 Waterline, Non -Str. Backfill 24" ANSI/AWWA C151/ A21.5. CL 200 OIP Water Line (Non -Str. Backfill) Water System Construction ! 6.00 2.00 2.00 1.00 1.00 6.00 3.00 60.00 641.00 66.00 478.00', 900.00 724.00 1,577.00 OTY 00'210'1 $ S 546.00 S 546.00 S 1.000.00 S 5.475.00 S 1,544.00 S 3,250.00 S 177.00 S 11.00 $ 18.00 S 12.00 S 20.00 I S 14.00 s 68.50 PRICE 5 6072.00 S 1,092.00 S 1,092.00 S 1,000.00 S 5,475.00 I S 9,264.00 S 9.750.00 S 10,620.00 S 7,051.00 5 1,224.00 5 5.736.00 S 18,000.00 S 10,136.00 S 108.024.50 SCHEDULED VALUE $6.072.00 51.092.00 $1.092.00 61,000.00 $5,475.00 $9,264.00 $9,750.00 S10.620.00 $7,051.00 51.224.00 $5,736,00 I 518.000.00 510,136.00 5108,024.50 PREVIOUS PERIOD WORK COMP 50.00 $0.00 50.00 50.0 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 THIS PERIOD $0.00 §r § -/ 6.00 2.00 2.00 1.00 1.00 6.00 3.00 60.00 641.00 68.00 478.00 900.00 724.00 1,577.00 TOTAL OTT TO DATE $6,072.00 $1.092.00 $1.092.00 $1,000.00 $5,475.00 $9,264.00 $9,750.00 $10.620.00 $7,051.00 $1,224.00 $5,736.00 418.000.00 $10.136.00 5108,024.50 $0.00 TOTAL COMPLETED 6 _ STORED 0 k $0.00 $0.00 50.00 $0.00 $0.00 $0.0i $0.00 50.00 $0.00 $0.001 $0.00 50.001 x0.00 $0.00 H BALANCE TO FINISH $607.20 $109.20 $109.20 $100.00 5547.50 $926.40 $975.00 $1,062.00 $705.10 $122.40 $573.80 S1, 800.00 Si .013.60 410,802,45 $0.00 RETAINAGE 3 t m n & & t ! & t a z r.,9 . � I 6" PVC 0 -3034 S0R26 . ; ..� ..... ..... .... . it -.. - 1 - _,_.._.__.__� - Sewer System Construction G co \ co } ( a i o G ¥ 2 / CD k \ % 9 s # Ca \ } k o UT M. s § 3 co / A. > 0 0 = A / o } k G cm co cr a. R "x24" MJ Anchor Coup lino DESCRIPTION OF WORK to I on Contracts where variable relainage for line hems may apply. B ; E ¢ 4.00 17.00 7.00 16.00 1.00 2.00 5.00 2.00 5.00 1.00 1.00 18.00 9.00 OTY It 1725 $ 1.492.00 I,$ 1.500.00 I S 450.00 $ 650.00 S 750.00 $ 176.00 $ 176.00 $ 125.00 $ 300.00 $ 750.00 $ 140.00 S 327.00 S 200.00 PRICE S 19.044.00 $ 5,966.00 S 25,500.00 $ 3.150.00 $ 10.400.00 $ 750.00 $ 352.00 S 880.00 $ 250.00 $ 1.500.00 $ 750.00 3 14000 $ 5,886.00 S 1.800.00 SCHEDULED VALUE $19,044.00 $5,968.00 $25,500.00 $3,150.00 $10,400.00 $1,500.00 $352.00 $880.00 $250.00 $1,500.00 $1,500.00 $140.00 $5,886.00 $1.800.00 PREVIOUS PERIOD $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 THIS I PERIOD ai 2§ 53 ig . r- 0, , ! Sonoma Phase II 1,104.00 4.00 17.00 I 7.00 16.00 2.00 2.00 5.00 2.00 5.00 2.00 1.00 18.00 9.00 TOTAL ONTO DATE $19,044.00 $5,968.00 $25,500.00 $3,150.00 $10 $1,500.00 $352.00 $860.00 $250.00 $1,500.00 $ $140.00 $5.886.00 $1,800.00 TOTAL COMPLETED & STORED er o $0.00 $0.00 $0.00 $0.00 $0.00 ($750.00) $0.00 $0.00 $0.00 $0.00 ($750.00) $0.00 S0.00 $0.00 BALANCE TO FINISH 50.00 $596.60 $2,550.00 $315.00 $1,040.00 $150.00 $35.20 $88.00 $25.00 $150.00 $150.00 $14.00 $588.60 $180.00 RETAINAGE S ' S 3 8- a 1 n c g a 4 N 4 n n g e Et. p < a m 0 t m Z s Z s a o s n u m x -1 j 3 & m = 3q � 3 K 3 m m s 3. Z ; D Silt Fence Type1 Erosion Control Plan & Sedimentation Control (per Item 106) includes (monitoring, record keeping. grass seeding, and clean up Erosion Control Construction Trench Safety (sewer) Extending Existing Sewer Service Long Side 4" Sewer Service ( >20') Short side 4" Sewer Service ( <20') Extra Depth (>6'), 5' Diam. Manhole Extra Depth ( >6'), 4' Diam. Manhole Connect to Ex. Sewer Line Standard 5' Diam. Manhole. 0-6 ft deep Standard 4' Dlam. Manhole, 0 -6 ft deep Non -Str. Backfill (8' -10' Depth) Non -Str. Backfill (5'-8' Depth) Str. Backfill (8' -10' Depth) t DESCRIPTION OF WORK m r rn Unit 1.00 1.00 1,104.00 11.00 10.00 5.00 7.00 14,00 3.00 1.00 6.00 212.00 500.00 389.00 CITY S 5,342.50 $ 500.00 $ 0.01 $ 500.00 $ 900.00 $ 400.00 $ 250.00 $ 200.00 $ 250.00 $ 3,000.00 S 2,000.00 $ 2.00 $ 2.00 $ 8.00 PRICE $ 5,342 -50 $ 500.00 $ 11.04 $ 5,500.00 00'000'6 S S 2,000.00 $ 1,750.00 $ 2,800.00 $ 75000 S 3,000.00 $ 12,000.00 $ 424.00 $ 1.000.00 S 3,112.00 SCHEDULED VALUE a $5,342.50 $475.00 $11.04 _ $5.500.00 $9000.00 $2,000.00 $1,750.00 $2,800.00 $750.00 $3,000.00. F __ $12,000.00 $424.00 $1.000.00 $3,128.00 PREVIOUS PERIOD I WORK COMP O $0.00 $0.00 $0.00 I $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 THIS _ PERIOD 'LETED m N A 0 ^ D CO M in IM a y D F W T 1,00 095 00'60 t't 11.00 10.00 5.00 7.00 14,00 3.00 1.00 6.00 212.00 500.00 391.00 TOTAL 0T' TO DATE $5.342.50 $475.00 PO' I. IS $5,500.00 . $9,000.00 $2,000.00 $1,750.00 $2,800.00 $750.00 I $3,000.00 $12,000.00 5424.00 $1,000.00_ $3,128.00 TOTAL COMPLETED 6 , STORED C, K 50.00 $25.00 $0.00 50.00 $0.00, $0.00 $0.00 so.00j $0.00 $0.00 $0.00 $0.00 $0.00 (516.00) BALANCE TO FINISH x $534.25 $47 50 $0.00 $ $550.00 $900.00 $200.00 $175.00 $280.00 $75.00 $300.00 $1,200.00 $42.40 $100.00 5312.80 RETAINAGE S ' S 3 8- a 1 n c g a 4 N 4 n n g e Et. p < a m 0 t m Z s Z s a o s n u m x -1 j 3 & m = 3q � 3 K 3 m m s 3. D CO rn 1 , li o \ 8 8 j k k § 2 k 0 d, • o \ \ \ ) ) © © V V d d - - 0 0 0 o . 1-1I11caluu Ic 1,77. 8" Crushed Limestone Base ; \ \ 3 / ® » n 3 f f * n m 0 I i m = = I I % % c DESCRIPTION OF WORK n I on Contracts where variable reteinape for line items may apply. R LS 94.0 I 20.01 184.0( 11,395.00 437.00 53.00 1.001 1.00 1.00 1.00 1.00 OTV D $ (11.00 )I S (8.50 11 $ ( 3.50' . $ 2.500.00 $ 0.72 $ 2.75 $ 8.50 S 1,800.00 $ 500.00 $ 1,800.00 $ 7.700.00 S 4.427,00 PRICE II $ (170.00 I $ (844.00, $ 2,500.00 _ $ 6,200.00 S 1,201.75 _$ 450.50 S 1,800.00 S 500.00 $ 1,800.00 00'00L'L $ $ 4,427.00 VALUE )I ($170.00 I ($644.00', $2,500.00 $8,200.00 $0.00 $450.50 $1,800.00 $500.00 $1,500.00 $0.00 $0.00 PREVIOUS PERIOD 0 I w E WORK COMPLETED }I $0.00 I $0.00 $0.00 $0.00 $1.201.75 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 THIS II PERIOD a 20.00 94.00 184.00 1.00 11,395.00 437.00 53.00 1.00 1.00 1.00 0.00 0.00 rOTAL Drr TO DATE ($170.00; ($1,034.00 ($644.00 $2,500.00 $8,200.00 $1,201 75 $450.50 $1,800.00 $500.00 51.800.00 $0.00 $0.00 TOTAL COMPLETED & STORED $0.0( $0.01 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7,700.00 $4,427.00 BALANCE TO FINISH ($103 401 1 ($64 40) $0.00 $250.00 $820.00 $120.18 $45.05 $0.00 $0.00 1 | Nnr EZ .01 000:13d co in §m» PAGE TOTALS Colored Sidewalk Ramps 6" Reinforced Concrete Pavement 2" HMAC Surface Course (including Prime Coat) DESCRIPTION OF WORK F $ q Unit I -DO 74.00 114.00 QTY Sr (250.00) $ (36.00) S (8.50) PRICE $ 765.942.29 $ (250.00) $ (2.684.00) $ (969.001 SCHEDULED VALUE $ 740,682.29 $0.00 $0.00 $0.00 $0.00 $0.00 L ($2,664.00)1 ($969.00) PREVIOUS PERIOD I WORK COMPLETED mo I E $ 15.960.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 THIS PERIOD ' 233 § _ NDIVl0! NDIV/0! NDIV/0! NDIV/O! 0.00 74.00 114.00 TOTAL QTY TO DATE r. S 756,662.29 $0.00 $0.00 $0.00 $0.00 $0.00 ($2,664.00) ($969.00) TOTAL COMPLETED 4 STORED 0 i at at at at at at . a at . a k k ' S 9,280.00 50.00 $0.00 $0.00 $0.00 ($250.00) $0.00 $0.00 BALANCE TO FINISH $ 75,66623 $0.00 $0.00 $0.00 $0.00 $0.00 15266.401 1596.901 RETAINAGE 1 | Nnr EZ .01 000:13d