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Home My WebLink AboutPayment app No. 5 Meridian Sr. Center LETTER OF TRANSMITTAL DATE: ATTN: company: address: fax phone JOB NAME: JOB NO.: RE: 26 August 2005 WILL BERG JOHNSON ARCHITECTS a professional corporation Rn~ I=<,,""'v(: ~ V'E~ """",' " , ~: ~ II \. ,. .~ "".,..!,. .u' CITY OF MERIDIAN 33 E. Idaho Ave. Metidian, ill 83642 208.888.4218 208.888.4433 ,:'\"';', ", ,::, ~,;;,,:'JrJ~,~ :_I~"J ,-, 440 0- cOlporato drive, ¡to, 102 rncridian,id.ho 83642 City of Meridi.an City Clerk OffIce Metidian Senior Center Remodel 04167 PAY APPLICATION NO.5 --- WE ARE SENDING YOU: VIA: hand delivery #OF TYPE OF DATE DATE DESCRIPTION COPIES CORRESPONDENCE REVISED 3 Pay Application No.5 THESE ARE TRANSMITTED: I8J For approval DFor your use DAs requested 0 For review and comment 0 Approved as submitted 0 Approved as noted 0 Returned for colTections 0 or y. ur record 0 Resubmit copies for approval 0 Submit copies for distribution 0 Return coITected prints 0- REMARKS: TRANSMITTED BY: chitect phone 208.846.9033 fax 208.846.9475 COpy TO: File, p:\projects\04167 -meridian senior center upgrades\transmittals\comwb _0 I O.doc RECEIVED JOHNSON ARCHITECTS a professional corporation StY i ~; ¿Otl,¡ City of Meridian Cìty Clerk Office 440 e. corporate drive, ste. 102 meridian, idaho 83642 t208.846. 9033/£208.846. 9475 August 26, 2005 City of Meridian 33 E. Idaho Ave. Meridian, II) 83642 Attn: Will Berg Re: Meridian Senior Citizens Center Payment Application and Certification No.5 Will, Attached are three copies of KMO's Payment Application No.5. Please forward one copy to KMO after review and approval. We have reviewed this Payment Application and the CUITent progress of the work. To the best of our knowledge we agree that this Payment Application reasonably represents the construction progress. We recommend payment in the amount of$4,849.38. Please call if you have any question~. .. JOHNS CHITECTS, P.c. Walter Lindgren, Architect Enclosures: (3) copies of Certificate for Payment p:lprojects\O4167-meridian senior centcrupgr"ddes\calpay appslpay app OS.doc P A YME NT AP PLICATION CITY OF MERIDIAN 33 E. IDAHO AVENUE MERIDIAN IDAHO 83642 WIL BERG FROM: KMO INC 923 16TH AVENUE SOUTH,SUlTE-A NAMPA IDAHO 83651 MERIDIAN SENIOR CENTER REMODEL TO: FOR: CONTRACTOR'S SUMMARY OF WORK Application is made for paymenl as shown below. Continuation Page is attached. 1. CON-TRACT AMOUNT 2. SUM OF ALL CHANGE ORDERS 3. CURRENT CONTRACT AMOUNT 4. TOTAL COMPLETED AND STORED (Column G on Continuation Page) 5. RETAINAGE: a. 0.00% of Completed Work (Columns D + E on Continuation Page) b. 0.00% of Material Stored (Column F on Continuation Page) Total Retainage (Line 5a + 5b or Column I on Continuation Page) 6. TOTAL COMPLETED AND STORED LESS RETAlNAGE (Line 4 minus Line 5 Total) 7. LESS PREVIOUS PAYMENT APPLICATIONS (Line 1 +/- 2) PROJECT NAME AND LOCATION: Page 1 PO# 25-79 MERIDIAN SENIOR MERIDIAN SENIOR CENTER REMODEL 133 BROADWAY AVE, MERIDIAN ID 83642 APPLICATION; PERIOD THRU: PROJECT #5: DATE OF CONTRACT: 5 Distribution to: 08/16/2005 0 OWNER P0#25-79 DARCHITECT 0412512005 D CONTRACTOR 0 0 ARCHITECT: JOHNSON ARCHITECTS 440 E. CORPORATE DRIVE SUITE #102 MERIDIAN IDAHO 83642 $93,000.00 $3,987.56 $98,987.56 $96,987.56 $0.00 $0.00 8. PAYMENT DUE 9. BALANCE TO COMPLETION (Line 3 minus Line 6) SUMMARY OF CHANGE ORDERS Total changes approved in previous months Total approved this month TOTALS NET CHANGES PAYMENT APPLICATION ADDITIONS $3,987.56 $0.00 $3,987.56 $3,987.56 $0.00 $96,987.56 $92,138.18 $4',á49:3tr' $0,00 DEDUCTIONS $0.00 $0.00 $0.00 re be~w is his assurance to Owner, concerning the payment herein appJied for, as bee performed as required in the Contract Documents, (2) all sums ontract r under the Contract have been used to pay Contractor's costs for labor, oblig . under the Contract for W01' previously paid for, and (3) Contractor is td t'is- - - By: Date: 08/16/2005 State of: County of: Subscribed and sworn to before me this day of Notary Public: My Commission Expires: ARC H ITECT'S CERTIFICATION Architect's signature below is his assurance to Owner, concerning the payment herein applied for, that: (1) Architect has inspected the Work represented by this Appfication, (2) such Work has been completed 10 the extent indicated in this Application, and the quality of workmanship and materials conforms wilh the Contract Documents, (3) this Application for Payment accurately states the amount of Work completed and payment due therefor, and (4) Architect knows of no reason why payment ,rSbÕUlo not be made. CERTIFIED .AMOUNT""""..................mu......................................................... .y¡.if.-J 841. :J - . (If the certified amount Is different from the payment due, you should attach an explanation InItial all the figures /hat are changed to match the certified amount) ARCHITECT: 1 :l. C By: i/- ~ Dale: e '2/19'5' Neither Ihj~p r payment applied for herein is assígnable or negotiable. Payment shall be made only to Con r, and is without prejudice to any rights of Owner or Contractor under the Contract Documents or otherwise. ass, INC. DOCUMENT CONTINUATION PAGE PROJECT: PO# 25-79 MERIDIAN SENIOR MERIDIAN SENIOR CENTER REMODEL Page 2 of 3 APPLICATION#: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 5 08/1612005 08/1612005 PO#25-79 Payment Application containing Contractor's signature is attached. A B C D I E F G H I COMPLETED WORK STORED TOTAL % BALANCE WORK DESCRIPTiON SCHEDULED AMOUNT AMOUNT MA TERJALS COMPLETED AND COMPo TO RETAINAGE ITEM # AMOUNT ('fVariable) PREVIOUS THIS PERIOD (NOT IN DORE) STORED (G 1 C) COMPLETION PERIODS (D+E+F) (C-G) 1. BOND FEE $2,790.00 $2,790.00 $0.00 $0.00 $2,790.00 100% $0.00 2. MOBILIZATION $1,000.00 $1,000.00 $0.00 $0.00 $1,000.00 100% $0.00 3. SUPERVISION $2,500.00 $2,500.00 $0.00 $0.00 $2,500.00 100% $0.00 4. TEMPORARY FACILITIES $1,500.00 $1,500.00 $0.00 $0.00 $1,500.00 100% $0.00 5. EXCAVATION-CONCRETE $8,000.00 $8,000.00 $0.00 $0.00 $8,000.00 100% $0.00 6. METAL HANDRAIL-LINTEL $7,000.00 $7,000.00 $0.00 $0.00 $7,000.00 100% $0.00 7. SAWCUTTING $400.00 $400.00 $0.00 $0.00 $400.00 100% $0 .00 8. SEleCTIVE DEMOUTION $4,800.00 $4,800.00 $0.00 $0.00 $4,800.00 100% $0.00 9. EPOXY & REBAR $250.00 $250.00 $0.00 $0.00 $250.00 100% $0.00 10. ROUGH CARPENTRY $4,000.00 $4,000.00 $0.00 $0.00 $4,000.00 100% $0.00 11. lUMBER-MA TERIALS $1,400.00 $1,400.00 $0.00 $0.00 $1,400.00 100% $0.00 12. MASONRY $800.00 $800.00 $0.00 $0,00 $800.00 100% $0.00 13. ELECTRICAL $8,400.00 $8,400.00 $0.00 $0.00 $8,400,00 100% $0.00 14. MECHANICAL $4,600.00 $4,600.00 $0.00 $0.00 $4,600.QO 100% $0.00 15, PLUMBING $10,000.00 $10,000.00 $MO $0.00 $10,000.00 100% $0.00 16. I~IRE SPRINKLERS $7,834.00 $7,834.00 $0.00 $0.00 $7,834.00 100% $0.00 SUB-TOTALS $65,274.00 $65,274.00 $0-.00 $0.00 $65,274.00 100% $0.00 CONTINUATION PAGE FOR PAYMENT APPliCATION ass, INC. DOCUMENT PROJECT: pO#: 25-79 MERIDIAN SENIOR MERIDIAN SENIOR CENTER REMODEL Page 3 of 3 APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #5: 5 08/16/2005 0811612005 PO#25-79 CONTINUATION PAGE Payment Application containing Contractor's signature is attached. A B C D I E F G H I COMPLETED WORK STORED TOTAL % BAlANCE ITEM # WORK DESCRIPTION SCHEDULED AMOUNT AMOUNT MATERIALS COMPLETED AND COMPo TO RET AINAGE AMOUNT PREVIOUS THIS PERIOD (NOT IN 0- OR E) STORED (GfC) COMPLET!ON (If Variable) PERIODS (D+E+F) (C-G) 17. INSULATION $350.00 $350.00 $0.00 $0.00 $350.00 100% $0.00 18. DRYWALL $2,200.00 $2,200.00 $0.00 $0.00 $2,200.00 100% $0.00 19. PAINTING $4,610.00 $4,610,00 $0.00 $0.00 $4,610.00 100% $0.00 20. VINYL FLOORING $400.00 $400.00 $0.00 $0.00 $400.00 100% $0.00 21. CERAMIC TilE $9,957.00 $9,957.00 $0.00 $0.00 $9,957.00 100% $0.00- 22. FINISH CARPENTRY $800.00 $800.00 $0.00 $0.00 $800.00 100% $0.00 23. DOORS & HARDWARE $3,007.00 $1,507.00 $0.00 $1 ,SOD. 00 $3,007.00 100% $0.00 24. GLAZING $250.00 $250.00 $0.00 $0.00 $250.00 100% $0.00 25. BATH PARTITIONS $2,000.00 $400.00 $0.00 $1,600.00 $2,000.00 100% $0.00 26. BATH ACCESSORIES $1,226.00 $331.00 $0.00 $895.00 $1,226.00 100% $0.00 27. FRP $2,576.00 $2,576.00 $0.00 $0.00 $2,576.00 100% $0.00 28. JANITORIAL $350.00 $350.00 $0:00 $0,00 $350.00 100% $0,00 29. CHANGE ORDER #1 $3,987.56 $3,987.56 $0.00 $0,00 $3,987.56 100% $0.00 TOTALS $96,987.56 $92,99256 $0.00 $3,995.00 $96,987.56 100% $0.00 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT