4.2.A. SR 10-15-2012 AEI REQUEST FOR ACTION
River
To ITEM NUMBER
Mayor and City Council 4.2.A
AGENDA SECTION MEETING DATE PREPARED BY
Consent October 15,2012 Tim Simon, Finance Director
ITEM DESCRIPTION REVIEWED BY
Public Works Project Pay Estimate #13 Cal Portner, City Administrator
REVIEWED BY
ACTION REQUESTED
The City Council is asked to approve the pay estimate as stated below.
BACKGROUND/DISCUSSION
Below is the pay estimate for the public works project. The pay estimate has been reviewed and approved
by the architect,RJM Construction, or department head in charge of the project.
FINANCIAL IMPACT
Pay Est.
Project No. Contractor Amount
Public Works Project 13 RJM Construction $641,323.81
ATTACHMENTS
• Pay estimate for the above project
ACTION Motion by Second by Vote
FOLLOW UP
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N:\Public Bodies\City Council\Council RCA\Agenda Packet\10-15-2012\Payestimate1015.docxNATURE
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APPLICATION AND CERTIFICATE FOR PAYMENT
CONSTRUCTION
SUBMITTED TO: City of Elk River PROJECT: Elk River Public Works INVOICE NO: 1109039613
Attn:Tim Simon 19000 Proctor Road APPLICATION DATE: 9130/2012
13065 Orono Parkway Elk River,MN 55330
Elk River,MN 55330 PERIOD END DATE: 9/30/2012
PROJECT NO: 2011-09-0396
REMIT TO: RJM CONSTRUCTION LLC ARCHITECT: CONTRACT DATE: 0
SDS 12-2903, PO Box 86
Minneapolis,MN 55486-2903 CONTRACT NO: 11090396
The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the ORIGINAL CONTRACT SUM $ 8,730,705.00
Work coved by this Application for Payment has been 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 NET CHANGE BY CHANGE ORDERS TO DATE . ... ., $ 0.00
issued and payments received from Owner,and that current payment shown herein is now due. CONTRACT SUM TO DATE
$ 8,730,705.00
WAIVER&RELEASE OF LIEN TOTAL COMPLETED AND STORED TO DATE $ 6,465,564.98
Where the undersigned Contractor has provided labor,services,materials,or equipment for the above project, q%OF COMPLETED WORK $ 285,960.14
under an agreement with the owner.
0%OF STORED MATERIAL $ 0.00
The undersigned does hereby waive and release all bond claims,liens,claims or right to claim,or right of lien,
statutory or otherwise,against the property,project Owner,or any other person or entity who is or may be TOTAL RETAINAGE $ 285,960.14
claimed to be liable,or any sureties,for labor,services,materials,or equipment,as provided by the TOTAL EARNED LESS RETAINAGE $ 6,179,604.84
undersigned,to the extent of payment received,as indicated herein,together with any previous payment(s)
already received but excluding any retainage or any labor,services,materials,or equipment provided after the LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 5,538,281.03
application period stated above. The undersigned agrees upon receipt of the above amount for labor,services,
materials,or equipment as described herein,he does herby grant this release unconditionally. CURRENT PAYMENT DUE $ 641,323.81
BALANCE TO FINISH INCLUDING RETAINAGE $ 2,551,100.16
The person signing below does hereby certify that he/she is fully authorized and empowered to execute this
instrument and to bind the undersigned hereto,and does in fact so execute this instrument
RAI CONSTRUCTION, LLC
700 3 W.LAKE ST.,SUITE 400 ARCHITECTS CERTIFICATE FOR PAYMENT
7003
ST. LOUIS PARK,MN 55426 In accordance with the Contract Documents,based on on-site observations and the data composing this
P 952-837-8601.. '14,2-832-96M application.the Architect certify to the Owner 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 Construction Documents,and the
SIGNED 1 DATED: 2
' Contractor is entitled to payment of the AMOUNT CERTIFIED. 8/„ ,,,4. /° } AMOUNT CERTIFIED $ i / 3 3. �a
PRINTED TITLE: a t f , r, Attach explanation if amount certified differs from the amount applied for,initial all figures on this
application and on the Continuation Sheets that changed to conform to the amount certified.
State of Minnesota
County Architect:
Coun of ,
.. 2 1 y= .
Subscribed and sworn to before me this day of B I t ificate is negotiable. The AMOUNT CERTIFIED payable only to the Contractor named
Notary Public Issuance,payment and acceptance of payment are without prejudice to any rights of the
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