A B C D E F G H I
1     CERTIFICATION FOR PAYMENT FOR ESTIMATED WORK    
2 BLOCK 1   Contractor: Dunn Construction Inc.          
3   Address: 10340 NE Weidler     Phone: (503) 408-7601
4   City, State, Zip: Portlnad, OR 97220     Fax: (503) 408-7602
5   Proj Manager Frank Dunn          
6                
7 BLOCK 2   Project: SW Arboretum Hills LID     Progress Payment #   6 Final
8   Contractor: Dunn Construction Inc.     Pay Period Ending Date:   04/30/02
9   Contract #: 33088     Notice to Proceed Date:   9/15/2000
10   Original Contract Amount: $152,577     No. of Days in Contract:   71
11   Change Orders Authorized: $1,992     No. of Days Added by Change Order:   0
12   Total Authorized: $165,193     Completion Date:   10/31/2001
13   Invoice Date: 10/31/01     Days Remaining:   *
14                
17 BLOCK 3 R Estimated Work Completed To Date (Page 2 Column N Total) 165,192.76      
18 S Material-on-Hand (Page 3, Column I Total)   0.00      
19 T Total Completed & Material On Hand (R + S)     165,192.76    
20 U Retainage to date     0.00      
21 V 15% Retainage for Materials-on-hand (15% of S)   0.00      
22 W Total Retainage (U+V)     0.00      
23 X Authorized Payments to Date (T-W)     165,192.76    
24 Y Total Progress Payments Made to Date   156,933.12      
26 AA Total of Payments to Date (Y+Z)   156,933.12      
27 AB PAYMENT DUE (X-AA)     $8,259.64
Pay this amount
28                
29                
30   Approved for Processing: Project Manager / Date          
31                
32                
33 BLOCK 4   For Accounting use only if there are multiple projects in a contract (completed by PM)            
34   Accounting: please make the following job number charges.            
35   Job # Current Charges          
36   Proj # _______ $0.00          
37   Proj # _______ $0.00          
38   Proj # _______ $0.00          
39   Proj # _______ $0.00          
40                
41   Total Proj Charges $0.00          
42                

Certification

  A B C D E F G H I J K L M N O P
1 BLOCK 1 APPLICATION AND CERTIFICATION FOR PAYMENT                  
2 To: City of Portland Bureau of Water Works           Contractor: Dunn Construction Inc.
3   1120 SW 5th Ave, Rm 600                 Address: 10340 NE Weidler
4   Portland, OR 97204                 City, State, Zip: Portlnad, OR 97220
5   Frank Dunn                   Phone: (503) 408-7601
6                       Fax: (503) 408-7602
7 BLOCK 2 Project: SW Arboretum Hills LID           Progress Payment #   6 Final
8 Contractor:   Dunn Construction Inc.         For Work Completed Through:   04/30/02
9 Contract #:   33088           Completion Date:   10/31/2001
10 Notice to Proceed Issued:   9/15/2000           Days Remaining   *
11 BLOCK 3 A B C D E F G H I J K L M N O
12       Bid Amount   Previous Work Current Work Total Completed to Date  
13 Item No. Description of Work QTY Unit Unit Price Original Authorization Revised Authorization Completed Quantity Amount Quantity Amount Qty Amount % Complete of Original Balance to Finish
14               ( Previous J ) ( Previous K )   (J * E ) (H +J) (I + K) (M / F ) or (M/G) (F - M) or (G - M)
15   1 Mobilization 1.0 LS 7,600.00 7,600.00 7,600.00 100% 7,600.00 0% 0.00 100% 7,600.00 100% 0.00
16   2 Trench Excavation 596.0 CY 5.00 2,980.00 2,980.00 596.0 2,980.00 0.0 0.00 596.0 2,980.00 100% 0.00
17   3 Rock Excavation 10.0 CY 10.00 100.00 0.00 0.0 0.00 0.0 0.00 0.0 0.00 100% 0.00
18   4 Trench Backfill (Import) 220.0 CY 10.00 2,200.00 2,200.00 220.0 2,200.00 0.0 0.00 220.0 2,200.00 100% 0.00
19   5 Trench Backfill (Native) 15.0 CY 10.00 150.00 132.00 13.2 132.00 0.0 0.00 13.2 132.00 100% 0.00
20   6 6" Class 52 Restrained DI Pipe w/ Pipe Zone Bedding and Backfill 1782.0 LF 31.00 55,242.00 55,242.00 1782.0 55,242.00 0.0 0.00 1,782.0 55,242.00 100% 0.00
21   7 AC Pavement (Base Lift) 1-1/2" 245.0 SY 23.00 5,635.00 5,543.00 241.0 5,543.00 0.0 0.00 241.0 5,543.00 100% 0.00
22   8 AC Pavement Overlay (Top Lift) 2" 2500.0 SY 10.00 25,000.00 22,100.00 2210.0 22,100.00 0.0 0.00 2,210.0 22,100.00 100% 0.00
23   9 Crushed Rock Pavement Base 41.0 CY 10.00 410.00 410.00 41.0 410.00 0.0 0.00 41.0 410.00 100% 0.00
24   10 Crush Rock Resurfacing 156.0 SY 15.00 2,340.00 2,619.00 174.6 2,619.00 0.0 0.00 174.6 2,619.00 100% 0.00
25   11 6" Gate Valve 4.0 EA 400.00 1,600.00 1,600.00 4.0 1,600.00 0.0 0.00 4.0 1,600.00 100% 0.00
26   12 Hydrant Assemblies 4.0 EA 1,900.00 7,600.00 7,600.00 4.0 7,600.00 0.0 0.00 4.0 7,600.00 100% 0.00
27   13 3/4" Air Release Assembly 1.0 EA 500.00 500.00 500.00 1.0 500.00 0.0 0.00 1.0 500.00 100% 0.00
28   14 3/4" Service Lateral 150.0 LF 12.00 1,800.00 1,740.00 145.0 1,740.00 0.0 0.00 145.0 1,740.00 100% 0.00
29   15 3/4" Backside Water Service 540.0 LF 53.00 28,620.00 42,135.00 795.0 42,135.00 0.0 0.00 795.0 42,135.00 100% 0.00
30   16 Connections for Other Backside Work 14.0 EA 200.00 2,800.00 2,800.00 14.0 2,800.00 0.0 0.00 14.0 2,800.00 100% 0.00
31   17 Erosion Control 1.0 LS 2,500.00 2,500.00 2,500.00 1.00 2,500.00 0.00 0.00 1.0 2,500.00 100% 0.00
32   18 Construction Sign 1.0 EA 500.00 500.00 500.00 1.0 500.00 0.0 0.00 1.0 500.00 100% 0.00
33   19 Landscape Restoration 1.0 LS 5,000.00 5,000.00 5,000.00 1.0 5,000.00 0.0 0.00 1.0 5,000.00 100% 0.00
34                                
35     Subtotal 1       152,577.00 163,201.00   163,201.00   0.00   163,201.00   0.00
36                                
37   20 Change Order 1 1.0 LS 873.49 0.00 873.49 1.0 873.49 0 0.00 1.0 873.49 100% 0.00
38   21 Change Order 2 1.0 LS 1,118.27 0.00 1,118.27 1.0 1,118.27 0 0.00 1.0 1,118.27 100% 0.00
39   22 Change Order 3 1.0 LS 0.00 0.00 0.00 1.0 0.00 0 0.00 1.0 0.00 100% 0.00
40                                
41     Subtotal 2       0.00 1,991.76   1,991.76   0.00   1,991.76   0.00
42                                
43     TOTALS       152,577.00 $165,192.76   $165,192.76   $0.00   $165,192.76   $0.00

PP1-date