Pay Voucher No. 1Pay Voucher
Owner: City of Shorewood
5755 Country Club Road
Shorewood, MN 55331 -8926
For Period: 5/9/2016 to 10/5/2016
Contractor: Pearson Bros., Inc.
11079 Lamont Avenue NE
Hanover, MN 55341 -4063
Pay Voucher
SHOR - 2016 Crack Fill & Seal Coat Project
Client Contract No.:
Project No.: 02925 -08
Client Project No.:
Page 1 of 3
Date: 10/5/2016
Request No.
Proiect Summary
1
Original Contract Amount
$182,020.00
2
Contract Changes - Addition
$13,860.00
3
Contract Changes - Deduction
$0.00
4
Revised Contract Amount
$195,880.00
5
Value Completed to Date
$136,515.00
6
Material on Hand
$0.00
7
Amount Earned
$136,515.00
8
Less Retainage 5%
$6,825.75
9
Subtotal
$129,689.25
10
Less Amount Paid Previously
$0.00
11
Liquidated Damages
$0.00
12
AMOUNT DUE THIS PAY VOUCHER NO. 1
$129,689.25
THIS IS TO CERTIFY THAT THE ITEMS OF WORK SHOWN IN THIS CERTIFICATE OF PARTIAL PAYMENT HAVE BEEN
ACTUALLY FINISHED FOR THE WORK COMPRISING THE ABOVE MENTIONED PROJECTS IN ACCORDANCE WITH THE PLANS
AND SPECIFICATIONS HERETOFORE APPROVED.
Recommended for Approval by
WSB & Associates, Inc.
Approved by Contractor:
Pearson Bros yInc.
Specified Contract Completion Date:
Comment:
Construction Observer:
Approved by Owner:
City of Shorewood
Date:
Pay Voucher
Project Material Status
Page 2 of 3
Item
No.
Item
Description
Units
Unit Price
Contract
Q
Quantity
Date
lCurrent
JQuantitylDate
JAmountto
SCHEDULE A - CITY OF SHOREWOOD
1
2021.501
MOBILIZATION
LS
$5,000.00
1
0.75
0.75
$3,750.00
2
2356.505
BITUMINOUS MATERIAL FOR SEAL COAT (CRS -2P)
GAL
$2.60
36100
27075
27075
$70,395.00
3
2356.604
SEAL COAT AGGREGATE FA -2 CLASS A (GRANITE)
S Y
$0.60
138600
103950
103950
$62,370.00
Totals For Section SCHEDULE A - CITY OF SHOREWOOD:
$136,515.00
SCHEDULE B - CITY OF VICTORIA
4
2021.501
MOBILIZATION
LS
$0.00
1
0
0
$0.00
5
2355.502
BITUMINOUS MATERIAL FOR FOG SEAL
GAL
$0.00
50
0
0
$0.00
6
2356.505
BITUMINOUS MATERIAL FOR SEAL COAT (CRS -2P)
GAL
$0.00
13800
0
0
$0.00
7
2356.604
SEAL COAT AGGREGATE CLASS A (TRAP ROCK)
S Y
$0.00
53100
0
0
$0.00
Totals For Section SCHEDULE B - CITY OF VICTORIA:
$0.00
SCHEDULE C - CITY OF MINNETRISTA ROADWAYS
8
2021.501
MOBILIZATION
LS
$0.00
1
0
0
$0.00
9
2356.505
BITUMINOUS MATERIAL FOR SEAL COAT (CRS -2P)
GAL
$0.00
6700
0
0
$0.00
10
2356.604
SEAL COAT AGGREGATE FA -2 CLASS A (GRANITE)
S Y
$0.00
25700
0
_ 0
$0.00
11
2331.619
ROUT AND SEAL BITUMINOUS PAVEMENT CRACKS
RD STA
$0.00
86
0
0
$0.00
Totals For Section SCHEDULE C - CITY OF MINNETRISTA ROADWAYS:
$0.00
SCHEDULE D - CITY OF MINNETRISTA TRAILS
12
1.501
MOBILIZATION
LS
$0.00
1
0
0
$0.00
13
5.502
K2331.619
BITUMINOUS MATERIAL FOR FOG SEAL
GAL
$0.00
2100
0
0
$0.00
14
ROUT AND SEAL BITUMINOUS PAVEMENT CRACKS
LF
$0.00
2500
0
0
$0.00
Totals For Section SCHEDULE D - CITY OF MINNETRISTA TRAILS:
$0.00
Change Order 1
15
2356.604
SEAL COAT AGGREGATE FA -2 CLASS A (TRAP ROCK)
I SQ YD
$0.70
138600
0
0
$0.00
16
2356.604
SEAL COAT AGGREGATE FA -2 CLASS A (GRANITE)
SQ YD
($0.60)
138600
0
0
$0.00
Totals For Change Order 1:
$0.00
Project Totals:
$136,515.00
Pay Voucher
Project Payment Status
Owner: City of Shorewood
Client Project No.:
Client Contract No.:
Project No.: 02925 -08
Contractor: Pearson Bros., Inc.
Contract Changes
Page 3 of 3
No.
(Type
Date
Description
Amount
C01
Change Order
7/14/2016
ISEAL COAT AGGREGATE REVISED
$13,860.00
Change Order Totals:
$13,860.00
Payment Summary
No.
From
Date 1
To Date
Payment
Total
Payment
Retainage Per
Payment
Total
Retainage
Total Payment +
Retainage
Work Certified
Per Payment
Total Work
Certified
1
5/9/2016
10/5/2C)161$129,689.25
$129,689.25
$6,825.75
$6,825.75
$136,515.00
$136,515.00
$136,515.00
Payment Totals:
$129,689.25
$6,825.75
$136,515.00
$136,515.00
Proiect Summary
Material On Hand:
Total Payment to Date:
Total Retainage:
Total Amount Earned:
$0.00
$129,689.25 Original Contract:
$6,825.75 Contract Changes:
$136,515.00 Revised Contract:
$182,020.00
$13,860.00
$195,880.00