PAGE TWO3 - Pay Estimate #5 - REV1E.T. & L. Corp873 Great Rd.Contractor's Application for Payment No.PO Box 295 Application Period: Application Date: 10/1/2019Stow, MA 01775To (Owner): From (Contractor):Project:Owner's Contract No.: 13-20 Contractor's Project No.: 19-031. ORIGINAL CONTRACT PRICE.................................................................$2. Net change by Change Orders........................................................................$3. Current Contract Price (Line 1 ± 2)..............................................................$4. TOTAL COMPLETED AND STORED TO DATE (Column F on Progress Estimate)..................................................................$5. RETAINAGE:a. 5% X$377,525.31Work Completed.............$b. 5% X$0.00Stored Material...............$c. Total Retainage (Line 5a + Line 5b)....................................$6. AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5c)..................................$7. LESS PREVIOUS PAYMENTS (Line 6 from prior Application).............$8. AMOUNT DUE THIS APPLICATION....................................................... $9. BALANCE TO FINISH, PLUS RETAINAGE (Column G on Progress Estimate + Line 5c above)......................................$Contractor's Certification Payment of: $ is recommended by: Payment of: $ is approved by:By: Date:E.T.& L. Corp. Approved by:Lucy Conley59/17/19 to 9/30/19$377,525.31$18,876.27City of Northampton E.T. & L. Corp.Rocky Hill Bike Trail - Northampton, MAApplication For PaymentChange Order SummaryApproved Change Orders$528,025.31Number Additions Deductions$11,025.311 $11,025.31$539,050.62$0.00$18,876.27$358,649.04TOTALS$11,025.31 $0.00$305,035.79NET CHANGE BY$11,025.31$53,613.25CHANGE ORDERS$169,376.27N/A N/A(Line 8 or other - attach explanation of the other amount)Wayne Feiden, DirectorBerkshire Design Group (Date)Jennie Lee Colosi, P.E., PresidentFunding Agency (if applicable) (Date)(Line 8 or other - attach explanation of the other amount)Planning & Sustainability (Date)The undersigned Contractor certifies that to the best of its knowledge: (1) all previous progress payments received from Owner on account of Work done under the Contract have been applied on account to discharge Contractor's legitimate obligations incurred in connection with Work covered by prior Applications for Payment; (2) title of all Work, materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for Payment will pass to Owner at time of payment free and clear of all Liens, security interests and encumbrances (except such as are covered by a Bond acceptable to Owner indemnifying Owner against any such Liens, security interest or encumbrances); and (3) all Work covered by this Application for Payment is in accordance with the Contract Documents and is not defective.1 of 2
Progress EstimateFor (contract):Rocky Hill Bike Trail - Northampton, MAApplication Number:5Application Period:Application Date: 10/1/2019ItemC D Materials Presently Total Completed Balance to FinishThis Period Stored and Stored to Date(B - F)Actual % Actual % (not in C or D)(C + D + E)Actual % Actual %1 TEMPORARY FACILITIES, MOBILIZATION, AND CLOSEOUT 1 LS$45,000.00 $45,000.00 $33,750.00 0.75 75% $0.00 0%$33,750.000.7575%$11,250.00 0 25%2 CLEARING & GRUBBING1 LS$70,000.00 $70,000.00 $70,000.00 1.00 100% $0.00 0%$70,000.001.00100%$0.00 0 0%3 EROSION CONTROL1 LS$35,000.00 $35,000.00 $31,500.00 0.90 90% $0.00 0%$31,500.000.9090%$3,500.00 0 10%4 EARTH EXCAVATION1 LS$105,000.00 $105,000.00 $94,815.00 0.90 90.3% $10,185.00 0.097 9.7%$105,000.001.00100%$0.00 0 0%5 DRAINAGE1 LS$45,000.00 $45,000.00 $36,000.00 0.80 80% $9,000.00 0.20 20%$45,000.001.00100%$0.00 0 0%6 ROADWAY GRAVEL1 LS$55,000.00 $55,000.00 $44,000.00 0.80 80% $11,000.00 0.20 20%$55,000.001.00100%$0.00 0 0%7 PAVING1 LS$100,000.00 $100,000.00 $0.00 0.00 0% $0.00 0%$0.000.000%$100,000.00 1 100%8A SEEDING & SODDING1 LS$29,000.00 $29,000.00 $0.00 0.00 0% $14,500.00 0.50 50%$14,500.000.5050%$14,500.00 1 50%8B RAIN GARDEN1 LS$15,000.00 $15,000.00 $0.00 0.00 0% $3,750.00 0.25 25%$3,750.000.2525%$11,250.00 1 75%9 BENCHES1 LS$8,000.00 $8,000.00 $0.00 0.00 0% $4,000.00 0.50 50%$4,000.000.5050%$4,000.00 1 50%10 PAVEMENT MARKINGS & SIGNS1 LS$6,000.00 $6,000.00 $0.00 0.00 0% $0.00 0%$0.000.000%$6,000.00 1 100%11 FENCE1 LS$4,000.00 $4,000.00 $0.00 0.00 0% $4,000.00 1.00 100%$4,000.001.00100%$0.00 0 0%EWO.001 DRAINAGE CHANGE ORDER1 LS$11,025.31 $11,025.31 $11,025.31 1.00 100% $0.00 0%$11,025.311.00100%$0.00 0 0%$528,025.31 $321,090.31 $56,435.00 $0.00 $377,525.31 $150,500.00 Contractor's Application9/17/19 to 9/30/19ABUnit PriceFQuantityTotalsEstimated QuantityDescriptionQuantity (D)EBid Item No.QuantityQuantity (C)G(G)(F)Scheduled ValueFrom Previous ApplicationWork Completed2 of 2