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HomeMy WebLinkAboutSouthland Construction Fisher Road Application for Payment -2004 04 02 .\ CONTRACTOR'S APPLICATION FOR PAYMENT PAYMENT REQUEST NO. 5 RETAINAGE PROJECT NAME: Fisher Road Roadway Improvements ENGINEERS FILE NO. W0107 BID NO. ITB018-03-KL FINANCE ACCOUNT NO. 00040789-00 CONTRACTOR Southland Construction, Inc. CONTRACT DATE September 9, 2003 COMPLETION DATE March 29, 2004 APPLICATION DATE April2,2004 FOR PERIOD ENDING March 31, 2004 STATEMENT OF WORK Original Contract Price $ 648,004.00 Work to Date $ 651,393.40 Net Change Order Work $ $ 3,389.40 Amount Retained $ $ 651,393.40 Current Contract Price 651,393.40 Subtotal Work to be Done $ Previous Payments Approved .jI <,:'_:' -:~.. ~ .,,, ,,,. :.bultBiBJi& Amount Due This Payment $ 65,139.34 The Undersigned Contractor hereby swears under penalty of perjury that (1) all previous progress payments received from the Owner on account of work performed under the Contract referred to above have been applied by the undersigned to discharge in full all obligations of the undersigned incurred in connection with work covered by prior Application for Payment under said contract, being Applications for Payment numbered 1 through L inclusive; and (2) all materials and equipment incorporated in said Project or otherwise listed in or covered by this Application for Payment are free and clear of all liens, claims, security interests and encumbrances. DATED if /;;. 200~ Southland Construction, Inc. BY ~ ~eY. Project Manager COUNTY OF SEMINOLE PAYMENT REQUEST No. 5 RETAINAGE STATE OF FLORIDA ENGINEERS FILENO. W0107 The foregoing inljt(ument was acknowledged before me this r i ~.:2.0 0 by c.ourt. CthJd,..a.y (Name of Person Acknowledged) as ' (type of authority, e.g. officer, trustee, attorney in fact) for Southland Constr ction. Inc. known to me or has produced identfficatiL I, / "'a\._co.H- ~ ~#~ !~ i My Commlllion 00087152 (Notary Public) ~c!p"" Expires March 31, 2006 (DATE) r and is personally SEAL My commission expires: 3/.31/06 I by pproved: dk Date by it I ~ ~/d'11 ~ . Y~JJ),-O L/ Date by Date General Contractor: Southland Construction, Inc. Bid No.: ITB018-03-KL Project:' Fisher Road Roadway Improvments Date: 3/31/2004 Contract Start Date: October 1, 2003 Estimate No. S Rat. - .. . ......... . . . ... . ... '.. . . . . ....... . .... . Wo~k P.erl.cirm~ tiii~~nod. .. .. .. . '... workPimorme<t:tQPate:: : ...... '. .. . ... .....-. ... . ... . . . .... . . . ... . ,....... . ....... .. ...- . . . . . . . . . .. .. . .' ... p:~evitlll~ :paYrnent: . . .. .. -...... . ... . .... . : . : : :(<iLirrent~YliHlrit) : : . : : . .., .. .. : : {totalto:da~e) . . .. . . . . . . . . . . .... .. .. .." ... . ... ... .. -. ... . . . I::: ... .... ... ........ . . . . . . . . ... . ...... ... ..... . ... . ...... . .... .' ..... .. ... . ... . .. .. . . . .. . .. . .. .. .. .. ......... . .. ,', Item No Bid Item Description Bid Quantity Unit Unit Cost Bid Item total Quantity Amount Quantity Amount Quantity Amount % Complete 1 Mobilization (Max 10% Of Bid) 1.00 LS 62,000.00 62,000.00 1.00 62,000.00 - 0.00 "':'; 62,000.00 100.00% 2 Preconstruction Video 1.00 LS 860.00 860.00 1.00 860.00 - 0.00 . .. 860.00 100.00% 3 Site Layout 1.00 LS 25,000.00 25,000.00 1.00 25,000.00 - 0.00 .,. '. 25,000.00 100.00% 4 Fdot Silt Fence Type 3 7,910.00 LF 0.70 5,537.00 7,910.00 5,537.00 - 0.00 1::0" 5,537.00 100.00% 5 Floating Turbidity Barrier 250.00 LF 8.50 2,125.00 250.00 2,125.00 - 0.00 I. 2,125.00 100.00% 6 Maintenance of Traffic 1.00 LS 35,000.00 35,000.00 1.00 35,000.00 - 0.00 I...... 35,000.00 100.00% 7 Clearing & Grubbina 1.00 LS 21,500.00 21,500.00 1.00 21,500.00 - 0.00 :,:' 21,500.00 100.00% 8 Earthworks (Cut & Fill) 1.00 LS 22,000.00 22,000.00 1.00 22,000.00 - 0.00 I: 22,000.00 100.00% 9 RemovelReplace Paved Drive With Cone 6" 538.00 SY 25.00 13,450.00 538.00 13,450.00 - 0.00 :.: 13,450.00 100.00% 10 RemovelReplace Unpaved Drive With Cone 6" 4.00 EA 760.00 3,040.00 4.00 3,040.00 - 0.00 :: . 3,040.00 100.00% 11 RemovelReplace Wood Fence - LF 8.00 - 0.00 - 0.00 .:.: 0.00 #DIVlO! 12 RemovelReplace CL Fence - LF 11.00 - 0.00 - 0.00 ',' 0.00 #DIVlO! 13 Relocate Mailbox 28.00 EA 50.00 1,400.00 28.00 1,400.00 - 0.00 1,400.00 100.00% 14 SawcuURepair Pavement 140.00 SY 9.50 1,330.00 140.00 1,330.00 - 0.00 I. 1,330.00 100.00% 15 Ribbon Curb l' 8,472.00 LF 4.60 38,971.20 8,472.00 38,971.20 - 0.00 38,971.20 100.00% 16 Header Curb 12''x18'' 156.00 LF 11.20 1,747.20 156.00 1,747.20 - 0.00 ... 1,747.20 100.00% 17 Fdot Type A Curb 1,000.00 LF 8.00 8,000.00 1,000.00 8,000.00 - 0.00 8,000.00 100.00% 18 Subbase 12" Thick 10,150.00 SY 2.25 22,837.50 10,150.00 22,837.50 - 0.00 22,837.50 100.00% 19 Road Base 8" Thick 9,080.00 SY 7.50 68,100.00 9,080.00 68,100.00 - 0.00 68,100.00 100.00% 20 Asphalt Type'S3 2" Thick 9,080.00 SY 5.50 49,940.00 9,080.00 49,940.00 - 0.00 .', 49,940.00 100.00% 21 Brick Pavers 100.00 SY 29.00 2,900.00 100.00 2,900.00 - 0.00 .' 2,900.00 100.00% 22 Striping & Sinage 1.00 LS 6,200.00 6,200.00 1.00 6,200.00 - 0.00 :. . 6,200.00 100.00% 23 Landscape Median 4.00 EA 6,000.00 24,000.00 4.00 24,000.00 - 0.00 '.' 24,000.00 100.00% 24 Circular Median 4.00 EA 1,200.00 4,800.00 4.00 4,800.00 - 0.00: '. 4,800.00 100.00% 25 RCP 12" 640.00 LF 28.00 17,920.00 640.00 17,920.00 - 0.00 .. 17,920.00 100.00% 26 RCP 15" 30.00 LF 26.50 795.00 30.00 795.00 - 0.00 I.:' 795.00 100.00% 27 RCP 18" 90.00 LF 28.50 2,565.00 90.00 2,565.00 - 0.00 ., 2,565.00 100.00% 28 HDPE 15" 1,160.00 LF 23.50 27,260.00 1,160.00 27,260.00 - 0.00 .,:, 27,260.00 100.00% 29 HDPE 18" 575.00 LF 25.50 14,662.50 575.00 14,662.50 - 0.00 ... 14,662.50 100.00% 30 HDPE 24" 170.00 LF 31.00 5,270.00 170.00 5,270.00 - 0.00 ...... . 5,270.00 100.00% .... .. 31 Underdrains and Cleanouts 8" 975.00 LF 13.00 12,675.00 975.00 12,675.00 - 0.00 12,675.00 100.00% 32 Fdot Mes 20.00 EA 400.00 8,000.00 20.00 8,000.00 - 0.00 .. . 8,000.00 100.00% 33 Fdot Outfall Structure 4.00 EA 700.00 2,800.00 4.00 2,800.00 - 0.00 , 2,800.00 100.00% 34 Fdot Ditch Bottom Inlet 17.00 EA 1,800.00 30,600.00 17.00 30,600.00 - 0.00 ..' :::: 30,600.00 100.00% 35 Storm Manhole 4.00 EA 2,300.00 9,200.00 4.00 9,200.00 - 0.00 ., .. 9,200.00 100.00% 36 Discharge EnergyDissipator (Cone Rubble) 4.00 EA 50.00 200.00 4.00 200.00 - 0.00 .. .' . 200.00 100.00% . ". 37 Swale Construction 10,020.00 LF 3.50 35,070.00 10,020.00 35,070.00 - 0.00 .. . 35,070.00 100.00% " . 38 Swale Checks 41.00 LF 28.00 1,148.00 41.00 1,148.00 0.00 ,. .. 1,148.00 100.00% - . .. 39 Geofabric 730.00 SY 4.50 . 3,285.00 730.00 3,285.00 - 0.00 .. .. 3,285.00 100.00% . ..' 40 Sodding 27,400.00 SY 1.95 53,430.00 27,400.00 53,430.00 - 0.00 : . .:a; 53,430.00 100.00% Sheet Subtotal 645,618.40 645,618.40 0.00 645,618.40 Page 1 of2 '" General Contractor: Southland Construction, Inc. Bid No.: ITB018-03-KL Project: Fisher Road Roadway Improvments Date: 3/31/2004 Contract Start Date: October 1, 2003 Estimate No. S Rat. . :::::: ' , . , :-:-c ,-, . ' . " , " .... .. ... .' , ' " " ' ,n, , " , " , WQ(k Pe(fQ.m~iiii$.~riod: ' Workp~()imed:tQD.~te: ' " . ,. ' .. .. .. .. ." ..- ... . " ' " , , :: :: : .. .. , " ,_.. .. p:r.evtous :p.ay~~t ", .... . ' , ' , . ...... " . , : :(<iurr.~nt~y.riHin~r , " :: : ~tQta!tG:d*teL : ..,... . ... . ......-.. .. ... . .. ... " ' " . ... ..... . ... . " , ....., ..... ,_.. .. " " , .... . ' , " , " " , .. .., ' " .... . " ' '" Item No Bid Item Description Bid Quantity Unit Unit Cost Bid Item total Quantity Amount Quantity Amount Quantity Amount % Complete . Change Orders 41 Fill Dirt Loading and Hauling to City Facilitv 650,00 CY 3.46 2,249,00 650.00 2,249.00 0 0.00 2,249.00 100.00% 42 Landscaping Revisions & Final Quantitv Variation 1.00 LS 1,140.40 1,140.40 1.00 1,140.40 0 0.00 Ell 1,140.40 100.00% 43 - - 0.00 0 0.00 " >:, ."~ ' :~ 0.00 #DIV/O! 44 - 0.00 0 0.00 ";.,, .... 0.00 #DIVlO! " 45 - 0.00 0 0.00 0.00 #DIV/O! 46 - 0.00 0 0.00 0.00 #DIV/O! Sheet Subtotal 3,389.40 3,389.40 0.00 3,389.40 Base Bid 645,618.40 645,618.40 - 645,618.40 100.00% Change Orders 3,389.40 3,389.40 - 3,389.40 TOTAL 649,007.80 649,007.80 - 649,007.80 100.00% ~ Page 2 of 2 -----------, RECEIVED City of Winter Springs 1126 E. SR 434 Winter Springs. FL 32708 Open Account Bank of America 110 E. SR 434 Winter Springs. FL 3270aMAY - 6 2004 63-4/630 2~~;e~ 016374 . i/!lll!1t\tP' .j1nP. 04/3012004 $65,139.34 *****65,139 DOLLARS AND 34 CENTS Pay To The Order Of SOUTHLAND CONSTRUCTION, INC. 172 W. FOURTH STREET APOPKA Fl 32703 au_~~ IJ. 1n~~ '7U~~'2tre'0~.~~:...."..MP ."."_"_._.,,,.~...~..."_:..,."~__..MP Authorized Signeture 1110 It b ~ 7 l. III I: 0 b ~ 0 0 DOl. 71: 0 0 ~ 0 b l. q b 2 2 20111 City of Winter Springs 04/02/04 5-RETAINAGE 40789 36859 ~:.N@lt':~:nIi~~~~a~iJf. 65,139.34