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SCANNED
BY
St. Lucie County L!)NTlNiMi°fONS12fihT67W MOP Of I PAGFS
Mcnou,ni 0702 APPLICATION AND CERTIFICATE FOR PAYMENT;amaalalaR APPLICATION NO: 2
Motra,weA sig"d ce tokatkal in altaah0d. APPLRAT1ON DATE: 4/012016
PEOIODTO: 4j9/2016
Use C Miano I wtCoatrac A whom varhW re"lanso, for line Items maY APPIY PKOJECr N0: ThrAll am
2
3
4
1 5
1 6
7 0. - 9
to 1 11
1 12
13
14
is
MISCKIIRMOPWORK -
SOMIJI 1..0
YYORKcIAhiturn
Mae comaireted
I
Tafelfmo,pleled
%
ZSCE
RffMNACa
rena "..
pasmenO
Yoml
'tltt4PS61au
VALUE,
and Straw
10 NNttN
(IFYA91Aaa
ArPuuno i
AWWAnOv
pry'ta1
_
t
Until
Price
3.6
7.0
7•S]_,
e•0
AOt if
6.12
7U111c0Lga1 i t� t ` M-LOS[ack •IJ•
&5o IR 11i11m0ies
CO 2 Rust spot Stack A
8,00
E.T
$2D.DD
$224,00
8.00
000.
$224.00
$0.00
$224.00
100.00%
$0,00
$22.40
G.02 Rust spot Stick A(small llalnnty)
moo
Ea
$28.00
$224.00
8.00
8,00
$224.00
$0.00
$224.00
100.00%
$0100
$22.40
/1.02 Evil Spot Stack
2MOD
Fa
$28,00
$560,00
20.00
20.00
$560,00
$0.00
$560.00
100.001A
$0.00
$56.00
Pernulte fees
1.00
1s
$235.63
$235,63
1.00
1.00
$235,63
$0.00
$235.¢3
'1 DOA0%
$0A0
CO 2 Rom Spot Stack A
1,00
EA
$28.00
$20.00
1.00
1100
$20,00
$0.00
$28,00-
100,00%
$0.00
UPID
CO2 Edge 6'
0,67
LF.
$110.00
$953,33
0.67
1167
$953,333
$0.00
053.33'
100.00%
$0.00
$95,33
Overhead repair
0,4a
$95:00
$45.60
0.10.
0.40
$45.60
$0.00
$45.60
100.00%
$0.00
$4.56
C 02 Rust spot
10.00
ea
$28.00
$2RO100
10.01)
10.00
$200,00
$0.00
$280,00
100.00%
$0,00
$28.00
GRANDTOTALS
$2,550,56
$2,550,56
$0.00
$2,55056
0.00%1
$0.00
$231.49
1
1
1
G702 APPLICATION AND CERTIFICATION FOR PAYMENT
rev
TOOWNERt FlirtService The AtriumlC.mldnmldnmAsso.
APPLICATION NO: 2
Distribution to:
3055 Cardinal Dr. Ste 200 2900 North ALA
RETAINAGE
DOWNER
Vero Umch. FL 32963 North Hutchinson Islarel
Application Dole: 04/(09/16
BENDINEER
PERIODTO; 04/09/16
CONTRACTOR
FROM CONTRACTOR: VIAENGINEMIU MOVEriginneringlne
Danielo,A Assoclates, Inc 103520thsttraiat
NOTA LUMPSUMBID: Theanneen sbased
2700 N. Australian Ave., Stu 9 9ere Baaeh.pl. 32960
open estimated 9uandties listed In Exhibit QuanOty.Schedule. Tlreamuunt paid
West Palm Reach, FI 33407
will be based upon actual quantlthei/work Performed at rates in Exhibit A
CONTRACT: Concrete Restoration Repairs
_.... _CONTRACT DATE:
CONTRACTOR'S APPLICATION FOR PAYMENT
The undersigned ContractorcertlRes that to the best of the Contractor's knowledge.
Application is made for payment, as shown below, in connection with the Comnd.
Information and belief the Work covered by this Application for Payment law been
/
Continuation Sheet Sheet G703, icatmched. •
completed I" accordance with the Contract Dnrumeots. that all amnums have been paid by
the Contractor for Work fnrwhich previous Certificates for Payment were Issued and
payments received from the Owner, and that correct payment shown turner Is now due
$
2314.93
2. Net thmrgc by Change Orclm
$
$
235A3
2,550.5ci
CONTRACTOi(1,,...
r
3. CONTRACT SOM TO DATG(I.Im 12.2)
.
C..�
4. TO rAI, COMPLETED & STOHI?D TD
S
2,55OS6
DATE (Column 12on G703)
By; (� .,..�5"^-
Date: G4/09/16
5. IiETNNAGE:
yy
: di,xrA tti$itair R
�p
a 10 %nfComphned Work S
State nil ^ illy Cn luau 4 :3T3 Florida County of: Palm Bench
Sulm"bed and sworn to before me this . r ;7.P12ES Z b-
h. % of Stated Material S
—
Notary Pnblic
My Cotmnissianexpiras:
Total Retain ige (Lines Sa +Sh or
Total In Column 15 ofO703)
S
0.00
ENGINEER'S CERTTFICATEFOR PAYMENT
6. TOTAL EARNED LESS RETAINAC.E
$
2,550,56
In artnntapce with the Contract Darnments, hated on on -site observationsand the dam
(Line 4 Less Line 5 Total)
comprising the appliention, the Engineer certifies to the Ownerthat to the host of the
7. 1,E5S 1'RBVIOUS CERTIFICArtiS lIOR
Engineer's knowledge. Information and belief the Work has prograasnd as indlcmed.
PAYMINT(Line 6 from prior Carl Ificate)
S
2,319.07
the quality or the Work is in accordance witrihe ContractDocnments, and the Contractor
O. CURRENT PAYMENT DUE
S
231A9
isentitiodinpaymentofthe AMOIINTCliliTIFiF.''D.
9.gALANCETOFINISFI.INCLUDINGRETAINAI
S
1
(Line 3 less Line 6)
AMOUNT CERTIFIED........... $
CHANGE ORDER SUMMARY
ADDITIONS
DEDUCTIONS
Total changes approved
In previous months by Omer
$235.63
Traxiloppraved this Month
TOTALS
S235.63
$0.00
NET CHANGES by Chang, Order
$235.63
(ANach explanation if amnantrertrpeddli fen fmm theumounlapplted laltiut all jigureson this
Application and an the Continuation Sheet that are changedre, conform with the amount maniflcd)
ENGINEER --
BY.,
This Ceriffame 19 not negattable. The AMOUNT CERTIFIED is payable only to the
Contractor named hamimissuarm, payment and acceptance of payment are without
preludicxlo mtyrights of the Owner or Card rector under this CoetracL
/GO/-G/G P
0702 APPLICATION AND CERTIFICATION FOR PAYMENT
"All
TO OWNED; FlsH s'n•Rr ThcAfthm l Omilomfol"m A+v+..
APPLICATIONNO. A
Dwriliatlpn fin'.
31155 Cardhml DAStc Efhl 29A0 Nutth A IA
RETAINAGE
Qn1YNElt
Vrrr Pew,11. 0L32963 NAdh Nnuhinwn lshnd
AppileaUrn Date. i14(OR(ife
PNGINEEH
PERIOD TO; 04/118/16
CONTRACTOR
FROMCONTRACTOM WAENGINEER! MVEnghmrHnalm
Dani¢Dn R Ass-onles. Inr, 11135z(4hs1Anegl
NOT A LIIMF SLIM DIU The an+m,ate,in,m1
2708 N. AnHmllnn Alc_ 51c•) Ycrn Deadl.11.32960
uprq mornalnl gwmak. lulM In Eahlldl A OVurAuyknotInk. Tw amwol paM
lVeMPalm O,arh.h7 1.1407
an4lx lows, almle u,wU mnmOma/wrxk pnbamrd al rmv u,laltllmA
CUN'rRAi;T:
CONTRACT DATE:
CONTRACTOR'S APPLICATION FOR PAYMENT
Tile Arnim lglhvtrunlmrurtmN{n"thalinthe hrHo(the rnNlnqur'ukplwicdµe,
Appilcallm, is made for paypnmt. is she" hclow,[new nrdlon will, Om Tomnel.
htfommdnn and hotter the Work viweml by fill, Applicant oil for Paynrm0 tons Well
CnnNnualun llunn..Sl,rel 0701p,At htrhe,l
,mvp1vtod-ortnnlmu'r Williite C+mtma Dnrnmrms, ibn1.1tanann, have been sad by
the cuntiaai} for WArk Inwhkh I'mMnns Cmillun.'r to, Payment We'll Ixsn.nLhiil
paymriaN r YHYCd from the comunG and Unit mmenl Imylhl1,l AhTHI herch, Ill nmV dUe.
L 010GINALIAUVINAGTSUM $ 0204.3,611
Z Net rhaagr by i3l.mv Ordem S 9,2240dCONTRACTOR;
3. CONTRACTSUMTODATEDAnn I s:1 5 9ZQfiT70 .7.
1.'I'OCAI, t:OM1O'IA•7p1f #.Sl'UIIEP TfI S 'IZIInZ 0 lr�"
UATIi fCnhlmn 12 on 1:70:11 - NQc"'""'ilx'iYi'`��4 ~'-
a. in -Lnl f:nnlldArJ Wark S 4.nrafa j
4Jwwriml and swan, It. Iminn
IS_".6 of 9fxrd M1inturGl 5 NaluryPuldlr, 1 • ' t
my Ormmininnncpinaf
Tonal Iimait•9r' (Une, 5.1 •Shur
Trn:d u, rydomn IS al G7%3)
A, TOTAL EARNED LKI RI:CAINACE
f1AneJ L`ro Ijne GTfmm)
7, IJ«b'11•ItiiY11111S fliltTll'U tl'1'1lTlit
pAYMnNT (Line A fine., pdnr 1]•nl1nn.•l
O. CURRENT PAYMENT DUE
9. RAt.ANCilTIIFINI511.iN1;lAU11Nr R,"rA1NA,
(LJn+3lrss IA,M AJ
v'...
I
S 0,00 ENGINEER:SCCRTIITCATG FOR PAYMENT
$ 02,Oh7.70 Innunrdnnce wulific Contract nortnnonfN hnuR on un nirnh,><•rvu8unxapd Ill.; Jail
romprNDAtile oppllcauuO.Ilu.IhighammrcHlOux OI IhpnwdrrOwl Ill file heel of the
Mldmvr`s MlmvlcdRr.ndurnroDnV m,A brlirfihoMknhl,Sx pmgmund.0 IndlmpNC
S 113,315,M IhrynalUy alth+t Wluk fix In rpn.rdannf swlh der C,nnlne, Oranmcnlx, and the•f�nnrmsm
S- 0.74Z66 is entilieJ In paymrnl nffhe Ad11111NT fIdO'IFifill
S
CHANGF,IIIIIIER,SUMMAIIY
ACurrinN¢
implicTION5
'fatal rllanges alrymned
in mmaaSumnlhshv Owue
S2:.d2219
Tomin tmvcA lhta MUNh...
k375.n0
SI6473,20
_
TOTAIt
S25A0729.
116.•7.120
NETCHANCVCirylltmt rnnlur
$44,24-00
94 067 70
me coo. 00
1�i oG 7.70
AMOUNT CERTIFIFII .......,,, S
Flin-10
(ANu^Arni(OrvHlrm rfrnnrunU,rrt((trddtrJrrsJmm (hewrtrgml nt9rUnl.Inirhrf nflQtpma un rble
APpgwllnn and nn Ilref?mrinmu(npShot 1hm nrr chnypv/nr mn(ann,vffh fMuunnn9l nHl/7nU
OF:
Tda CxH10dffiI k,unt m'gaOal,le, The AMOUNT CERTIFIED K pnyahie only iplhu
C•mf wur mlmrd Itereia ISAuanrr. payment And a, reptalpx of paymnni Are willmul
pminilki• to any rlghlsnflhe Owner ur Cnnirannr Omle! thhecAni na.
"'zj '4 L V..4C t'01F,
Dar: 1!i/110(16
Cnnfay Of, P,Jin Rm.l.
7 2. 6 6
Dane:
-/GO/- o/G�
G702 APPLICATION AND CERTIFICATION FOR PAYMENT
FACE t
TOCIWNERt Fisttfirvicc The Atrium l Condomin@m Asso.
APPLICATION NO: 2
Distribution to:
3055 Cardinal Dr. Ste 200 290ONoM,AIA
RECAINAGE
DOWNER
Veto Reach, FL 32963 North Hutchinson Island
Application Data: 04/D9(76
=ENCINEER
.PERIOD TO: 04/09/I6
CONTRACTOR
FROM CONTRACTOR: VW ENGINEER: MOVEnRinneringlnc
Daniello& Associates, Inc 183520th Ament
NOT A LAMP SUM RID: Tbm mlkannt is baxed
Q
27U0 N. Australian Ave., Ste 9 Vero Ueach,FL32960
spun estimated quantities listed In Rithlidt A Quantity Schedule. The amount paid
West Pnlm Death. H 33407
will be lwsdepon anted quanon.re/work perfnemal at rates in l?sid6ltA.
CONTRACT: Cuncretollestomtion Ropalrs
CRNTRACTDATE:
CONTRACTOR'S APPLICATION FOR PAYMENT
The underAgned Contractor(eMfieN Riot to the hestofthe Contractor's knowledge,
Appitrntlnn is made forpaymenl. as shown below, in connection with the Contract
Information and bellefthe Work covered by dills Application for Payment has been
Continuation SheeL Sheet G703, A attached.
completed In accordance with the Contract Documents, thatall amounts have been paid by
the Conireetnrfor Work for Whidr previous Certificates for Payment ware Wind and
payments received from the Owner, and That current payment shown heroin is now dui.
2. Net change by Change Orders
3. C()NTRAIT sum TO DATE (Line I 1 2)
4. TOTAL COMPLIETED & STORP.O TO
DATE (Column 12 on G703)
5. RETAINAGF_-
a. 10 %of Completed Wnrk
III _%al'Slared Material
71nn1 Retalnage (Lines So * Sh nr
Total in Column 15 of(703)
6. TIYTAl. EARNED LESS RETAINAC,F.
(Line 4 Less Line S Total)
7. LESSPREVIOUSCERTIFICATILS FOR
PAYMENT (Line 6 from prior Certificate)
0. CURRENTPAYMENTDUE
9. OALANGE TO PINISN, INCLI/DING RETAINAI
(Line 31ecs Line 6)
S 2,314.93
$.. _ 23S.0 CONTRACI'OIL
$ 2,550.56.
$ 2.550.56
Date: 04/09/16
State AT: Florida CauntyoL• PalmBeach
Subscriia:d and sworn to before me this
Notary Puhllr.
My Commission expires:
$ 0.00 ENGINEER'S CERTIFICATE FOR PAYMENT
S 2.55056 In acetrrda0en with the Contact Dammenla, bused on omsito observaUnns and the dam
comprising the application. the Engineer all Ines tothe Owner [bat it, the (pest of the
Engf mer's knowledge, information mid belief the Work has progrecswl us Rullented,
$ 2.319.07 the quality of the Work is In accordance Withhe Contract Documents; And the Contractor
$ 231A9 IscmIllml In payment of the AMOIINT CERTIEIRD.
f !�APIOUNT (:RItTIPI CD........... S
CIIANGEORDERSUMMARY
ADDITIONS
DEDUCTIONS
Total changes approved
In previturs months by Owner
S23S.63
Total approved this Month
TUTAU.S
$235,63
$0.00
NI, r CRANGIES by Change Order
$235.63
(Attach explanation if umount certiftEd differs fram the omuuat applied. Initial aR figureson this
AppflwNau and an the fomth uation Sheet that am changed in conform with the amount certified)
ENGINEER:
By:
ThLs[ertl0cale is not negotiable. The AMOUNTCERTIFIED is payable only to the
Contractor named herein. Issuance,, payment and acceptance of payment are without
prejudicti too myright%of the Owner or Contractor under this C rmrat L
CONTINUA "ON SNEFT 6703
PAGE I OF IPAGFS
DmOwOt G702 APPLICATION AND L'EIT IFICATEFOR PAYMENT, tilnmining
APPLICATION NO: 2
Cnntracmr5 dgned CertiOeiOon hi n.hed.
APPOCATION DATE: 4/0/2016
PERIODTO: 4/0/2016
DM Column 1 w COntradswhert Yart bb rrlainagc for HRO Hems ma7 Pply
PROIECTNO: TheAtdmn
3
4
5
6
7 0 9
to 11
I f2
-' 13
1 it
15
DFSCRm77ON OF WORK
1Y:UtDU1RD
YAMGt
MMPLetED
YaluPCnm
lFM4
lOWIemnpIdc4
%
RAMhM
RIRAINA6R
FROM vmvvv l9
TIrt PfiNRW
Thul
rWIal'UM0R1
TRAFtRmn
VALOR
And5lnrago
TU1Nb'll
IIPYAWAPLR
AYMJ wl
APIWATnN
mm
I•
Onl
lidre
3•5
Tva
7.5
a-5
lo+ III
t2
CO 2 HO51 spot Stack A
ROD
Ea
$28.00
$224.00
BAO
8.00
$224.00
SO.00
$224.00
100.000A
snob
$22.40
CO 2 Him spot Stack A (Small Ralrony)
0.00
Ea
$28.00
$224.00
0.00
&00
$224.DD
$0.00
$224.00
100.00%
$0.00
$22.40
CO 2 Rust Spot Stack B
20.G0
Ea
01.00
$560,00
20.00
20.00
$560.00
$0.00
$561100
100.00%
$0:00
$56.00
Pertulm fees
1,00
Is
$23S.63
$235.63
1.00
1.00
$235.63
$0.00
S275.63'
10D.00%
SO.GO
GO 2 Host Spot Stack A
LOG
EA
S28.00
$28.00
1.00
1.00
S2&6p
$0.00
$20.00
100.00%
$&nn
52.80
CO2 Edge 6'
&67
LL
$110.00
$953.33
0.67
8.67
$953,33
$0.00
$953.33
100.00%
$0,00
$95133
Overhead repair
OAR
$95.00
$45.60
0.48
GAB
S45.60
$0.00
$45.60
100.00%
$OAO
$4.56
CO Rost spot
10,00
ea
529.00
$280.00
10.00
10.00
$28&00
$0.00
$200.00
100.00%
$0.00
SUM
_ GRAND TOTAIS
$2.550.56
$2,5S0.5G I
S0.00
$2,55056
0.00%-
SOAO
S231.49