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HOUSING CHOICE-Burts Pit Road INVOICE 1 AND 2
In accordance with the Contract Documents, based on on-site observations and the data comprising the above application the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the Amount Certified. 1,409,272.50 0.00 1,409,272.50 185,037.15 9,251.86 175,785.29 0.00 0.00 0.00 9,251.86 0.00 Page 1 Contractor: By: ____________________________________Date: _____________ State of: __________________County of: ______________________ Subscribed and sworn to before me this _____ day of ____________, _________ (year). Notary public: _____________________________ My commission expires ____________________. Original contract sum Net change by change orders Contract sum to date Total completed and stored to date Retainage 5.0% of completed work 0.0% of stored material Total retainage Total earned less retainage Less previous certificates of payment Current sales tax 0.000% of taxable amount Current sales tax Current payment due Architect's Certificate for Payment Architect: By: _____________________________Date: ____________ The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief the work covered 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 issued and payments received from the Owner, and that current payment shown herein is now due. Amount Certified:$ ___________________________ 175,785.29 This Certification is not negotiable. The Amount Certified is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. Date: 05/07/2019 PALMER PAVING CORPORATION 25 BLANCHARD STREET P. O. BOX 47 PALMER, MA 01069 CITY OF NORTHAMPTON DPW 125 LOCUST STREET NORTHAMPTON, MA 01060 To Owner: From (Contractor): Phone: Project:BURTS PIT RD NHAMPTON BURTS PIT RD CITY OF NORTHAMPTON NORTHAMPTON, MA Via (Architect): Application No: 1 Architect's Project No: Contract For: INVOICE #: 19-023* 1 Contractor's Application For Payment Number Date Approved Additions Deductions Change orders approved this month Totals Net change by change orders Contractor Job Number:19-023 Application and Certificate For Payment Period To: 05/07/19 Change Order Summary Change orders approved in previous months by owner 413 283-8354 6.0000 0.00 0.00 .00 0.00 0.0 0.00 12.0000 0.00 0.00 .00 0.00 0.0 0.00 135.0000 0.00 135.00 1.00 135.00 1.0 6.75 30.0000 0.00 0.00 .00 0.00 0.0 0.00 150.0000 0.00 0.00 .00 0.00 0.0 0.00 25.0000 0.00 8,196.75 327.87 8,196.75 327.9 409.84 45.0000 0.00 5,769.90 128.22 5,769.90 284.9 288.50 4.0000 0.00 0.00 .00 0.00 0.0 0.00 400.0000 0.00 400.00 1.00 400.00 10.0 20.00 4,000.0000 0.00 4,000.00 1.00 4,000.00 12.5 200.00 2,500.0000 0.00 0.00 .00 0.00 0.0 0.00 3,800.0000 0.00 30,400.00 8.00 30,400.00 160.0 1,520.00 5,000.0000 0.00 0.00 .00 0.00 0.0 0.00 410.0000 0.00 0.00 .00 0.00 0.0 0.00 390.0000 0.00 0.00 .00 0.00 0.0 0.00 350.0000 0.00 0.00 .00 0.00 0.0 0.00 850.0000 0.00 0.00 .00 0.00 0.0 0.00 900.0000 0.00 0.00 .00 0.00 0.0 0.00 90.0000 0.00 0.00 .00 0.00 0.0 0.00 58.0000 0.00 77,517.00 1336.50 77,517.00 94.1 3,875.85 80.0000 0.00 0.00 .00 0.00 0.0 0.00 110.0000 0.00 0.00 .00 0.00 0.0 0.00 1,800.0000 0.00 0.00 .00 0.00 0.0 0.00 35.0000 0.00 0.00 .00 0.00 0.0 0.00 45.0000 0.00 0.00 .00 0.00 0.0 0.00 5.9500 0.00 0.00 .00 0.00 0.0 0.00 22.0000 0.00 0.00 .00 0.00 0.0 0.00 0.6500 0.00 0.00 .00 0.00 0.0 0.00 150.0000 0.00 0.00 .00 0.00 0.0 0.00 To Owner:CITY OF NORTHAMPTON DPW From (Contractor):PALMER PAVING CORPORATION Project:BURTS PIT RD NHAMPTON Date: 05/07/19 Period To: 05/07/19 Architect's Project No: Contractor's Job Number:19-023 Item Number Description Unit Price UM Scheduled Value Work Completed Previous Application Quantity Amount Contract Quantity Quantity Amount Work Completed This Period Completed and Stored To Date Quantity Amount %Retention Memo BP 102.51 LF .00 .00 200.00 102.52 LF .00 .00 100.00 102.53 EAC .00 1.00 100.00 120.1 CY .00 .00 2000.00 144 CY .00 .00 25.00 151 CY .00 327.87 100.00 156 TON .00 128.22 45.00 170 SY .00 .00 2300.00 191.6 EAC .00 1.00 10.00 201 EAC .00 1.00 8.00 201.1 EAC .00 .00 2.00 202 EAC .00 8.00 5.00 203.9 EAC .00 .00 2.00 220 EAC .00 .00 82.00 220.2 VF .00 .00 9.00 220.95 EAC .00 .00 17.00 222.3 EAC .00 .00 4.00 222.4 EAC .00 .00 14.00 238.1 LF .00 .00 40.00 241.12 LF .00 1336.50 1420.00 241.15 LF .00 .00 12.00 241.24 LF .00 .00 57.00 242.24 EAC .00 .00 1.00 269.06 LF .00 .00 2400.00 402.11 TON .00 .00 700.00 403 SY .00 .00 30000.00 405.1 CY .00 .00 900.00 440 LB .00 .00 2000.00 443 MGA .00 .00 20.00 1,200.00 1,200.00 13,500.00 60,000.00 3,750.00 2,500.00 2,025.00 9,200.00 4,000.00 32,000.00 5,000.00 19,000.00 10,000.00 33,620.00 3,510.00 5,950.00 3,400.00 12,600.00 3,600.00 82,360.00 960.00 6,270.00 1,800.00 84,000.00 31,500.00 178,500.00 19,800.00 1,300.00 3,000.00 Application and Certificate For Payment -- page 2 Water for Roadway Du mporary Fence Tree Protection -Tre nch & Pruning Tree Protection - Tr unk Protection Unclassified Excavat ion Class B Rock Excavat ion Gravel Borrow Crushed Stone Fine Grading & Compa cting Test Pit Catch Basin Special Catch Basin Manhole Deep Sump Manhole Drainage or Sanitary Structure Adjusted Drainage Structure O r Sanitary Structure Rebuilt Or Remodele Adjust Water Gate Bo xes and Services to Grade Frame and Grate Muni cipal Standard Frame and Cover Muni cipal Standard 10-In. Ductile Iron Pipe 12" Reinforced Concr ete (Class IV) Pipe 15" Reinforced Concr ete (Class IV) Pipe 24" Reinforced Concr ete (Class IV) Pipe 24" Reinforced Concr ete Pipe Flared End Subdrain Dense Grade Crushed Stone for Shoulders Reclaimed Pavement f or Base Course Processed Gravel Calcium Chloride for Roadway Dust Control Water for Roadway Du st Control Application No: 1 5.0000 0.00 0.00 .00 0.00 0.0 0.00 75.0000 0.00 0.00 .00 0.00 0.0 0.00 100.0000 0.00 16,406.00 164.06 16,406.00 164.1 820.30 1.5000 0.00 0.00 .00 0.00 0.0 0.00 4.5000 0.00 0.00 .00 0.00 0.0 0.00 22.0000 0.00 0.00 .00 0.00 0.0 0.00 75.0000 0.00 0.00 .00 0.00 0.0 0.00 75.0000 0.00 0.00 .00 0.00 0.0 0.00 50.0000 0.00 0.00 .00 0.00 0.0 0.00 300.0000 0.00 0.00 .00 0.00 0.0 0.00 5.0000 0.00 0.00 .00 0.00 0.0 0.00 175.0000 0.00 0.00 .00 0.00 0.0 0.00 160.0000 0.00 0.00 .00 0.00 0.0 0.00 75.0000 0.00 0.00 .00 0.00 0.0 0.00 85.0000 0.00 0.00 .00 0.00 0.0 0.00 32,500.0000 0.00 24,375.00 75.00 %24,375.00 75.0 1,218.75 5,000.0000 0.00 5,000.00 100.00 %5,000.00 100.0 250.00 55.0000 0.00 0.00 .00 0.00 0.0 0.00 0.8000 0.00 0.00 .00 0.00 0.0 0.00 10.0000 0.00 0.00 .00 0.00 0.0 0.00 3.5000 0.00 4,158.00 1188.00 4,158.00 59.4 207.90 5.7500 0.00 0.00 .00 0.00 0.0 0.00 25,000.0000 0.00 8,250.00 33.00 %8,250.00 33.0 412.50 3.4500 0.00 0.00 .00 0.00 0.0 0.00 0.7500 0.00 0.00 .00 0.00 0.0 0.00 0.7500 0.00 0.00 .00 0.00 0.0 0.00 150.0000 0.00 0.00 .00 0.00 0.0 0.00 20.0000 0.00 0.00 .00 0.00 0.0 0.00 235.0000 0.00 0.00 .00 0.00 0.0 0.00 325.0000 0.00 0.00 .00 0.00 0.0 0.00 65.0000 0.00 0.00 .00 0.00 0.0 0.00 To Owner:CITY OF NORTHAMPTON DPW From (Contractor):PALMER PAVING CORPORATION Project:BURTS PIT RD NHAMPTON Date: 05/07/19 Period To: 05/07/19 Architect's Project No: Contractor's Job Number:19-023 Item Number Description Unit Price UM Scheduled Value Work Completed Previous Application Quantity Amount Contract Quantity Quantity Amount Work Completed This Period Completed and Stored To Date Quantity Amount %Retention Memo 452 GAL .00 .00 1400.00 460 TON .00 .00 6400.00 472 TON .00 164.06 100.00 570.1 LF .00 .00 6200.00 570.2 LF .00 .00 7000.00 583 LF .00 .00 100.00 620.1 LF .00 .00 25.00 627.1 EAC .00 .00 1.00 630 LF .00 .00 25.00 632 EAC .00 .00 5.00 697 LF .00 .00 500.00 703 TON .00 .00 175.00 706.1 SY .00 .00 50.00 715.12 EAC .00 .00 96.00 734 EAC .00 .00 6.00 748 LS 0.00 % 75.00 % 1.00 748.9 LS 0.00 %100.00 % 1.00 751 CY .00 .00 45.00 765 SY .00 .00 4100.00 767.12 LF .00 .00 200.00 767.33 LF .00 1188.00 2000.00 767.8 LF .00 .00 200.00 851.1 LS 0.00 % 33.00 % 1.00 865.1 SF .00 .00 150.00 866.04 LF .00 .00 14000.00 867.04 LF .00 .00 18000.00 874 EAC .00 .00 3.00 874.4 EAC .00 .00 8.00 874.6 EAC .00 .00 26.00 874.8 EAC .00 .00 2.00 983 TON .00 .00 10.00 7,000.00 480,000.00 10,000.00 9,300.00 31,500.00 2,200.00 1,875.00 75.00 1,250.00 1,500.00 2,500.00 30,625.00 8,000.00 7,200.00 510.00 32,500.00 5,000.00 2,475.00 3,280.00 2,000.00 7,000.00 1,150.00 25,000.00 517.50 10,500.00 13,500.00 450.00 160.00 6,110.00 650.00 650.00 Application and Certificate For Payment -- page 3 Asphalt Emulsion for Tack Coat Hot Mix Asphalt Pave ment Hot Mix Asphalt for Patching Removal Of Hot Mix A sphalt Curb Hot Mix Asphalt Curb , Complete-In- Place Edging Removed and R eset Steel W Beam Highway Guard (Single Faced) Steel W Beam Termina l Section (Single Faced) Highway Guard Remove d and Reset Individual Post Remo ved And Reset Sedimentation Fence ? Silt Fence Hot Mix Asphalt Driv eway Brick or Flagstone W alk or Driveway Removed and Relaid Rural Mailbox Remove d And Reset Sign Removed And Res et Mobilization & Demob ilization NPDES Storm Water Co nstruction General Permit Compliance Loam Borrow Seeding Filter Sock Straw Wattle Bales of Straw for E rosion Control Safety Controls for Construction Operations Crosswalks and Stop lines Reflectorized White (Thermoplastic Four Inch Reflectori zed White Line (Thermoplastic) Four Inch Reflectori zed Yellow Line (Thermoplastic) Street Name Sign Water for Roadway Du gn Removed & Discarded Traffic Warning Sign s (Type-2/2A) Traffic Warning Sign s (Type- 3/3A/3B) Dumped Riprap Application No: 1 70.0000 0.00 0.00 .00 0.00 0.0 0.00 100.0000 0.00 200.00 2.00 200.00 4.4 10.00 60,000.0000 0.00 229.50 .00 229.50 0.4 11.47 1,000.0000 0.00 0.00 .00 0.00 0.0 0.00 1,000.0000 0.00 0.00 .00 0.00 0.0 0.00 1,000.0000 0.00 0.00 .00 0.00 0.0 0.00 1,409,272.50 0.00 185,037.15 185,037.15 9,251.86 1,409,272.50 0.00 185,037.15 185,037.15 9,251.86 To Owner:CITY OF NORTHAMPTON DPW From (Contractor):PALMER PAVING CORPORATION Project:BURTS PIT RD NHAMPTON Date: 05/07/19 Period To: 05/07/19 Architect's Project No: Contractor's Job Number:19-023 Item Number Description Unit Price UM Scheduled Value Work Completed Previous Application Quantity Amount Contract Quantity Quantity Amount Work Completed This Period Completed and Stored To Date Quantity Amount %Retention Memo 986 TON .00 .00 25.00 999.001 EAC .00 2.00 45.00 999.1 AL .00 .00 1.00 999.11 AL .00 .00 1.00 999.12 AL .00 .00 1.00 999.13 AL .00 .00 1.00 Total Application Total 1,750.00 4,500.00 60,000.00 1,000.00 1,000.00 1,000.00 Application and Certificate For Payment -- page 4 Modified Rock Fill Inlet Protection Traffic Police Monthly Price Adjust ment for Hot Mix Asphalt Mixtures Monthly Price Adjust ment For Diesel Fuel And Gasoline Monthly Price Adjust ment for Portland Cement Concrete Mixes Application No: 1 In accordance with the Contract Documents, based on on-site observations and the data comprising the above application the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the Amount Certified. 1,409,272.50 0.00 1,409,272.50 939,582.63 46,979.13 892,603.50 175,785.29 0.00 0.00 46,979.13 0.00 Page 1 Contractor: By: ____________________________________Date: _____________ State of: __________________County of: ______________________ Subscribed and sworn to before me this _____ day of ____________, _________ (year). Notary public: _____________________________ My commission expires ____________________. Original contract sum Net change by change orders Contract sum to date Total completed and stored to date Retainage 5.0% of completed work 0.0% of stored material Total retainage Total earned less retainage Less previous certificates of payment Current sales tax 0.000% of taxable amount Current sales tax Current payment due Architect's Certificate for Payment Architect: By: _____________________________Date: ____________ The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief the work covered 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 issued and payments received from the Owner, and that current payment shown herein is now due. Amount Certified:$ ___________________________ 716,818.21 This Certification is not negotiable. The Amount Certified is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. Date: 05/31/2019 PALMER PAVING CORPORATION 25 BLANCHARD STREET P. O. BOX 47 PALMER, MA 01069 CITY OF NORTHAMPTON DPW 125 LOCUST STREET NORTHAMPTON, MA 01060 To Owner: From (Contractor): Phone: Project:BURTS PIT RD NHAMPTON BURTS PIT RD CITY OF NORTHAMPTON NORTHAMPTON, MA Via (Architect): Application No: 2 Architect's Project No: Contract For: INVOICE #: 19-023* 2 Contractor's Application For Payment Number Date Approved Additions Deductions Change orders approved this month Totals Net change by change orders Contractor Job Number:19-023 Application and Certificate For Payment Period To: 05/31/19 Change Order Summary Change orders approved in previous months by owner 413 283-8354 6.0000 0.00 0.00 .00 0.00 0.0 0.00 12.0000 0.00 0.00 .00 0.00 0.0 0.00 135.0000 135.00 0.00 1.00 135.00 1.0 6.75 30.0000 0.00 1,170.00 39.00 1,170.00 2.0 58.50 150.0000 0.00 0.00 .00 0.00 0.0 0.00 25.0000 8,196.75 8,044.00 649.63 16,240.75 649.6 812.04 45.0000 5,769.90 1,678.50 165.52 7,448.40 367.8 372.42 4.0000 0.00 0.00 .00 0.00 0.0 0.00 400.0000 400.00 4,000.00 11.00 4,400.00 110.0 220.00 4,000.0000 4,000.00 48,000.00 13.00 52,000.00 162.5 2,600.00 2,500.0000 0.00 0.00 .00 0.00 0.0 0.00 3,800.0000 30,400.00 7,600.00 10.00 38,000.00 200.0 1,900.00 5,000.0000 0.00 0.00 .00 0.00 0.0 0.00 410.0000 0.00 0.00 .00 0.00 0.0 0.00 390.0000 0.00 0.00 .00 0.00 0.0 0.00 350.0000 0.00 0.00 .00 0.00 0.0 0.00 850.0000 0.00 0.00 .00 0.00 0.0 0.00 900.0000 0.00 0.00 .00 0.00 0.0 0.00 90.0000 0.00 1,980.00 22.00 1,980.00 55.0 99.00 58.0000 77,517.00 20,445.00 1689.00 97,962.00 118.9 4,898.10 80.0000 0.00 280.00 3.50 280.00 29.2 14.00 110.0000 0.00 6,160.00 56.00 6,160.00 98.2 308.00 1,800.0000 0.00 1,800.00 1.00 1,800.00 100.0 90.00 35.0000 0.00 101,010.00 2886.00 101,010.00 120.3 5,050.50 45.0000 0.00 0.00 .00 0.00 0.0 0.00 5.9500 0.00 176,613.85 29683.00 176,613.85 98.9 8,830.69 22.0000 0.00 0.00 .00 0.00 0.0 0.00 0.6500 0.00 9,646.98 14841.51 9,646.98 742.1 482.35 150.0000 0.00 6,000.00 40.00 6,000.00 200.0 300.00 To Owner:CITY OF NORTHAMPTON DPW From (Contractor):PALMER PAVING CORPORATION Project:BURTS PIT RD NHAMPTON Date: 05/31/19 Period To: 05/31/19 Architect's Project No: Contractor's Job Number:19-023 Item Number Description Unit Price UM Scheduled Value Work Completed Previous Application Quantity Amount Contract Quantity Quantity Amount Work Completed This Period Completed and Stored To Date Quantity Amount %Retention Memo BP 102.51 LF .00 .00 200.00 102.52 LF .00 .00 100.00 102.53 EAC 1.00 .00 100.00 120.1 CY .00 39.00 2000.00 144 CY .00 .00 25.00 151 CY 327.87 321.76 100.00 156 TON 128.22 37.30 45.00 170 SY .00 .00 2300.00 191.6 EAC 1.00 10.00 10.00 201 EAC 1.00 12.00 8.00 201.1 EAC .00 .00 2.00 202 EAC 8.00 2.00 5.00 203.9 EAC .00 .00 2.00 220 EAC .00 .00 82.00 220.2 VF .00 .00 9.00 220.95 EAC .00 .00 17.00 222.3 EAC .00 .00 4.00 222.4 EAC .00 .00 14.00 238.1 LF .00 22.00 40.00 241.12 LF 1336.50 352.50 1420.00 241.15 LF .00 3.50 12.00 241.24 LF .00 56.00 57.00 242.24 EAC .00 1.00 1.00 269.06 LF .00 2886.00 2400.00 402.11 TON .00 .00 700.00 403 SY .00 29683.00 30000.00 405.1 CY .00 .00 900.00 440 LB .00 14841.51 2000.00 443 MGA .00 40.00 20.00 1,200.00 1,200.00 13,500.00 60,000.00 3,750.00 2,500.00 2,025.00 9,200.00 4,000.00 32,000.00 5,000.00 19,000.00 10,000.00 33,620.00 3,510.00 5,950.00 3,400.00 12,600.00 3,600.00 82,360.00 960.00 6,270.00 1,800.00 84,000.00 31,500.00 178,500.00 19,800.00 1,300.00 3,000.00 Application and Certificate For Payment -- page 2 Water for Roadway Du mporary Fence Tree Protection -Tre nch & Pruning Tree Protection - Tr unk Protection Unclassified Excavat ion Class B Rock Excavat ion Gravel Borrow Crushed Stone Fine Grading & Compa cting Test Pit Catch Basin Special Catch Basin Manhole Deep Sump Manhole Drainage or Sanitary Structure Adjusted Drainage Structure O r Sanitary Structure Rebuilt Or Remodele Adjust Water Gate Bo xes and Services to Grade Frame and Grate Muni cipal Standard Frame and Cover Muni cipal Standard 10-In. Ductile Iron Pipe 12" Reinforced Concr ete (Class IV) Pipe 15" Reinforced Concr ete (Class IV) Pipe 24" Reinforced Concr ete (Class IV) Pipe 24" Reinforced Concr ete Pipe Flared End Subdrain Dense Grade Crushed Stone for Shoulders Reclaimed Pavement f or Base Course Processed Gravel Calcium Chloride for Roadway Dust Control Water for Roadway Du st Control Application No: 2 5.0000 0.00 0.00 .00 0.00 0.0 0.00 75.0000 0.00 324,898.50 4331.98 324,898.50 67.7 16,244.93 100.0000 16,406.00 4,384.00 207.90 20,790.00 207.9 1,039.50 1.5000 0.00 7,861.50 5241.00 7,861.50 84.5 393.08 4.5000 0.00 0.00 .00 0.00 0.0 0.00 22.0000 0.00 0.00 .00 0.00 0.0 0.00 75.0000 0.00 0.00 .00 0.00 0.0 0.00 75.0000 0.00 0.00 .00 0.00 0.0 0.00 50.0000 0.00 0.00 .00 0.00 0.0 0.00 300.0000 0.00 0.00 .00 0.00 0.0 0.00 5.0000 0.00 0.00 .00 0.00 0.0 0.00 175.0000 0.00 0.00 .00 0.00 0.0 0.00 160.0000 0.00 0.00 .00 0.00 0.0 0.00 75.0000 0.00 0.00 .00 0.00 0.0 0.00 85.0000 0.00 0.00 .00 0.00 0.0 0.00 32,500.0000 24,375.00 0.00 75.00 %24,375.00 75.0 1,218.75 5,000.0000 5,000.00 0.00 100.00 %5,000.00 100.0 250.00 55.0000 0.00 0.00 .00 0.00 0.0 0.00 0.8000 0.00 0.00 .00 0.00 0.0 0.00 10.0000 0.00 0.00 .00 0.00 0.0 0.00 3.5000 4,158.00 0.00 1188.00 4,158.00 59.4 207.90 5.7500 0.00 0.00 .00 0.00 0.0 0.00 25,000.0000 8,250.00 8,250.00 66.00 %16,500.00 66.0 825.00 3.4500 0.00 0.00 .00 0.00 0.0 0.00 0.7500 0.00 0.00 .00 0.00 0.0 0.00 0.7500 0.00 0.00 .00 0.00 0.0 0.00 150.0000 0.00 0.00 .00 0.00 0.0 0.00 20.0000 0.00 0.00 .00 0.00 0.0 0.00 235.0000 0.00 0.00 .00 0.00 0.0 0.00 325.0000 0.00 0.00 .00 0.00 0.0 0.00 65.0000 0.00 1,463.15 22.51 1,463.15 225.1 73.16 To Owner:CITY OF NORTHAMPTON DPW From (Contractor):PALMER PAVING CORPORATION Project:BURTS PIT RD NHAMPTON Date: 05/31/19 Period To: 05/31/19 Architect's Project No: Contractor's Job Number:19-023 Item Number Description Unit Price UM Scheduled Value Work Completed Previous Application Quantity Amount Contract Quantity Quantity Amount Work Completed This Period Completed and Stored To Date Quantity Amount %Retention Memo 452 GAL .00 .00 1400.00 460 TON .00 4331.98 6400.00 472 TON 164.06 43.84 100.00 570.1 LF .00 5241.00 6200.00 570.2 LF .00 .00 7000.00 583 LF .00 .00 100.00 620.1 LF .00 .00 25.00 627.1 EAC .00 .00 1.00 630 LF .00 .00 25.00 632 EAC .00 .00 5.00 697 LF .00 .00 500.00 703 TON .00 .00 175.00 706.1 SY .00 .00 50.00 715.12 EAC .00 .00 96.00 734 EAC .00 .00 6.00 748 LS 75.00 % 0.00 % 1.00 748.9 LS 100.00 % 0.00 % 1.00 751 CY .00 .00 45.00 765 SY .00 .00 4100.00 767.12 LF .00 .00 200.00 767.33 LF 1188.00 .00 2000.00 767.8 LF .00 .00 200.00 851.1 LS 33.00 % 33.00 % 1.00 865.1 SF .00 .00 150.00 866.04 LF .00 .00 14000.00 867.04 LF .00 .00 18000.00 874 EAC .00 .00 3.00 874.4 EAC .00 .00 8.00 874.6 EAC .00 .00 26.00 874.8 EAC .00 .00 2.00 983 TON .00 22.51 10.00 7,000.00 480,000.00 10,000.00 9,300.00 31,500.00 2,200.00 1,875.00 75.00 1,250.00 1,500.00 2,500.00 30,625.00 8,000.00 7,200.00 510.00 32,500.00 5,000.00 2,475.00 3,280.00 2,000.00 7,000.00 1,150.00 25,000.00 517.50 10,500.00 13,500.00 450.00 160.00 6,110.00 650.00 650.00 Application and Certificate For Payment -- page 3 Asphalt Emulsion for Tack Coat Hot Mix Asphalt Pave ment Hot Mix Asphalt for Patching Removal Of Hot Mix A sphalt Curb Hot Mix Asphalt Curb , Complete-In- Place Edging Removed and R eset Steel W Beam Highway Guard (Single Faced) Steel W Beam Termina l Section (Single Faced) Highway Guard Remove d and Reset Individual Post Remo ved And Reset Sedimentation Fence ? Silt Fence Hot Mix Asphalt Driv eway Brick or Flagstone W alk or Driveway Removed and Relaid Rural Mailbox Remove d And Reset Sign Removed And Res et Mobilization & Demob ilization NPDES Storm Water Co nstruction General Permit Compliance Loam Borrow Seeding Filter Sock Straw Wattle Bales of Straw for E rosion Control Safety Controls for Construction Operations Crosswalks and Stop lines Reflectorized White (Thermoplastic Four Inch Reflectori zed White Line (Thermoplastic) Four Inch Reflectori zed Yellow Line (Thermoplastic) Street Name Sign Water for Roadway Du gn Removed & Discarded Traffic Warning Sign s (Type-2/2A) Traffic Warning Sign s (Type- 3/3A/3B) Dumped Riprap Application No: 2 70.0000 0.00 0.00 .00 0.00 0.0 0.00 100.0000 200.00 0.00 2.00 200.00 4.4 10.00 60,000.0000 229.50 13,260.00 .22 13,489.50 22.5 674.46 1,000.0000 0.00 0.00 .00 0.00 0.0 0.00 1,000.0000 0.00 0.00 .00 0.00 0.0 0.00 1,000.0000 0.00 0.00 .00 0.00 0.0 0.00 1,409,272.50 185,037.15 754,545.48 939,582.63 46,979.13 1,409,272.50 185,037.15 754,545.48 939,582.63 46,979.13 To Owner:CITY OF NORTHAMPTON DPW From (Contractor):PALMER PAVING CORPORATION Project:BURTS PIT RD NHAMPTON Date: 05/31/19 Period To: 05/31/19 Architect's Project No: Contractor's Job Number:19-023 Item Number Description Unit Price UM Scheduled Value Work Completed Previous Application Quantity Amount Contract Quantity Quantity Amount Work Completed This Period Completed and Stored To Date Quantity Amount %Retention Memo 986 TON .00 .00 25.00 999.001 EAC 2.00 .00 45.00 999.1 AL .00 .22 1.00 999.11 AL .00 .00 1.00 999.12 AL .00 .00 1.00 999.13 AL .00 .00 1.00 Total Application Total 1,750.00 4,500.00 60,000.00 1,000.00 1,000.00 1,000.00 Application and Certificate For Payment -- page 4 Modified Rock Fill Inlet Protection Traffic Police Monthly Price Adjust ment for Hot Mix Asphalt Mixtures Monthly Price Adjust ment For Diesel Fuel And Gasoline Monthly Price Adjust ment for Portland Cement Concrete Mixes Application No: 2