HomeMy WebLinkAboutAPPLICATION AND CERTIFICATION FOR PAYMENTG732 CMa (formerly G702 CMa) APPLICATIONandCERTIFICATE for PAYMENT
To: Oceana North IICondominium
Project: Oceana North If
Application No; 3
Distribution to:
9900 South Ocean Blvd.
App. Date: February 12, 2018
® OWNER
Jensen Beach, FL 31967
SCgNN
❑ CONSTRUCTION MGR.
E�
-Period to:
❑ ARCHITECT
From: Blue coast ConstructionBY
0 CONTRACTOR
2587 BE Monroe st
St
CUC.
Project NO:
❑ OTHER
Stuart, Florida 34597'
fe COUn.
Contract Date:
Contract For: Concrete Restoration
Construction Manager: SEP
Architect:
APPLICATION FOR PAYMENT
Application is made for payment, as shown;below, in connection with the Contract.
Continuation Sheet, G703, is attached.
1.. ORIGINAL CONTRACT SUM O:DD
2. Net Change By Change Orders 152,591:40
3. CONTRACT SUM TO DATE 152',591.40
4. TOTAL COMPLETED AND STORED TO DATE 1527591.40
5. RETAINAGE;
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 andpayments
receivedfrom the Owner, and that current payment show. herein is now due.
CONTRACTOR:.
State of:
Date:
County of:
a. of Completed Work
0;00
Subscribed and sworn before me this day of
b. of Stored Material
0.00
The above personally appeared before me, the undersigned notary public, and,provided
_
satisfactory evidence of identification to be the person who signed this document in my
TOTAL RETAINAGE
0:00
presence and swore or affirmed to me that the contents of this document are truthful and
accurate tothe. best of his/her knowledge and belief.
6. TOTAL EARNED LESS RETAINAGE
152,591.40
7. LESS PREVIOUS CERTIFICATES FOR
PAYMENT 137,903:83
Notary Public: My'Commissionezpires:
CERTIFICATE FOR PAYMENT
8. CURRENT PAYMENT DUE
_ _ 14,687:57
In accordance with the Contract Documents, based on on -site observations and the. data
9. BALANCE TO FINISH, INCLUDING RETAINAGE
0.00
comprising this application, the Construction Manager and Architect certify to the Omer that
_..
to the best of their knowledge,informationand'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.
CHANGE ORDER SUMMARY
ADDITIONS
DEDUCTIONS
Total changes approved in
previous months by Owner
152,591.40
0.00
Total approval this Month
0.00
0.00
TOTALS
162,591.40
0.00
NET CHANGES by Chan a Order
152,591.40
AMOUNT CERTIFIED
CONSTRUCTION' MANAGER:
By: Date:
ARCHITECT:
In
Date:
This Certificateisnot 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.
f
CAUTION: You should use an original document which has this cautionprinted in red. An original assures that changes will not be obscured as may occur when documents are reproduced.
TORGOSOFTWARE w .TorgoSoflwaremm ®1906-2013 ALL RIGHTS RESERVED ,:1x I" r I'.� ,%" ., J, ,:" , , . I I _ r . + _ , ,
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CONTINUATION SHEET G703 PROJECT: Oceana North 11
Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT,, containing
Contractor's signed Certification is attached.
Use Column I on Contracts where variable retainage for line items may apply.
Blue coast Construction
Page 1 of
Application No: 3
App. Date: February 12, 2018
Period to:
Project No:
A
-B.
C
D
I E
F
G
H
I
Item
#
Description of Work
Schedule
of
Values
Work
leted
Materials
Stored & Used
.Prior +Current
Total Completed
and Stored
To Date
0/U
Balance
to Finish
Retainage
From Previous
Application(s)
This
Period
1
Mobolization
0.00
:2,000.00
0.00
2,000.00
-2,000.00
0.00
2
Demobilization
0.00
0.00
0.00
0.00
0:00
0.00
3
Permit Fees.
._ - 0.00,
2,175.63
0.00
2,175.63
-2.175.63
0.00
4
Concrete Beam Repair
-0,00
... 0.00
0.00
0.00
?
0.00
0.00
5
Concrete. Column Repair
0.00
10,176.60
0.00
10,176.60
?
-10,176.60
0.00
6
Concrete Deck Slab Repair (Full Depth)
_ _ 0.00
22,150.40
0.00
22,150.40
-22,150.40
0.00
7
Concrete Deck Slab Repair (Overhead)
0.00
0.00
0.00
8
Concrete.Deek Slab Repair (Partial)
0.00
23,181.33
0.00
23,181.33
?
-23,181.33
0.00
9
Concrete Edge Repairs (9 Deep)
0:00
,56,595.00
0.00
56,595.00'
?
-56,595.00
0,00
13
Epoxy injection overhead (LF)
0.00
0.00
0.00
0.00
?
0.00
0.00
15
Horizontal cracks gravity feed (LF)
16
Zinc Anodes
17
Migration Corrosion Inhibitor.. Ferro ard)
_ 0.00
4,686.00
0.00
4,686.00
?
-4,686.00
0.00
21
Stucco Repair
0.00
1,855.44
0.00
-
1.855.44
?
-1.855.44
0.00
22
Helical. Piers W/ Footing
23
Plumbing Relocation
24
Sidewalk Reconstruction
25
Oversee Column Subcontractor
26
Preparation & testing of Cone. cylinders
0.00
0:00
0.00
0.00
?
0.00
0.00
27
Weather wall installation & Removal
0.00
_ 2,640.00
0.00
2,646.00
?
-2-,640.00
0.00
34 '
Remove, store, &reinstall Glass Doors
0.00
3,250.00
0.00
3.250.00
?
-3,250.00
0.00
PAGE 1 TOTAL: 1 0.001 128,710.401 0.001 1 128,710A0 ?-128,710.40 0.00
A=Line Item Number B=Brief Item Description C=Total Valueof Item D=Total of D and E From Previous Application(s) (if Any) E=Total Work Completed For This Application
F=Materials Purchased and Stored for Project G=Total of All Work Completed and Materials Stored for Project H=Remaining Balance of Amount to Finish 1=Amount Withheld from G
TORGO SOFTWARE ,TwWS*Iwame m 0199S2013 ALL RIGHTS RESERVED,;., ,-,,, ..-
-
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CONTINUATION SHEET G703PROJECT: Oceana North It Blue coast Construction Page 2 of 2
Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing Application No: 3
Contractor's signed Certification is attached. App. Date: February 12, 2018
Use Column I on Contracts where variable retainage for line items may apply.
Period to:
Project No:
A.
B
C,
D
'E
F
G
H
Item
#
Description of Work
Schedule
of
Values
WorkCofr
leted
Materials
Stored & Used
Prior + Current
Total Completed
and Stored
To Date
%
Balance
to Finish
Retainage
From Previous
Application(s)
This
,Period
36
Remove, store & reinstall • Railing...
0.00
-0.00
0:00
-0.00
?
0.00
0.00
37-
Remove, store & reinstall shutters
0.00
12,150.00
0.00
12,150.00
?
-12,150.00
0.00
38
Remove &.reinstall shutter guide rail
0.00
2,025,00
0.00
2,025.00
?
-2,025.00
0.00
41
Tile Removal
post
0.06
4,686:00
0.00
4,686,00
?
-4,686.00
0t00
42
Hook Bars for rail
0♦00
1,730.00
0.00
1,730.00
?
-1,730.00
0.00
44
Dowels for new bars
no
1;750.00
am
1,750.00'
?
-1,750,00
0,00
45
Rust Spots
1,540.00
0100'
1,540.00
-1,540.00
PAGE TOTAL:
GRAND TOTAL:
A --Line Item Number B=Brief Item Description C=Total Value of Item D=Total of 0 and E'From Previous Application(s) (if Any) E=Total Work Completed For This Application
F=Materials. Purchased, and Stored for Project G=Total of All Work Completed and Materials Stored for Project H=Remaining Balance of Amount to Finish 1=Amount Withheld from G
TORGOSOFTWARE vrow.Tor9030f"ro-01996-2013 ALL RIGHTS RESERVEOn ,;. T. al , e 1 " 1 " 2-! .. • v.
G732'CMa (formerlyG702 C.Ma) APPLICATION and CERTIFICATE for PAYMENT
To: Oceanallorth II'Condominium
9900.South Ocean Blvd.
Jensen Beach, FL 31957
From: Blueaoast Construction
2587 SE Monroe at
Stuart, Florida 34997
Project: Oceana.North II,
SCANNED
BY
St. Lucie County
Application No: 3
App. Date: February, 12, 2018
Period to:
Project No:
Contract Date:
Distribution to:
®.OWNER
O CONSTRUCTION MGR.
❑ ARCHITECT
IN CONTRACTOR
❑ OTHER
Contract For. Concrete Restoration
Construction Manager: SEP
Architect:
APPLICATION FOR PAYMENT
The undersigned Contractor certifies that to the best of the Contractors knowledge,
Application is made for'payment, as shown below, in connectionwith the Contract.
information and belief the Work covered by this Application for Payment has been completed
inaccordance,with the Contract Documents,that all amounts'have been paidby the
Continuation Sheet, G703; is attached.
Contractor for Work for which previous'Certificates for Payment were issued and payments
1. ORIGINAL CONTRACT SUM
0.00
received,from the Owner, and that current payment shown bemin is now due.
2. Net Change'By Change Orders
t52,591.40
CONTRACTOR:
3. CONTRACT SUM TO DATE
152,691.40
By. Date:
4. TOTAL COMPLETED AND STORED TO DATE 152,591,40
5. RETAINAGE:
State of: County of.
a. of Completed Work
0:.00
Subscribed,and sworn before me this -day of
b. Of Stored Material
0.00
The above personally appeared before me, the undersigned notary public, andprovided
satisfactory evidence of identification tote the person who signed this document in my
TOTAL RETAINAGE
0.00
presence and swore or affirmed to me that the contents of this document are truthful and
6. TOTAL EARNED LESS RETAINAGE
752,591.40
accurate tothe besi of his/her knowledge and belief,
Nofary Public :My Commission expires:
7. LESS PREVIOUS CERTIFICATES FOR
PAYMENT 137,903.83
CERTIFICATE FOR PAYMENT
8. 'CURRENT PAYMENT DUE
14,687I57
In. accordance with the Contract Documents,.based on on -site observations and the data
. 9. BALANCE TO FINISH, INCLUDING RETAINAGE 0:00
comprising this application,. the Construction Manager and Architect certify to the Omer that
to the best of their knowledge, informationand belief the Work has progressed as indicated,
the quality of the Work is in accordance with the Contract Documents, and the Contractoris
entitled to payment of the AMOUNT CERTIFIED.
CHANGE ORDER SUMMARY
ADDITIONS
DEDUCTIONS
Total changes approved in
previous months by Owner
152,591.40
0.00
Total approval this Month
- 0.00
0.00
TOTALS
152,591.40
- 0.00
NET CHANGES by Change Order
152,591.40
AMOUNT CERTIFIED
CONSTRUCTION MANAGER:
ARCHITECT:
Date:
Date:
'This Certificate 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.
CAUTION: You should use an original document which has this caution printed in red. An original assures lhat.changes willnotbe obscured as may occurwhen documents are reproduced. �.
TORGO SOFTWARE waw.TorgoSoftm.=IC19W2013 ALL RIGHTS RESERVED ...,FI:rh,j ,,,,,,: e,: --, '.. ._,J -,.,• --� 111.w. 11 ..�,�;,.�. ,
•
CONTINUATION SHEET G703 PROJECT: Oceana North II
Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing
Contractor's signed Certification is attached.
Use Column I on Contracts where variable retainage for line itemsmay apply.,
Blue coast Construction;
Paged of 2
Application No: 3
App. Date: February 12, 2018
Period to:
Project No:
A
B.
C
D
I E
FG
H
1
Item
#
Description of Work
Schedule
of
Values
Work C
m feted
Materials
Stored & Used
Prior+ Current
Total Completed
and Stored
To Date
%
Balance
to Finish
Retainage
From Previous
Application(s)
This
Period
1
Mobolizalion
0.00
2,000.00
0.00
2,000.00
-2.000.00
_ 0.00
2
Demobilization
'0.00
0.00
0.00
0.00
0.00
3
Permit Fees
0.00
2,175.63
0.00
•
2,175.63
-2,175.63
4
Concrete Beam Repair
0.00
0.00
0.00
0.00
?
0.00
5
Concrete Column Repair
0:00
10,176.60
0.00
10,176.60
?
-10,176.60
1000
6
Concrete.DeckSlab Repair (Full Depth)
0.00
22,150.40
0.00.
'22;150.40
-22.150.40
7
Concrete Deck Slab Repair (Overhead)
0.00
O.OD
0:00
8
Concrete Deck Slab Repair (Partiao
0.00
23,181.33
0.00
23,181.33
- ?
-23,181.33
9
Concrete Edge Repairs 6"Deep)
0.00
56,595.00
0.00
56,595.00
?
-56,595.00
0.00
13
Epoxy injection overhead (LF)
0.00
0.00
0.00
0.00
?
0.00
0.00
15
Horizontal cracks gravity feed (LF) _
16
Zinc Anodes
17
Migration Corrosion Inhibitor .(Ferrog ard)
0.00
4,686.00
0.00
4,686.00
?
-4,686.00
0.00
21
Stucco: Repair
0.00
1,855A4
0.00
1.855.44
?
-1.855.44
0.00
22
Helical Piers W/ Footing'
23
Plumbing Relocation
24
Sidewalk Reconstruction
25
Oversee Column Subcontractor
26
Preparation & testing of Cone. cylinders
0:00
_ _ 0.00
0.00
0.00
?
0.00
0.00
27
Weather wall installation & Removal
0.00
2,640.00
0.00
2,640.00
1
-2.6Z 001
0.00
34
Remove, store, & reinstall Glass Doors
0.00
3,250.00
0.00
3,250.00
?
-3,250.00
D,OD
PAGE 1 TOTAL: 0.001 128,710.401 0.001 1 128,710.40 ?-128,710.40 0.00
A=Line Item Number 'B=Brief Item. Description C=Total Value of Item D=Total of D and From Previous Application(s) (If Any) E=Total Work Completed For This Application
F=Matedals Purchased and Stared for Project G=Total of All Work Completed and Materials Stored for Project H=Remaining Balance of Amount to Finish 1=Amount Withheld from G
TORGO SOFTWARE, w.yw.TorgoSoflwar ..m ®199S2gi3 ALL RIGMS RESERVED•
•
CONTINUATION SHEET G703PROJECT: Oceana North 11 Blue coast Construction Page 2 of 2
Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing Application No: 3
Contractor's signed Certification is attached. App. Date: February 12, 2018
Use Column I on Contracts where variable retainage for line items may apply.
Period to:
Project No:
A
B
C
D
E
F
G
H
I
Item
#
Description of Work
Schedule
of
Values
WorkComplated
Materials
Stored & Used
Prior + Current
Total Completed
and Stored
To Date
%
Balance
to Finish
Retainage
From Previous
Applicalion(s)
This
Period'
36
Remove, store & reinstall Railing
0.00
0.00
0.00
0.00
?
0.00
0.00
37
Remove, store & reinstall shutters
0.00
_ 12,150.00
0.00
12,150.00
-?
-12,160.00
0.00
38
Remove &:reinstall shutter guide rail _
0.00
2,025.00
0.00
.2,025.00
?
-2,025.00
0.00
41
Tile.Removal
0.00
4,686.00
0.00
4,686.00
?
-4,686.00
0.00
42
Hook Bars for rail post
0.00
1,730:00
0.00
1,730.0
?
-1.730.00
0.00
44
Dowels: for new bars
0.00
1,750.001
0.00
1,750.00
?
-1,750:00
0.00
45
Rust Spots.
1,540.001
0,00
1,540.00
-1,540.00
PAGE 2 TOTAL:
0.001
23,881.001
0.001
1 23,881.00
?
-23,881.001
0.00
GRAND TOTAL: 1
0.001
152,591 A01
0.001
1 152.591.40
?
-152.591.40
0,00
A=Line Item Number B=Brief Item Description- C=Total Value of Item D=Total of D and E•From Previous Application(s) (if Any) E=Total Work Completed For This Application
F=Materials Purchased and Stored for Project G=Total of All Work Completed and Materials Stored for Project H=Remaining Balance of Amount to Finish 1=Amount Withheld from G
TORGOSOFTWARE, w .ToNoSoRaaro.00rn 01996-2013ALL RIGHTS RESERVEUG.-, Y*r..,.,r ,cu, t ,na:t ..r..n-..nr>. 2- : ^ r. _ �.✓+d,e3 . - t' .. .. .:, - .. ..