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Imp. Proj. #495COUNCIL Originating Department Approved for Agenda Agenda Section Planning & Development Parks and Recreation / Item No. By: Shari French I By: 1 8.7 RESOLUTION AWARDING CONTRACT FOR FRED SIMS/MEADOW LAKE PLAYGROUND EQUIPMENT IMPROVEMENTS (IMPROVEMENT PROJECT 495) At the May 26 Council meeting the City Council approved plans and specifications for playground equipment improvements for Fred Sims and Meadow Lake parks (Improvement Project 495). There is $80,000 in CIP for this project. Total bids were received on June 8, 1992 and will be available at the June 8th Council meeting. MOTTONBY SECOND BY Im Review: Administration: Finance: CITY OF NEW HOPE RESOLUTION NO. 92- 111 RESOLUTION AWARDING CONTRACT FOR FRED SIMS /MEADOW LAKE PLAYGROUND EQUIPMENT IMPROVEMENTS (IMPROVEMENT PROJECT 495) TO ARRIGONI BROTHERS AND CO. - $56,450 WHEREAS, pursuant to advertisement for bids for playground equipment for Fred Sims /Meadow Lake parks, bids were received, opened and tabulated according to law, and the following bids were received complying with the advertisement: Contractors Total Bid Alltech Engineering $70,468.00 Sunram Landscaping 58,055.00 Perkins Landscape 59,644.00 Shingobee Builders 77,689.00 Talberg Lawn & Landscape 61,116.53 Arrigoni Brothers Co. 56,450.00 WHEREAS, budgeted allocation allows total dispersion of $80,000 and WHEREAS, it appears that Arrigoni Bros. Co. is the lowest responsible bidder. NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of New Hope, Minnesota: 1. the Mayor and City Manager are hereby authorized and directed to enter into the attached contract with Arrigoni Brothers Company in the name of the City of New Hope for Fred Sims /Meadow Lake Playground Equipment Improvements according to the plans and specifications (for a total bid cost of $56,450.00) therefore approved by the City Council and on file in the office of the City Clerk. 2. The City Clerk is hereby authorized and directed to return forthwith to all bidders the deposits made with their bids, except that the deposits of the successful bidder and the next lowest bidder shall be retained until a contract has been signed. Adopted by the City Council of the City of New Hope, Hennepin County, Minnesota, this 8th day June, 19 2. r S� Mayor Attest• Ze • City Clerk r Bonestroo Rosene Uf s Anderlik & Associates Engineers & Architects Otto G. 8onestroo, PE. Robert W. Rosen, PE Joseph C. Anderlik, PE. Marvin L. Sorvala, P.E. Richard E. Turner. PE, Glenn R. Cook, PE. Thomas E. Noyes, PE. Robert G. SWunlcht. P.E. Susan M. Eberlin. C.P.A. 'Senior Consultant Howard A. Sanford, P.E. Keith A. Gordon, PE. Robert R. Pfefferle. PE Richard W. Foster P.E. David O. Loskota. P.E. Robert C. Russek. A.I.A. Jerry A. Bourdon. PE. Mark A. Hanson, P.E. Michael T. Rauimann. P.E. Ted K. Field, P.E. Thomas R. Anderson, A.I.A. Donald C. Burgardt. PE. Thomas E. Angus. P.E. Gary F Rylandec PE. Ismael Martinez. PE. Michael P Rau, PE. Agnes M. Ring, A.LC.P. Thomas W Peterson. PE. Michael C. Lynch, PE. James R. Maland, PE. Jerry D. PetUSCh, PE. Kenneth P Anderson. PE. Mark R. Rolfs, PE. Mark A. Seip. P.E. Gary W, Monen, PE. Daniel J. Edgerton. PE. Philip J. Caswell. PE Mark D. Wall.s, P.E. Miles 8, Jensen, PE. L. Phillip Gravel ill, P.E. Karen L. Wiemerl, PE. E Todd Foster. PE, Kenn R. Yapp. PE. Shawn D. Gustafson, P.E. Cecilia Olivier. PE. Charles A, Enckson Leo M Pawwelsky Harlan M. Olson James F. Engelhardt June 8, 1992 City of New Hope 4401 Xylon Ave. N. New Hope, MN 55428 Attn: Mr. Daniel Donahue Re: Fred Sims & Meadow Lake Park Playground Equipment and Site Improvements City Project No. 495 - Our File No. 34142 Dear Dan, Bids were received June 8, 1992 for the above project. The low bid of the six bids received is from Arrigoni Brothers and Co. with a total base bid of $56,450. The engineer's estimate and budget amount for the work is $75,000. Arrigoni Brothers and Co. are a responsible contractor and have done similar work in St. Paul. It's recommended the contract be awarded to Arrigoni Brothers and Co. for $56,450.00. If you have any questions, please feel free to contact me at this office. Yours very truly, BON STROO, R ENE, ANDERLIK & ASSOCIATES, INC. Ma . Hanson MAH:li 34142.cor 2335 West Highway 36 • St. Paul, Minnesota 55113 • 612- 636 -4600 8onestroo Project Name Fred Sims & Meadow Lake Park Playground Equipment & Site Improvements Rosen Pro ect No. 495 , File No. 34142 Anderitk & Associates P J Mmnecu ST. & Ard St. Paul, , M Bid Opening 11:30 a.m., C.D.S.T., Monday, June 8, 1992 Owner New Hope, MN No. Item Part 1 - Fred Sims BID TABULATION Tabulation 1 1 w Bids of d Bid No. 1 Arrigoni Brothers Company Bid No. 2 Bid No. 3 Bid No. 4 Bid No. 5 Sunram Landscaping Perkins Landscape Talberg Lawn & Alltech Engineering 15,664.00 Contractor Landscape Corp. 1,230.00 1,230.00 1,175.00 1,175.00 Unit Unit Unit Unit Price Total Price Total Price Total Price Total Unit Unit Q - ty Price Total 1 Furnish & install playground structure with handicap access ramp EA 2 Furnish and install tire swing EA 3 Furnish and install space arch climber EA 4 Furnish and install leg swing - 2 sections w/2 seats /section (1 enclosed tot seat) 8' high EA 1 13,000.00 13,000.00 12,900.00 12,900.00 13,862.00 13,862.00 12,752.00 12,752.00 15,664.00 15,664.00 1 1,150.00 1,150.00 1,230.00 1,230.00 1,175.00 1,175.00 1,257.66 1,257.66 1,260.00 1,260.00 1 620.00 620.00 750.00 750.00 750.00 750.00 736.31 736.31 715.00 715.00 1 1,450.00 1,450.00 1,650.00 1,650.00 1,575.00 1,575.00 1,684.00 1,684.00 1,625.00 1,625.00 34142.TAB BT -1 Bid No. 1 Arrigoni Brothers Company No. Item Unit Unit Qty Price Total 5 Furnish and install police car EA 6 Furnish and install backhoe digger EA 7 Sand cover & spread existing sand CY 8 Class 5 100% crushed aggregate base TN 9 Type 41 bit. wear course (2" thick) TN 10 Bituminous material for mixture TN 11 Topsoil borrow CY 12 Sod SY Bid No. 2 Bid No. 3 Bid No. 4 Sunram Landscaping Perkins Landscape Talberg Lawn & Contractors Landscape Unit Unit Unit Price Total Price Total Price Total Bid No. 5 Alltech Engineering Corp. Unit Price Total 1 820.00 820.00 900.00 900.00 940.00 940.00 954.00 954.00 933.00 933.00 1 400.00 400.00 400.00 400.00 350.00 350.00 431.00 431.00 418.00 418.00 60 5.00 300.00 14.00 840.00 25.00 1,500.00 20.70 1,242.00 7.50 450.00 30 25.00 750.00 12.00 360.00 12.00 360.00 17.00 510.00 20.00 600.00 20 70.00 1,400.00 100.00 2,000.00 55.00 1,100.00 90.00 1,800.00 70.00 1,400.00 2 150.00 300.00 175.00 350.00 150.00 300.00 137.50 275.00 120.00 240.00 15 10.00 150.00 7.00 105.00 7.00 105.00 15.00 225.00 25.00 375.00 200 4.00 800.00 1.50 300.00 1.65 330.00 2.75 550.00 2.25 450.00 Total Part I - Fred Sims $21,140.00 $21,785.00 $22,347.00 $22,416.97 $24,130.00 Part 2 - Meadow Lake 13 Remove existing bituminous surface SY 10 10.00 100.00 10.00 100.00 10.00 100.00 5.00 50.00 25.00 250.00 14 Remove existing playground equipment LS 1 200.00 200.00 400.00 400.00 300.00 300.00 350.00 350.00 500.00 500.00 34142.TAB B.I. -2 Bid No. 1 Bid No. 2 Bid No. 3 Arrigoni Brothers Sunram Landscaping Perkins Landscape Company Contractors No. Item Unit Unit Qty Price Total 15 b° PVC perforated drain pipe w /geotextile 500.00 28.00 fabric Type I & coarse filter aggregate LF 16 Geotextile fabric, Type V SY 17 Common excavation LS 18 Modular block retaining wall (beige) SF 19 Class 5 100% crushed aggregate base TN 20 Type 41 bit. wear course (2" thick) TN 21 Furnish and install 6' bench w/back EA 22 Furnish & install playground structure 2,300.00 2,500.00 w/handicap access ramp EA 23 Furnish and install tire swing EA 24 Furnish and install space arch climber EA Unit Unit Price Total Price Total Bid No. 4 Bid No. 5 Talberg Lawn & Alltech Engineering Landscape Corp. Unit Unit Price Total Price Total 100 5.00 500.00 28.00 2,800.00 15.00 1,500.00 11.75 1,175.00 12.00 1,200.00 580 1.00 580.00 1.50 870.00 1.25 725.00 1.10 638.0 1.85 1,073.00 1 2,000.00 2,000.00 2,300.00 2,300.00 2,500.00 2,500.00 2,500.00 2,500.00 6,500.00 6,500.00 500 13.00 6,500.00 12.00 6,000.00 14.50 7,250.00 14.00 7,000.00 16.90 8,450.00 45 22.00 990.00 12.00 540.00 12.00 540.00 15.00 675.00 20.00 900.00 20 70.00 1,400.00 100.00 2,000.00 55.00 1,100.00 71.50 1,430.00 70.00 1,400.00 2 350.00 700.00 300.00 600.00 285.00 570.00 370.00 740.00 350.00 700.00 1 13,000.00 13,000.00 12,900.00 12,900.00 13,862.00 13,862.00 12,752.00 12,752.00 15,664.00 15,664.00 1 1,150.00 1,150.00 1,230.00 1,230.00 1,175.00 1,175.00 1,257.66 1,257.66 1,260.00 1,260.00 1 620.00 620.00 750.00 750.00 750.00 750.00 736.31 736.31 715.00 715.00 34142.TAB BT-3 Bid No. 1 Bid No. 2 Bid No. 3 Arrigoni Brothers Sunram Landscaping Perkins Landscape Company Contractors No. Item 25 Furnish and install 3 leg swing - Unit Unit Unit Unit Qty Price Total Price Total Price Total Bid No. 4 Bid No. 5 Talberg Lawn & Alltech Engineering Landscape Corp. Unit Unit Price Total Price Total Total Part i - Fred Sims 21,140.00 21,785.00 22,347.00 22,416.97 24,130.00 Total Part 2 - Meadow Lake 35,310.00 36,270.00 37,297.00 38,699.56 46,338.00 Total Base Bid $56,450.00 $58,055.00 $59,644.00 $61,116.53 $70,468.00 34142.TAB BT4 2 sections w/2 seats /section (1 enclosed tot seat) 8' high EA 1 1,450.00 1,450.00 1,650.00 1,650.00 1,575.00 1,575.00 1,684.00 1,684.00 1,625.00 1,625.00 26 Furnish and install police car EA 1 820.00 820.00 900.00 900.00 940.00 940.00 954.00 954.00 933.00 933.00 27 Furnish and install backhoe digger EA 1 400.00 400.00 400.00 400.00 350.00 350.00 431.59 431.59 418.00 418.00 28 Sand cover CY 180 15.00 2,700.00 8.50 1,530.00 15.00 2,700.00 20.70 3,726.00 7.50 1,350.00 29 Topsoil borrow CY 100 10.00 1,000.00 7.00 700.00 7.00 700.00 15.00 1,500.00 25.00 2,500.00 30 Sod SY 400 3.00 1,200.00 1.50 600.00 1.65 660.00 2.75 1,100.00 2.25 900.00 Total Part 2 - Meadow Lake $35,310.00 $36,270.00 $37,297.00 $38,699.56 $46,338.00 Total Part i - Fred Sims 21,140.00 21,785.00 22,347.00 22,416.97 24,130.00 Total Part 2 - Meadow Lake 35,310.00 36,270.00 37,297.00 38,699.56 46,338.00 Total Base Bid $56,450.00 $58,055.00 $59,644.00 $61,116.53 $70,468.00 34142.TAB BT4 Bid No. l Bid No. 2 Bid No. 3 Bid No. 4 Bid No. 5 Bid Bond, Five Percent Five Percent Five Percent Five Percent Cert. check, Five Percent Cash deposit Firm Arrigoni Brothers Sunram Landscaping Perkins Landscape Talberg Lawn & Landscape Alltech Engineering Company Contractors Inc. Corp. By Dennis J. Arrigoni Lee W. Sunram John Perkins Jr. Mark Talberg Steven Peterson Title President Owner Owner President Vice President Address 817 Vandalia Street 7675 Troy Lane 5531 Eden Prairie Road 100 Wilshire Drived 815 East 79th Street City, state, St. Paul, MN Maple Grove, MN Minnetonka, MN Minnetonka, MN Bloomington, MN Zip Code 55114 55369 55343 55343 55420 Telephone 645 -9321 420 -2140 612- 851 -9330 Fax No. 645 -9323 494 -3951 612- 851 -9519 34142.TAB BT -5 r Bonestroo Bidder ARRIGONI BROTHERS COMPANY Total B Bd Address Telephone No. 645 -9321 917 Vnndn1Jn Street AnderM a Assodates City, Fax. No. 645 -9323 12 u. ,n. `"""m`" PROPOSAL FRED SIMS AND MEADOW LAKE PARK PILAYGROUND EQUIPMENT AND SffE IMPROVEMENTS Honorable City Council City of New Hope 4401 Xylon Avenue North Minneapolis, Minnesota 55428 Dear Council Members: D , Monday, June 8, 1992 The undersigned, being familiar with your local conditions, having made the field inspections and investigations deemed necessary, having studied the plans and specifications for the work including Addenda Nos. — and being familiar with all factors and other conditions affecting the work and cost thereof, hereby proposes to furnish all labor, tools, materials, skills, equipment and all else necessary to completely construct the project in accordance with the plans and specifications on file with your Clerk and Bonestroo, Rosene, Anderlik & Associates, Inc., 2335 W.Trunk highway 36, St. Paul, Minnesota 55113, as follows: • . 16: 1 Furnish and install playground structure with handicap access ramp 2 Furnish and install tire swing 3 Furnish and install space arch climber 4 Furnish and install 3 leg swing - 2 sections w /2seats /section (1 enclosed tot seat) 8' high 5 Furnish and install police car EA 1 $ 13,000.00 $ 13,000.00 EA 1 $ 1,150.00 $ 1,150.00 EA 1 $ 620.00 $ 620.00 EA 1 $ 1,450.00 $ __L,450.00 EA 1 $ 820.00 $ 820.00 34142TRO P_1 34142.PRO P_2 NO. itcIn Unit Otp unit Price Total 25 Furnish and install 3 leg swing - 2 sections w /2seats /section (1 enclosed tot seat) 8` high EA 1 1,450.00 1,450.00 26 Furnish and install police car EA 1 $ __820 - 00 $ 820.00 27 Furnish and install backhoe digger EA 1 $ ___400.00 $ 400.00 28 Sand cover CY 180 $ 15,00 $ 2,700.00 29 Topsoil borrow CY 100 $ 10.00 $ 1,000.00 30 Sod SY 400 $ 3.00 $ 1,200.00 Total Part 2 - Meadow Lake . ao $ 35.510.00 34142TRO P -3 The final amount of the contract shall be determined by multiplying the final measured quantities of the various items actually constructed and installed by the unit prices therefor, in the manner prescribed in the specifications. However, the low bidder shall be determined by adding the sums resulting from multiplying the quantities stated by the unit prices bid therefor. Accompanying this bid is a bidder's bond, certified check or cash deposit in the amount of $ , which is at least five percent (5 %) of the amount of my /our bid made payable to the Owner, and the same is subject to forfeiture in the event of default on the part of the undersigned or failure on the part of the undersigned to execute the prescribed contract and bond within fifteen (15) days after its submittal to me /us. In submitting this bid it is understood that the Owner retains the right to reject any and all bids and to waive irregularities and informalities therein and to award the contract to the best interests of the Owner. In submitting this bid, it is understood that payment will be by cash or check. It is understood that bids may not be withdrawn for a period of 45 days after the date and time set for the opening of bids. It is understood that the Owner reserves the right to retain the certified check or bond of the three lowest bidders as determined by the Owner for a period not to exceed 45 days after the date set for the opening of bids. Respectfully submitted, (A Corporation) President Tide Dennis J. Arrigoni Printed Name of Signer 34142.PRO P_4 Arrigoni Brothers Company 817 Vandalia Street St. Paul, MN 55114 Re: Fred Sims and Meadow Lake Park Playground Equipment and Site Improvements Project No. 445 Gentlemen: Enclosed are five (5) copies of the contract documents between you and the City of New Hope covering the above referenced project. Please have your bonding company complete pages 51 through 61 of the Conditions of the Contract. The insurance and indemnity requirements of pages 13, 14, 15, & 16 shall be provided. After the bonding company has completed the documents, forward them to Mr. Steve Sondrall, Attorney -at -law, Edinburgh Executive Office Plaza, 8525 Edinbrook Crossing, Brooklyn Park, MN 55443 who will review them for the City of New Hope. After the necessary City officials have copies, one for your file and one for retained by the City for their file, one us for our file. signed the contracts you will be sent two your bonding company. One copy will be by the attorney, and one will be sent to Upon receipt of a signed contract and a filed Certificate of Insurance, approved by the City Attorney, a pre - construction conference will be scheduled with you and the City to review the project. After the pre- construction conference, you will be issued a notice to proceed with the work as outlined in the plans and specifications. Yours very truly, Enclosures: 5 Steve Sondrall, Attorney CORRIOK LAW OFFICES, PA. WILLIAM J. CORRICK STEVEN A. SONDRALL, PA. STEVEN A.SONDRALL MICHAEL R, LAFLEUR MARTIN P. MALECHA WILLIAM C. STRAIT July 20, 1992 CORMCK & SONDRALL A PARTNERSHIP OF PROFESSIONAL CORPORATIONS LAWYERS Edinburgh Executive Office Plaza 8525 Edinbrook Crossing Suite #203 Brooklyn Park, Minnesota 55443 TELEPHONE (612) 425-5671 FAX (612) 425-5867 Ms. Valerie Leone City Clerk City of New Hope 4401 Xylon Avenue North New Hope, MN 55428 RE: City Project No. 495 Playground Equipment and Site Improvements Dear Val: LEGAL ASSISTANTS LAVONNE E. KESKE SHARON D. DERBY Enclosed are the Contracts for the above-captioned improvement, all of which have been reviewed and are in order from a legal standpoint. I have also reviewed the Certificates of Insurance, which are also in order from a legal standpoint. Very truly yours, N "'I 3 Martin P. Mal echa s3m Enclosures 4401 Xylon Avenue North New Hope, Minnesota 55428 Phone: 531 -5100 FAX (612) 531 - 5171 July 28, 1992 Arrigoni Brothers Co. 817 Vandalia Street St. Paul, MN 55114 SUBJECT: PROJECT 495 (FRED SIMS /MEADOW LAKE PLAYGROUND EQUIPMENT AND SITE IMPROVEMENTS) Enclosed are two fully executed copies of the contract documents for New Hope Project No. 495. One copy is for your records and the second copy should be transmitted to your bonding company. Also enclosed is return of your bid bond. A copy of the contract documents is on file with our City Engineer and City Attorney. Also enclosed is a "Withholding Affidavit for Contractors" (IC -134 form). We cannot make final payment to contractors until this is approved by the Minnesota Department of Revenue and submitted to our office (Minnesota Statute 290.97). The form contains instructions for completion. Sincerely, Valerie Leone City Clerk enc. cc: City Engineer City Attorney Family Styled City For Family Living Originating Department City Manager Kirk McDonald By: Management Assistant Agenda Section Consent Item No. 6.7 MOTION APPROVING FINAL PA REQUEST TO RICHARD KNUTSON, INC. FOR 1992 LOCAL STREET RESURFACING AND UTILITY PROJECT (IMPROVEMENT PROJECT NO. 485) IN THE AMOUNT OF $38,127.83 This is the final pay request for Richard Knutson, Inc. for the 1992 Local Street Resurfacing and Utility Project (Improvement Project No. 485) in the amount of $38,127.83. The City Engineer has indicated that the work on this project has been satisfactorily completed and recommends approval of the pay request. The final amount is approximately 1. 49 % over the revised contract amount due to minor differences between estimated quantities bid and actual quantities used. Staff recommends approval of a motion approving the final pay request to Richard Knutson, Inc. for the 1992 Local Street Resurfacing and Utility Project (Improvement Project No. 485) in the amount of $38,127.83. MOTION BY TO: Review: Administration: Approved for Agenda Finance: • I1 Otto G. Bonestroo, P.E. Howard A. Sanford. P.E. Michael P. Rau, PE. Mark D. Wallis, P.E. Robert W. Rosen. RE.* Keith A. Gordon, P.E. Philip J. Pyne, P.E. Miles B. Jensen, P.E. Joseph C. Anderlik, P.E. Robert R. Pfefferle, P.E. Agnes M. Ring, A.I.C.P. L. Phillip Gravel ill, P.E. Marvin L. Sonrala, PE. Richard W. Foster, P.E. Thomas W, Peterson, P.E. Karen L. Wiemeri, P.E. Richard E. Turner, P.E. David O. Loskota. P.E. Michael C. Lynch. P.E. Gary D. Kristofitz, P.E. Glenn R. Cook, P.E. Robert C. Russek. A.I.A. James R. Maland. P.E. F Todd Foster, P.E. Thomas E. Noyes, P.E. Jerry A. Bourdon, P.E. Jerry D. Pertzsch. P.E. Keith R. Yapp, P.E. Robert G. Schunicht, P.E. Mark A. Hanson, P.E. Kenneth P. Anderson, P.E. Douglas J. Benoit P.E. Susan M. Eberlin, C.P.A. Michael T. Rautmann. P. E. Mark R. Rolls. P.E. Shawn D. Gustafson, P.E. *Senior Consultant Ted K. Field, PE: Mark A. Seip, P.E. Cecillo Olivier, P.E. Thomas R. Anderson. A.I.A. Gary W. Morien, P.E. Charles A. Erickson Donald C. Burgardt P.E. Daniel J. Edgerton, P.E.. Leo M. Pawetsky Thomas E. Angus. P.E. Allan Rick Schmidt, P.E. Harlan M. Olson Ismael Martinez, P.E. Philip J. Caswell. RE.' James F. Engelhardt March 3, 1994 Mr, Larry Watts Finance Director City of New Hope 4401 Xylon Ave. N. New Hope, MN 55428 Re: 1992 Local Street Resurfacing's Utility Project City Project No. 485 Our File No. 34144 Dear Larry: Transmitted herewith are three (3) copies of Request for Payment No. 13 & Final, along with the required signed Minnesota Withholding Form IC -134, for the above referenced project. The work on this project has been satisfactorily completed and we recommend payment at this time. The final amount is approximately 1.49% over the revised contract amount, due to minor differences between estimated quantities bid and actual quantities used. Should you have any questions regarding this project, please feel free to call. Yours very truly, BON S TROO,RGSENE , ANDERLIK & ASSOCIATES, INC. Mar A. Hanson MAH: pr Encl. 2335 West Highway 36 • St. Paul, MN 55113 • 612 -636 -4600 Bonestroo ®/J Rosen Owner City of New Ilope, 4401 Xylon Av N, New Hope, MN 55428 Date February 14, 1994 now " Anderlik & Associates For Period November 9 1993 to February 14 1994 Request No. 13 &Final En s '"`"' s ,,,t St. Paul, Minnesota Contractor Richard Knutson, Inc., 12585 Rhode Island Av S, Savage, MN 55378 REQUEST FOR PAYMENT 1992 Local Street Resurfacing Utility & Street Improvements Project No. 485 File No. 34144 SUMMARY 1 Original Contract Amount 2 Change Order - Addition 3 Change Order - Deduction 4 Revised Contract Amount 5 Value Completed to Date 6 Material on Hand 7 Amount Earned 8 Less Retainage 9 Sub -Total 10 Less Amount Paid Previously 11 AMOUNT DUET HIS REQUEST FOR PAYMENT NO. $ 1,711,360.55 $ 43,273. $ $ 1,754,63 $ 1,780,729.14 $ 0.00 $ 1,780,729.14 $ 0.00 $ 1,780,729.14 $ 1,742,601.31 13 & Final $ 38,127.83 Recommended for Approval by: IBONESTR O, ROSENE, DERLIK & ASSOCIATES, INC. Approved by Contractor: RICHARD KNUTSON, INC. Specified Contract Completion Date: October 17, 1992, .tune 1, 1993 Approved by Owner: CITY OF NEW HOPE, MN Date: 34144.RFP No. Item Part A - Street Reconstruction 1 Remove existing bituminous pavement 2 Remove existing concrete pavement 3 Remove existing concrete curb & gutter 4 Saw cut concrete driveway 5 Mill bituminous surface 6 Class 5, 100% crushed recycled aggregate base (including excavation) 7 Class 5, 100% crushed quarry rock (including excavation) 8 Type 31 bit. base course for patching 9 Type 31 bit. binder course for Ievefing 10 Type 41 bituminous wear course 11 Bituminous material for mixture 12 Bituminous material for tack coat 13 Concrete curb and gutter (patch) 14 B618 concrete curb and gutter 15 Concrete valley gutter (7" thick) 16 Reinforcing for concrete curb & gutter 17 3" thick wearing course for driveway 18 6" thick concrete driveway pavement with 66 x 1010 mesh 19 Adjust gate valve and box 20 Adjust Ml I frame and casting 21 Remove existing bituminous pavement from manhole cover and frame 22 Sod with 3" existing topsoil 23 Topsoil borrow (LV) Total Part A - Street Reconstruction Part B - Driveway Reconstruction 24 Remove concrete curb and gutter 25 Remove bituminous driveway pavement 26 Remove concrete driveway pavement 27 Saw cut concrete driveway 34144.RFP Unit SY SY LF LF SY TN TN TN TN TN TN GL LF I.,F SY LF SY SY FA 1?A LA SY C LF SY SY LF RP -1 Contract Quantity 15,100 700 26,700 600 3.5,000 2,000 1,000 1,800 100 10,100 770 4,200 17,810 8,890 30 2,100 550 700 75 130 75 10,000 400 Unit Quantity Price To Date 1.85 12,575.08 8.00 730 2.00 29,307.6 3.50 1,427 0.65 26,295 6.50 1,528.43 7.75 2,535.2 24.60 2,592.01. 24.60 2,742.25 16.20 9,647.77 110.00 530.63 1.05 5,155 7.25 15,076.5 5.25 15,750.5 30.00 1.00 2,120 7.30 420.2 23.00 730 150.00 76 225.00 128 50.00 62 2.00 19,302 8.00 Amount. To Date 23,263.90 5,840.00 58,615.20 4,994 50 17,091.75 9,934.80 19.647.80 63,763.45 156,293.87 58,369.30 5,412.7.5 109,304.63 82,690.13 2.120.00 3,067.46 16,790.00 11,400.00 28,800.00 3,100.00 38,604.00 $719,103.52 1,500 2.00 350 700.00 1,400 2.00 1,524 3,048.00 1,100 8.00 1,075.66 8,605,28 600 3.50 783.5 2,742.25 Contract Unit Quantity Amount No. Item Unit Quantity I'rice To Date To Date 28 Concrete curb and gutter at driveway LF 1,500 8.25 2,676.5 22,081.13 29 Class 5, 100% crushed recycled aggregate base for driveway (incl excavation) TN 300 6.50 120.6 783,90 30 3" thick wearing course for driveway SY 1.400 7.30 1,266.89 9,248.30 31 6" thick concrete driveway pavement with 66 x 1010 mesh SY 1,100 23.00 1,200 27-600_00__ Total Part B - Driveway Reconstruction $74,808.85 Part C - Northwood Pkwy 32nd Av & 32nd Circle Driveway Reconstruction 32 Remove bituminous driveway pavement SY 330 3.00 519.1 1,557.30 33 Remove concrete driveway pavement SY 530 8.00 631.6 5,052.80 34 Saw cut concrete driveway pavement LF 600 3.50 1,205.5 4,219.25 35 Cl. 5, 100 %n crushed, recycled aggregate base for driveway (including excavation) TN 300 6.50 230.41 1,497.67 36 3" thick wearing course for driveway SY 330 7.30 310 2.263.00 37 6" thick concrete driveway pavement with 66 x 1010 mesh SY 530 23.00 671.38 Total Part C - Northwood Pkwy, 32nd Av & 32nd Cir Driveway Reconstruction $30,031.76 Part D - Northwood Pkwy Sanitary Sewer 38 Remove bituminous SY 9,490 0.80 10.052.22 8,041.78 39 Remove concrete walk SF 3.360 1.50 3,752.5 5,628.75 40 Sanitary sewer bypass pumping US 1 39,625,00 1 39,625.00 41 Remove manhole IAA 13 185.00 14 2,590.00 42 Remove 27" RCP sanitary sewer LF 5 5.00 5 25.00 43 Remove 15" RCP sanitary sewer LF 5 5.00 5 25.00 44 Remove 12" RCP sanitary sewer LF 966 5.00 580 2.900.00 45 Remove 9" VCP sanitary sewer LF 2,462 3.00 1,818 5,454.00 46 Remove 12" CIP water main LF 20 5.00 47 Remove 6" CIP water main LF 50 5.00 48 Plug 15" RCP sanitary sewer LA 2 43.00 2 86.00 49 Plug 4" sewer service IAA 3 2850 3 85.50 50 Salvage castings LA 13 50.00 13 650.00 51 Transplant tree I:A 6 300.00 6 1.800.00 34144.RFP RP -2 No. item 52 10" PVC, SDR 35 san. sewer 8' -10' dp. 53 10" PVC, SDR 35 san. sewer 10' -t2' dp. 54 10" DIP, Cl. 50 san. sewer, 0' -10' deep 55 12" PVC, SDR 35, san. sewer 8' -10' dp. 56 12" PVC, SDR 35, san. sewer 10' -12' dp. 57 18" PVC, SDR 35, san, sewer 0' -8' dp. 58 18" PVC, SDR 35, san. sewer 8' -10' dp. 59 18" PVC, SDR 35, san. sewer 10' -12' dp. 60 20" DIP, Cl. 50, san. sewer 0' -8' deep 61 20" DIP, Cl. 52, sau. sewer 0' -8' deep 62 Connect to existing 9" VCP 63 18" x 4" wye 64 12" x 4" wye 65 10" x 4" wye 66 Manhole with salvaged casting 67 Manhole with R1642B casting 68 Manhole depth greater than 8' 69 Box culvert /Ml -I structure w /R1642 -A casting & Type B lid 70 10" outside drop at MH 71 4" PVC, SDR 26 sewer service 72 Connect to exist. 4" sewer service 73 12" DIP, Class 52 water main 74 6" DIP, Class 52 water main 75 Fittings 76 Connect to existing 12" CIP 77 Connect to existing 6" CIP 78 Cl. 5, 100 % crushed, recycled agg. base course (including excavation) 79 Type 31, bituminous base course 80 Type 41, bit. wear course for patch 81 Bituminous material for mixture 82 4" concrete walk 83 Televise sanitary sewer 84 Impr. pipe Ind. per 6" depth increment 34144.RFP RP -3 Contract Unit Quantity Amount Unit Quantity Price To Date To Date LF 386 21.20 350 7,420.00 LF 892 23.20 918 21,297.60 I_F 50 23.90 20 478.00 LF 80 25.25 100 2,525.00 LF 1,054 26.00 1,034 26.884.00 LF 125 30.10 125 3,762.50 LF 495 32.80 591 19,384.80 LF 346 33.80 250 8,450.00 LF 608 39.35 616.6 24,263.21 LF 30 42.70 30 1,281.00 EA 8 435.00 7 3,045.00 EA 4 206.00 5.63 1,159.78 FA 22 71.00 31.58 2,242.18 EA 30 54.00 42.17 2,277.18 EA 3 50.00 1 50.00 EA 20 920.00 23 21,160.00 LF 38.5 68.50 40.3 2,760.55 LS 1 18,400.00 1 18,400.00 LF 15.0 178.00 15.4 2,741.20 LF 570 12.95 570 7381.50 IA 57 200.00 57 11,400.00 LF 20 62.90 LF 50 43.00 10 430.00 L13 2,650 0.80 428 342.40 EA 2 495.00 EA 5 425.00 TN 4,740 7.75 6,551 50,770.25 TN 1,310 14.80 1,310 19,388.00 TN 7 47.75 TN 66 110.00 65.5 7,205.00 SF 3,360 2.00 3,752.5 7,505.00 LF 4,000 0.25 4,013 1,003.25 LF 6,000 2.60 5,145 13377.00 34144.RFP RP -3 No. Item Contract Unit Quantity Amount Unit Quantity Price To Date To Date 85 Mechanical trench compactin LF 4,706 0.10 4,103 __4.1.0,3.0_ Total Part D - Northwood Parkway Sanitary Sewer $355,705.73 Part E - Water Main Reconstruction 86 Remove bituminous SY 1,540 3.00 2,745 8,235.00 87 Remove 6" CIP water main LF 10 5.00 5 25,00 88 Salvage hydrant EA l 185.00 1 185.00 89 Salvage valve box EA 3 25.00 3 75.00 90 6" DIP, Class 52 water main LF 960 15.25 908.72 13,857.98 91 Fittings LB 985 0.80 865 692.00 92 6 "x6' wet tap w /6" gate valve & box EA 1 1,270.00 1 1270.00 93 Hydrant EA 1 1,063.00 1 1,063.00 94 6" gate valve and box EA 2 335.00 2 670.00 95 Connect to existing 6" CIP EA 1 250.00 1 250.00 96 1" copper water service I_F 125 14.55 100 1,455.00 97 1" corporation stop EA 14 32.00 16 512,00 98 Connect to existing 1" water service EA 14 210.00 16 3,360.00 99 Cl. 5, 100% crushed quarry rock (including excavation) TN 560 7.75 813.31 6,30115 100 Type 31, bit. base course for patch TN 190 25.00 311.44 7,786.00 101 Bituminous material for mixture TN 10 110.00 102 Impr. pipe Ind. per 6" depth increment LF 500 2.60 103 Mechanical trench compaction LF 1,085 0.10 1,048 Total Part E - Water Main Reconstruction $45,843.93 Part F - Sanitary Sewer Repairs 104 Bituminous removal SY 1,300 4.00 1,188.7 4,754.80 105 Repair 9" VCP san. sewer, 8' -14' dp. LF 260 127.75 221 28,232.75 106 Repair 9" VCP san. sewer, 14' -18' dp. LF 110 128.75 181 23,303.75 107 Connect to existing 9" VCP EA 20 410.00 19 7,790.00 108 Connect 10" PVC to existing MLI EA 13 420.00 2 840.00 109 Cl. 5, 100% crushed quarry rock (including excavation) 'I'N 480 6.50 526.34 3,421.21 110 Type 31, bituminous base course patch TN 160 24.20 168 4,065.60 34144.RFP RP -4 34144.RFP RP -5 Contract Unit Quantity Amount No. Item Unit Quantity Price To Date To Date 111 Bituminous material for mixture TN 8 110.00 Total Part F - Sanitary Sewer Repairs $72,408.11 Part G - Storm Sewer 112 Remove structure EA 37 185.00 32 5,920.00 113 Salvage casting EA 42 50.00 40 2.000.00 114 Remove 12" RCP LF 510 5.00 821 4.105.00 115 Remove 18" RCP LF 275 5.00 264 1,320.00 116 Remove 36' RCP LF 67 5.00 66 330.00 117 Remove bituminous SY 5,880 0.95 5,462 5,188.90 118 Mill bituminous surface SY 1,000 0.65 1,369 889.85 119 Remove concrete walk SF 50 1.25 340 42.5.00 120 Grade overland drainage swale 32nd Ave. and Circle LS 1 11,000.00 1 11,000.00 121 4" PE perforated pipe drain LF 1,000 6.79 700 4,753.00 122 12" RCP, Class 5 LF 2,150 19.50 2,179 42,490.50 123 15" RCP. Class 5 LF 4,200 19.95 4,928.5 98.323.58 124 18" RCP, Class 5 LF 2,020 23.70 1,861 44,105.70 12.5 21" RCP, Class 5 LF 310 26.90 192.5 5,178.25 126 24" RCP, Class 3 LF 40 27.50 38 1,045.00 127 30" RCP, Class 3 I_F 130 36.30 141 5,118.30 128 42" RCP, Class 1 LF 70 59.65 66 3,936.90 129 21" RCP apron with trash guard EA 1 810.00 1 810.00 130 30" RCP apron with trash guard EA 1 1,135.00 1 1,135.00 131 Connect 4" PE draintile to ex. structure BA 40 235.00 8 1,880.00 132 Connect 12 " -18" RCP to ex. structure EA 6 310.00 21 6,510.00 133 Connect 21 " -24" RCP to ex. structure FA 3 335.00 2 670.00 134 Connect 42" RCP to ex. structure EA 1 570.00 1 570.00 135 Std. M14 w /RI642B cstg. (Plate 1 -10) EA 23 1,010.00 26 26,260.00 136 Std. CI3MI -I w/R -3067V cstg, (Plate 1 -16) EA 35 1,060.00 34 36,040.00 137 Std. CB w/R -3067V cstg. (Plate 1 -19) EA 63 730.00 63 45,990.00 138 Dbl. CB w/R -3067V cstg. (Plate 1 -22) EA 4 1,570.00 5 7,850.00 139 R -3067V grate EA 9 85.00 9 765.00 140 R -3067V casting EA 1 196.00 141 R- 1642B casting EA 4 130.00 4 520.00 142 Adjust catch basin EA 18 100.00 12 1,200.00 34144.RFP RP -5 Contract Unit Quantity Amount No. Item Unit Quantity Price To Date To Date 143 Repair structure EA 10 720.00 2 1,440.00 144 Relocate catch basin EA 2 820.00 2 1,640.00 145 Class 5, 100% crushed quarry rock (including excavation) TN 2,250 6.50 2,250 14,625.00 146 Type 31. Bit. base course for patch TN 800 24.60 840 20.664.00 147 Type 41, bituminous wear course TN 270 19.35 46.22 894.36 148 Bituminous material for mixture TN 56 110.00 2.65 291.50 149 Bituminous material for tack coat CiL 145 2.00 145 290.00 150 4" concrete walk SF 50 2.00 340 680.00 151 Class 2 riprap w /gcotextile fabric CY 10 47.00 10 470.00 152 Impr. pipe fnd. per 6" depth increment LF 000 2.60 1,734 4.508.40 153 Mechanical trench compaction LF 8,920 0.10 9,415 Total Part G - Storm Sewer $412,774.73 Part H - Backyard Drainage 154 12" draintile LF 770 19.05 824 15,697.20 155 Yard drain w/R1642 cstg. & Type C grate EA 10 597.00 10 5.970.00 156 Remove 4" & 6" PVC LF 160 14.80 157 Shape drainage Swale LS 1 3,500.00 1 3,500.00 158 4" concrete Swale SF 420 3.00 780 2,340.00 159 Sod with 3" existing topsoil SY 950 2.00 160 Topsoil borrow (LV) CY 100 8.50 240 _2.040.00 —_ Total Part II - Backyard Drainage $29,547.20 Change Order No. 1 161 Propex 4553 non -woven fabric SY 6,500 2.10 6,500 13,650.00 162 Hydrant relocation IS 1 2,100.00 1 Total Change Order No. 1 $15,750.00 Change Order No. 2 - Drainage Part A - 3501 Wisconsin Avenue 163 Mobilization IS 1 1,500.00 1 1,500.00 164 12" PVC, SDR 35 LF 195 19.50 202 3,939.00 165 12" PVC perforated drainage pipe with aggregate base & geotextile fabric LF 200 19.05 221 4,210.05 166 MH 4' dia. w/R1642 frame type C grate EA 1 1,060.00 1 1,060.00 34144.RFP RP -6 34144.RFP RP -7 Contract Unit Quantity Amount No. Item Unit Quantity Price To Date To Date 167 Yard drain 2' dia. w/R1642 frame type C grate FA 3 597.00 2 1,194.00 168 Connect to existing CBMH EA 1 310.00 1 310.00 169 Remove existing concrete driveway pvtnt SY 60 8.00 94.61 756.88 170 6" thick concrete driveway pavement SY 60 23.00 94.61 2,176.03 171 Sod with existing topsoil LP 900 2.00 172 Topsoil borrow CY 80 8.56 173 Shape drainage Swale LS 1 1,065.00 1 "Total Part A - 3501 Wisconsin Avenue $16,210.96 Part B - 9209 Northwood Parkway 174 Mobilization I-S 1 1,500.00 1 1,500.00 175 12" PVC perforated drainage pipe with aggregate base & geotextile fabric LF 230 19.05 207 3,943.35 176 Yard drain 2' dia. w/R1642 frame type C grate I 2 597.00 3 1,791.00 177 Connect to existing CBMI-i GA 1 310.00 1 310.00 178 Sod with existing topsoil LF 600 2.00 179 Topsoil borrow CY 30 8.50 180 Shape drainage swale I S 1 1,000.00 1 — 1..000.0(1__ Total Part B - 9209 Northwood Parkway $8,544.35 Total Part A - 3501 Wisconsin Avenue 16.210.96 Total Part B - 9209 Northwood Parkway __._.__.. 8-544.35 "Total Change Order No. 2 - Drainage $24,755.31 34144.RFP RP -7 No. Item Total Part A - Street Reconstruction Total Part I3 - Driveway Reconstruction Total Part C - Northwood Pkwy, 32nd Av & 32nd Circle Driveway Reconstruction Total Part D - Northwood Parkway Sanitary Sewer Total Part L - Water Main Reconstruction Total Part F - Sanitary Sewer Repairs Total Part G - Storm Sewer Total Part I-I - Backyard Drainage Total Change Order No. I Total Change Order No. 2 Total Work Completed to Date Unit Contract Unit Quantity I'rice. Quantity Amount To Date To Date 719,103.52 74,808.85 30.031.76 355,705.73 45,843.93 72,408.11 412,774.73 29,547.20 15,750.00 _. - -_. - 24_754 31, -- $1,780,729.14 34144.RPP RP -8 PROJECT PAYMENT STATUS Owner City of New I -lope Project 1992 Street Resurfacing Project No. 485 File No. 34144 Contractor Richard Knutson Inc. CRANGE ORDERS No. Date Amount 1 2 -23 -93 Fabric & hydrant relocation $15,750.00 2 5 -14 -94 Drainage improvements (q) 3501 Wis Avenue & 9209 Northwood Pkwy $27,523.80 3 Total Change Orders - Add $43,273,80 PAYMENT SUMMARY No. Period Payment Retainage Completed 1 Start 8 -31 -92 $225,172.80 $11,851.20 $237,024.00 2 8 -31 -92 10 -13 -92 384,336.26 32,079.42 641,588.48 3 10 -13 -92 11 -3 -92 519,701.02 59,432.11 1,188,642.19 4 11 -3 -92 1 -13 -93 177,192.69 68,758.04 1,375,160.81 5 1 -13 -93 2 -23 -93 1,938.00 68,860.04 1,377,200.81 6 2 -23 -93 3 -1 -93 14,962.50 69,647.54 1,392,950.81 7 3 -1 -93 6 -10 -93 242,583.33 82,415.08 1,648,301.68 8 6 -10 -93 7 -8 -93 96,861.54 87,513.06 1,750,261.20 9 7 -8 -93 8 -10 -93 19,000.00 88,513.06 1,770,261.20 10 8 -10 -93 9 -9 -93 53,107.84 35,405.22 1,770,261.20 11 9 -9 -93 10 -18 -93 4,826.45 35,503.72 1,775,186.15 12 10 -18 -93 11 -9 -93 2,918.88 35,563.29 1,778,164.60 13 11 -9 -93 2 -14 -94 38,127.83 0.00 1,780,729.14 Total Payment to Date $1,780,729.14 Original Contract 1,711,360.55 Retainage, Payment No. 13 & Final 0.00 Change Orders 43,273.80 "Total Value Completed $1,780,729.14 Revised Contract 1,754,634.35 34 144. RFP RP -9 ?%Fo`m� 1�g� IC -134 Rev. 11/90 437 Minnesota Department of Revenue Withholding Affidavit for Contractors This affidavit must be approved by the Minnesota Department of Revenue before the State of Minnesota or any of its subdivisions can make final pa to contractors. Company name Richard Knutson, Inc. Address 12585 Rhode Island Ave So. City State Zip Code Savage MN 55378 Please type or print clearly above. This will be your m ailing label for returning the completed form. Telephone number ( 612 890 -8811 Did you have employees work on this project? yes If none, explain who did the work: Minnesota to number 7319476 Month /year work began 7/92 Month /year work ended 11/93 Total contract amount: 17 Amount still due: 38,127.83 Project number:_6ity_ Pro ect485 _Projegfocation ;19.9 Local Street, Resurfac Proiectowner. Citv of Ne , Hone Address DeW (- HbP' eri r MN Check the box that describes your involvement in the project and fill in all information requested in that category: ❑ Sole contractor ❑ Subcontractor E2XPrime Contractor If you are a subcontractor, fill in the name and address of the contractor that hired you: If you subcontracted out any work on this project, all of your subcontractors must file their own IC -134 affidavits and have them certified by the Department of Revenue before you can file your affidavit. For each subcontractor you had, fill in the business information below, and attach a copy of each subcontractor's certified IC -134. (If you need more space, attach a separate sheet.) Business name Address Owne /Office M onarch Turf & S upply 13481 No. 60th S tree t Stillwater, MN 55082 CR Fischer & Sons Inc. 3438 W. 151st St., Rosemount, MN 55068 Mids Reclamation, Inc. 12515 Pennsylvania Ave., Savage, PIN 55378 M idw es t Asphalt Cor P.O. Box 5477 Hopkin MN 553 Jay Brothers, Inc. 2209 Phelp Rd., H ugo, MN 55038 I declare that all information I have filled in on this form is true and complete to the best of my knowledge and belief. I authorize the Department of Revenue to disclose pertinent information relating to this project, including sending copies of this form, / a s1, a1u he pr / con I am a subc an d to a Title am a rime c ontractor, and to t he contractin agenc sub co ntr actors if I . _ — _ g y, Contractor Date T 3/4 For certification, mail original and one copy to: Minnesota Department of Revenue, Business Trust Tax Section Mail Station 6610, St. Paul, MN 55146 -6610 Certificate of Compliance with Minnesota Income Tax Withholding Law Based on records of the Minnesota Department of Revenue, I certify that the contractor who has signed this certificate has fulfilled all the requirements of Minnesota Statutes 290.92 and 290.97 concerning the withholding of Minnesota income tax from wages paid to employees relating to contract services with the state of Minnesota and /or its subdivisions. Sc,nature,tjf authorttf De it ent o u ti — — Date Stock No. 5000134 From : MONARCH TURF 0 IC- 134 nov. 11/90 PHONE No. : 612 486 0660 Mar. 1Q 1994 3:22PM F`011 Minnesota Department of Aevenuo Withholding Affidavit for Contractors Thic affidavit must b4) approved by thG Minnesota Dopattmrvit of Ravanim hAinrA the Stato of Minno .rats any of its subdIvisions can make ��ntto qqqa t ctorr.- T, Mirinesols ID numbor T Turf and Landscape 42-&-94t` 1 13481 1 60th Straot m.rwiym,, wwl trepan Stillwater, M%T 35082 10--9 stt%ti, yip tW" MgMI,+tVolty work ended 1 type Cx prini CIV-06y *hove. Th.1a MP be your f1r1,-0V.n9 13IM41 itf YOtLIV'4ng that CQMP1qM&d f6riffi. 1'41.ptlonp numbor Ox! you 11"wo onlployocm wor On thIs rlojoc!7 it IIXI{t, CKPIaln wt did tits wwk- No—g pelforraed by partnerG . 92 ° 7 Q-.— - I MOO WIWI Mum: Afownt still due; .$ I Northwood Parkway/ W-V Popp Addiess Check the b0X tha'descrIbe.9 your Involve In the project and fill in au information requested in that calegary: L sole comractoi "X: Subcontractor it ye.0 at v a tpjbuut ti actor, fill in the name and addre-B's of 016 contractor fiat Krod you Richard imutson Corifstruutfuii Cu. r Iric. 12507, Rhode 5 5 3 7 8 Pflme Contravtor If you sut)C-Vi11TakAL1d out any vvoik on thI5 project, a: of your subcontractort, must file tho'r own IC-i34 alfldavlhi d10 hdvtt thdlo (;eilillRd by the Depatti of Plevenu6 bcfott YOU VIM file your tifildavit. Fur ea i you had, fill in the bvr>1rwe6r, information 6 and attnoh n 00py of f-ach subcontractors ce IC: -1 34. (If you need more space, attaol i a saparate tll eet-') Duslflec-"3 nallw Address Ownpr/Offkor PI. Oeq',';. twulro tat Pnvc�n.uo to d4 km-kc# rArtimint information falafloig to this pro)@r Imiuding vending Coplo� of Ois fnrr-,, 11�v ILAt A p1ma ' aomtmoioc, 0A01 .. 01 n �tf Min ft e-.ro , AP . -2 F or mail original and one copy to; 05 0, c - r � t ti, �� - =Derdi i fi ' ne t of rievenue, Butih tess Tani Tax Section Mail staiiuii 6610, St. Paul, MN 55140-613,10 Ctp-rtlijCato of Compliance with Minnesota Inn omit Tax Withholding Law l3ased on, records r�', ti ie Mirtnesoti Departniont of Revenue, I certify that the contraMor who has stgns(i lhlq cortificstOl hag - - luffilled all tho requiiements of KMr1p,5oLa Statutes 290 92 and 299.97 conceming the withholding of Min inc tax from a;aq,n paid to employee- MlEjfing i.0 co! wrvices with the state of Minne-. and/or Its subdivisior.s. rl t'roa »d 1 RECEIVED SEP 21 F IC -134 Minnesota Department of Revenue Rev. 11/90 Withholding Affidavit for Contractors This affidavit must be approved by the Minnesota Department of Revenue before the State of Minnesot or a ny of its subdivision can make fi pa to contractors. Company name Minnesota ID number MidState Reclamation, Inc. 17195 Address Month /year work began 12515 Pennsylvania Ave. 8/92 City State Zip Code Month /year work ended s MN 55378 9/92 Please type or print clearly above. This will be your Total contract amount: mailing label for return th e complete form 10,332.50 Telephone number Amount still due: ( 612) 89 -6795 0 Did you have employees work on this project? Yes Pro*e num ber : 4 3 7 If none, explain who did the work: Project location: New _ Hope , MN _ Project owner: Richard Kni Inc Address 12585 Rhode Island Ave. So. Check the box that describes your involvement in the project and fill in all information requested in that category: ❑ Sole contractor ® Subcontractor If you are a subcontractor, fill in the name and address of the contractor that hired you: ❑ Prime Contractor if you subcontracted out any work on this project, all of your subcontractors must file their own IC -134 affidavits and have them certified by the Department of Revenue before you can file your affidavit. For each subcontractor you had, fill in the business information below, and attach a copy of each subcontractor's certified IC -134. (if you need more space, attach a separate sheet.) Business name Address Owner /Officer Certificate of Compliance with Minnesota Income Tax Withholding Law Based on records of the Minnesota Department of Revenue, I certify that the contractor who has signed this certificate has fulfilled all the requirements of Minnesota Statutes 290.92 and 290.97 concerning the withholding of Minnesota income tax from wages paid to employees relating to contract services with the state of Minnesota and /or its subdivisions. - - - - - -- — — - - - - -- - -- ignature of authorized Department of Revenue official S Date - - -- Stock No. 5000134" RFCFIVEDJAN05 1994 Form Form Minnesota Department of Revenue Rev. 11/90 Withholding Affidavit for Contractors This affidavit must be approved by the Minnesota Department of Revenue before the State of Minnesota or anv of it s subdivisions can make final oavment to contractors. Company name Minnesota ID number MIDWEST ASPHALT CORPORATION 7252554 Month/year work began Address PO BOX 5477 September 1992 Month/year work ended City State Zip Code HOPKINS MN 55343 October 1993 Please type or print clearly above. This will be your mailing label for returning the completed form. Total contract amount: $ 434 529.75 Telephone number Amount still due: i 612 ? 937 -8033 FAX (612) 9 37 -6910 $ 51,774.22 Did you ha'v'e Chic If none, explain who did the work: Prnin r number: 1992 L ocal St ree t I m_prp -, m_ nt s 41 Project location: New Hope, MN — Project owner: City of New Hope Yes Address 4401 Xylon Ave., N., New Hope, MN 5 Check the box that describes your involvement in the project and fill in all information requested in that category: ❑ Sole contractor Nk Subcontractor If you are a subcontractor, fill in the name and address of the contractor that hired you: Richard Knutson. Inca 12585 Rhode Island Avenue South, Savage. MN ❑ Prime Contractor If you subcontracted out any work on this project, all of your subcontractors must file their own IC -134 affidavits and have them certified by the Department of Revenue before you can file your affidavit. For each subcontractor you :had, fill in the business information below, and attach a copy of each subcontractor's certified IC434. (If you need more space, attach a separate sheet.) Business name Address Owner/Officer I declare that all information I have filled in on this form is true and complete to the best of my knowledge and belief. I authorize the Department of Revenue to disclose pertinent information relating to this project, including sending copies of this form, to the Prime contractor if I am a subcontractor, and to any subcontractors if I am a prime contractor, and to the contracting agency. Contra ors signature Title Date r; Vice President December 23, 1993 For certification, mail original and one copy to: :a Department of Revenue, Business Trust Tax Section Mail Station 6610, St. Paul, MN 55146 -6610 485 5428 Certificate of Compliance with Minnesota Income Tax Withholding Law Based on records of the Minnesota Department of Revenue, I certify that the contractor who has signed this certificate has fulfilled all the requirements of Minnesota Statutes 290.92 and 290.97 concerning the withholding of Minnesota income tax from wages paid to employees relating to contract services with the state of Minnesota and /or its subdivisions. Signature of a 'zed Department of Re vial a Date DEC Stock No. 5000134 59 Form IC -134 Rev. 11/90 R F G E IVES JAN 05 1994 Minnesota Department of Revenue Withholding Affidavit for Contractors This affidavit must be approved by the Minnesota Department of Revenue before the Stntp of Minnesota nr anv of its suhrfivisinn z can makp final navmpnt tn cnntractnrs- Company name Minnesota 10 number MIDWEST ASPHALT CORPORATION 7252554 Month/year work began Address PO BOX 5477 September 1992 Month/year work ended city State Zip Code HOPKINS MN 55343 October 1993 Please type or print clearly above. This will be your mailing label for returning the completed form. Total contract amount: $ 434 529.75 Telephone number Amount still due: ( 612 ) 937 -8033 FAX (612) 9 37 -6910 $ 51,774.22 Did you hwve 3imployeec .vo. or.. this project? If none, explain who did the work: froiect numb 1992 Local St I �l Project location: New Hope, MN Project owner: City of New Hope Yes Address 4401 Xylon Ave., N., New Hope, MN 5 Check the box that describes your involvement in the project and fill in all information requested in that category: ❑ Sole contractor Qk Subcontractor If you are a subcontractor, fill in the name and address of the contractor that hired you: Richard Knutson. Inca 12585 Rhode Island Avenue South. Savaae. MN ❑ Prime Contractor If you subcontracted out any work on this project, all of your subcontractors must file their own IC -134 affidavits and have them certified by the Department of Revenue before you can file your affidavit. For each subcontractor yob had, fill in the business information below, and attach a copy of each subcontractor's certified IC434. (If you need more space, attach a separate sheet.) Business name Address Owner /Officer I declare that all information I have filled in on this form is true and complete to the best of my knowledge and belief. I authorize the Department of Revenue to disclose pertinent information relating to this project, including sending copies of this form. to the orime contractor if I am a subcontractor, and to any subcontractors if I am a orime contractor. and to the contracting aaencv. Contra or's signature Title Date Vice President December 23, 1993 For certification, mail original and one copy to: :a Department of Revenue, Business Trust Tax Section Mail Station 6610, St. Paul, MN 55146 -6610 MR 5428 Certificate of Compliance with Minnesota Income Tax Withholding Law Based on records of the Minnesota Department of Revenue, I certify that the contractor who has signed this certificate has fulfilled all the requirements of Minnesota Statutes 290.92 and 290.97 concerning the withholding of Minnesota income tax from wages paid to employees relating to contract services with the state of Minnesota and /or its subdivisions. Signature of y0 Department of Revaauseicial r Date --- Y- °������ - - - - -- _ ___ ----------- - - - - -- - - - - - -- D EC 9 x'.1993 Stock No. 5000134 DEC ' f k Form IC -134 Rev. 11/90 m RE CE I VED OCT 051 Minnesota Department of Revenue Withholding Affidavit for Contractors This affidavit must be approved by the Minnesota Department of Revenue before the State of Minnesota or any of its subdivisi ca n make final payment to contractors. Company name Jay Bros., Inc. Address 2209 Phelps Road City State Zip Code Hug MN 55038 Please type or print clearly above. This will be your mailing label for returning the completed for Telephone number ( 612) 429 4363 Did you have employees work on this project? yes If none, explain who did the work: Minnesota to number 6964154 Month /year work began August 1992 Month /year work ended August 1992 Total contract amount: 3,160.00 Amount still due: 158.00 _Project numbe Project loca Ne Hope M Address New Hope MN Check the box that describes your involvement in the project and fill in all information requested in that category; ❑ Sole contractor ON Subcontractor If you are a subcontractor, fill in the name and address of the contractor that hired you: Richard Knutson _Inc. _- _12585_ Rhode __1s,land Avenue South _Sava MN 5 5378 El Prime Contractor If you subcontracted out any work on this ro'ect all of our subcont t Cl I I declare that all information I have filled in on this form is true and complete to the best of my knowledge and belief. I authorize the Department of Revenue to disclose pertinent information relating to this project, including sending copies of this form, to the prime contractor if I am a subcontractor, and to any subcontr if I am a prime contr and to the c ontracting agenc - - --- - - -- - - - _ Contractor's signature Title Date Sec /Treas Se 22, 1 993 For certification, mail original and one copy to: Minnesota Department of Revenue, Business Trust Tax Section Mail Station 6610, St. Paul, MN 55146 -6610 Certificate of Compliance with Minnesota Income Tax Withholding Law Based on records of the Minnesota Department of Revenue, I certify that the contractor who has signed this certificate has fulfilled all the requirements of Minnesota Statutes 290.92 and 290.97 concerning the withholding of Minnesota income tax from wages paid to employees relating to contract services with the state of Minnesota and /or its subdivisions. Signature uthorized Department of Revenfficial Date Stock No. 5000134 p f y raC ors must l e t felr own IC -134 affidavits and have them certified by the Department of Revenue before you can file your affidavit, For each subcontractor you had, fill in the business information below, and attach a copy of each subcontractor's certified IC -134. (If you need more space, attach a separate sheet.) B name Address Owner /Officer Form 1C.1 34 Rev. 11/90 Withholding Affidavit for Contractors This affidavit must be approved by the Minnesota Department of Revenue before the State of Minnesota or an of its subdivisions can make final payment to contractors. Company name Jay Bros., Inc. Address 2209 Phelps Road City State Zip Code Hugo MN 55038 Minnesota to number 6964154 Month/year work began August 1992 Month/year work ended August 1992 Please type or print clearly above. This will be your mailing label fo returning the completed form. Total contract amount: 3 ,160.00 Telephone number (612 ) 429 4 363 Amount still due: 158.00 Did you have employees work on this project? yes If none, explain who did the work: Project num Project location: New Hope MN Projectowner• City of New Hope Address New Hope MN Check the box that describes your involvement in the project and fill in all information requested in that category: Sole contractor E3 Subcontractor If you are a subcontractor, fill in the name and address of the contractor that hired you: Richard_ Knutson Inc. 12585 Rhode _Islan Avenue Sou th_ Savage MN 55378 ❑ Prime Contractor If you subcontracted out any work on this project, all of your subcontractors must file their own IC -134 affidavits and have them certified by the Department of Revenue before you can file your affidavit. For each subcontractor you had, fill in the business information below, and attach a copy of each subcontractor's certified IC -134. (If you need more space, attach a separate sheet.) Business name Address Owner /Officer RE CEIVED OCT 051993` o Minnesota Department of Revenue t declare that all information I have filled in on this form is true and complete to the best of my knowledge and belief. I authorize the Department of Revenue to disclose pertinent information relating to this project, including sending copies of this form, blithe pri contractor if I am a subcontracto and to any subcontractors if I am a prime c ontractor, and to the contracting a Contractor's signature Title Date �� - - - -- -- Se / Trews _ September 22, 1993 For certification, mail original and one copy to: Minnesota Department of Revenue, Business Trust Tax Section Mail Station 6610, St. Paul, MN 55146 -6610 Certificate of Compliance with Minnesota Income Tax Withholding Law Based on records of the Minnesota Department of Revenue, I certify that the contractor who has signed this certificate has fulfilled all the requirements of Minnesota Statutes 290.92 and 290.97 concerning the withholding of Minnesota income tax from wages paid to employees relating to contract services with the state of Minnesota and /or its subdivisions. - -- _ Signature 9yuthorized Department of Revenue tficial Date r Stock No. 5000134 n4 1994 Form �'� Form Department of Revenue Rev. 11/90 W ithholding f i vi for C ontracto rs This affidavit must be approved by the Minnesota Department of Revenue before the State of Minnesota or an of its subdivisions ca make final pa to contractors. Company name Minnesota to number (4nL( Address Month /year work began �' \ U r }} 3 C . city State Zip Code Month /year work ended n Please type or print clearly above. This will be your Total contract amount. mailing label for returning the completed form v c Telephone number Amount still due: Did you have employees work on this project? Project number. �_� Project location: )1-s � y)z- If none, explain who did the work: —�- Address k Check the box that describes your involvement in the project and fill in all information requested in that category: ❑ Sole contractor Subcontractor If you are a subcontractor, fill in the name and address of the contractor that hired you: Yl c . 1 �� ) 4>c ( i1 ?, (- TL ❑ Prime Contractor If you subcontracted out any work on this project, all of your subcontractors must file their own IC -134 affidavits and have them certified by the Department of Revenue before you can file your affidavit. For each subcontractor you had, fill in the business information below, and attach a copy of each subcontractor's certified IC -134. (If you need more space, attach a separate sheet.) Business name Address Owner /Officer I declare that all information I have filled in on this form is true and complete to the best of my knowledge and belief. I authorize the Department of Revenue to disclose pertinent information relating to this project, including sending copies of this form, to the rime contractor if I am a subcontractor, and to any subcontractors if I am a prime contractor, and to the contracting agency_ _ -- -- - P - - -- - - - -- - - - _ Contractor 's (� Title Date For certification, mail original and ohe copy to: Minnesota Department of Revenue, Business Trust Tax Section Mail Station 6610, St. Paul, MN 55146 -6610 Certificate of Compliance with Minnesota Income Tax Withholding Law Based on records of the Minnesota Department of Revenue, I certify that the contractor who has signed this certificate has fulfilled all the requirements of Minnesota Statutes 290.92 and 290.97 concerning the withholding of Minnesota income tax from wages paid to employees relating to contract services with the state of Minnesota and /or its subdivisions. of Re nue offic" I uate FEB .18 1 Stock No. 5000134 ° 1l E C V ED MAR 0 2 1994 rm IC -134 Minnesota Department of Revenue Rev. 11/90 t Withholding Affidavit for Contractors 0 This affidavit must be approved by the Minnesota Department of Revenue before the State of Minnesota or any of its subdivisions can make final pa yment to contractors. Company name Minnesota ID number Address Month/year work began 34M W City State Zi Code Monthtyear work ended (� nn Please type or print clearly above. This will be your Total contract amount: mailing label for returning the completed form. O �� Telephone number Amount still due: ,�,,' �.j �} f 1 ' t,: Did you have employees work on this project? If none, explain who did the work: 1.� Address �f=EO 1 K V j on f-U) Check the box that describes your involvement in the project and fill in all information requested in that category: ❑ Sole contractor ® Subcontractor If you are a subcontractor, fill in the name and address of the contractor that hired you: r \ I ch C l 1.61 1 n l (�jr— -Cn c j ` � j1 f ^� .1 G I1 d OtQ-e -- , ❑ Prime Contractor If you subcontracted out any work on this project, all of your subcontractors must file their own IC -134 affidavits and have them certified by the Department of Revenue before you can file your affidavit. For each subcontractor you had, fill in the business information below, and attach a copy of each subcontractor's certified IC -134. (If you need more space, attach a separate sheet.) Business na A ddress Owner /Off I declare that all information I have filled in on this form is true and complete to the best of my knowledge and belief. i authorize the Department of Revenue to disclose pertinent information relating to this project, including sending copies of this form, to the rp ime contractor if I am a sub contractor, and to any subcontractors if I am a prime contractor, and to the contracting agency Contractor's signature Title Date For certification, mail original and o�e copy to: Minnesota Department of Revenue, Business Trust Tax Section Mail Station 6610, St. Paul, MN 55146 -6610 Certificate of Compliance with Minnesota Income Tax Withholding Law Based on records of the Minnesota Department of Revenue, I certify that the contractor who has signed this certificate has fulfilled all the requirements of Minnesota Statutes 290.92 and 290.97 concerning the withholding of Minnesota income tax from wages paid to employees relating to contract services with the state of Minnesota and /or its subdivisions. Signature thori�ed Departm tot Re �ohic ' � D ate UU FEB 1 999 Stock No. 5000134 8onestroo Bidde ® Rosene Total Base Bill Address Telephone No. Anderiik Associates s �"` City, State, Zip Faz. No. FRED SIMS AND MEADOW LAKE PARK PLAYGROUND EQUIPMENT AND SITE IMPROVEMENTS PROJECT NO. 495 FILE NO. 34142 NEW HOPE, MINNESOTA June 3, 1992 Opening Time: 11 :30 A.M., C.D.S.T. Opening Date: Monday, June 8, 1992 Handicap Access Ramp: The plans and specifications require the "Handicap Access Ramp" to be constructed at a 12:1 slope (8.33 %). The "Handicap Access Ramp" shall be constructed at a 20:1 slope (5 %) to comply with the Americans with Disabilities Act (ADA). Section 0231.3. MATERIALS: A "Space Out Climber" (Game Time No. 6485) shall be constructed at Fred Sims, not a "Space Cube" (Game Time No. 3031) as listed under Separate Items. BONESTROO, ROSENE, ANDERLIK & ASSOCIATES, INC. 2335 WEST TRUNK HIGHWAY 36 ST. PAUL, MINNESOTA 55113 34142.ADD FRED SIMS AND MEADOW LAKE PARK PLAYGROUND EQUIPMENT PROJECT NO. 495 FILE NO. 34142 NEW HOPE, MINNESOTA 1992 0231. Recreational Facilities - Specific & General Requirements 2104. Removing Miscellaneous Structures - Specific & Gen'l. Requirements 2105. Excavation and Embankment - Specific & General Requirements , 2211. Aggregate Base - Specific & General Requirements 2331. Plant Mixed Bituminous Pavement Specific & General Requirements 0411. Modular Block Retaining Wall - Specific & General Requirements 2575. Turf Establishment - Specific & General Requirements 24,000. Sewers - Specific Requirements Conditions of the Contract Date: MI(V 28,1992 Reg. No. 14260 RM IPA Sealed bids will be received by the City of New Hope, Minnesota in the City Hall at 4401 Xylon Avenue until 11:30 A.M., C.D.S.T. on Monday, June 8,1992, at which time they will be publicly opened and read aloud for the furnishing of all labor and materials and all else necessary for the following: tv 18W07MR LUMP SUM Furnish and Install Playground Equipment with Miscellaneous Site Imrovements and Correlated Appurtenances. Plans and specifications, proposal forms and contract documents may be seen at the office of the City Clerk, New Hope Minnesota, and at the office of Bonestroo, Rosene, Anderlik & Associates, Inc., Consulting Engineers, 2335 W. Trunk Highway 36, St. Paul, MN 55113, (612) 636-4600. Each bid shall be accompanied by a bidder's bond naming the City of Aew Hope as obligee, certified check payable to the Clerk of the City of New Hope or a cash deposit equal to at least five percent (5%) of the amount of the bid, which shall be forfeited to the City'in the event that the bidder fails to enter into a contract. The City Council reserves the right to retain the deposits of the three lowest bidders for a period not to exceed 45 days after the date and time set for the opening of bids. No bids may be withdrawn for a period of -forty-five (45) days after the date and time set for the opening of bids. Payment for the work will be by cash or checi Contractors desiring a copy of the plans and specifications and proposal forms may obtain them from the office of Bonestroo, Rosene, Anderhk & Associates, Inc., upon payment of a deposit of $25.00. See "Information to Bidders"' for plari/specification deposit refund policy. i W ' OT-WW"All of the City. 1. BID PROC.EDURE Each planholder has been furnished a specification, plan set and two extra proposals. Bids shall be submitted on the sepaiate Proposal Form designated "BID COPY" and Ile Proposal containing the bid shall be submitted in a sealed envelope. 2. DEPOSIT AND REFUND: Plans and specifications may be obtained for the deposit amount stipulated in the Advertisement for Bids. * Planholders may obtain more than one set of plans and specifications for the stipulated amount, however, refunds will not be given for these additional sets. Refunds of deposit will be made to all bidders, subcontractors, and suppliers who return plans and specifications, in good condition, within 15 days of the bid date provided they: a) Were a prime bidder who submitted a bona-fide bid to the Owner, or b) Submitted quotes to at least two prime bidders which are identified with the returned plans and specifications. The following planholders need riot return plans and specifications to receive a refund of deposit: ,a) Low prime bidder, or b) Successful low subcontractors and suppliers who notify the receptionist within 15 days of the bid. Refunds of deposit will also be made, for one set (if plans and specifications only, to those planholders who return plans and specifications at least 48 ours before the bid-letting hour. 3. INDIVID1 JAI.. DRA"NINGS AND spL_(IFICATION SHEETS- Individual drawings and specifications sheets may be purchased at the, rate of Five Dollars ($5.00) per sheet of drawings and Twenty-five cents ($025) per sheet of specifications for which no refund will be made. Eonestroo Rasene Bidder Arrigoni Brothers Company Total Base Bid $55,45Q.OQ WIN � Address 817 Vandalia Street Telephone No. 645 -9321 Anaerk Associ "M "" City, State, Zip St. Paul, MN 55114 Fax. No. 645 -9323 PROPOSAL FRED SIMS AND MEADOW LAKE PARK PLAYGROUND EQUIPMENT AND SITE IMPROVEMENTS PROJECT NO. 495 FILE NO. 34142 NEW HOPE, MINNESOTA 1992 Honorable City Council City of New Hope 4401 Xylon Avenue North Minneapolis, Minnesota 55428 Dear Council Members: Opening Time: 11:30 A.M., C.D.S.T. Opening Date: M o n day, June 8, 1992 The undersigned, being familiar with your local conditions, having made the field inspections and investigations deemed necessary, having studied the plans and specifications for the work including Addenda Nos. _Q_ and being familiar with all factors and other conditions affecting the work and cost thereof, hereby proposes to furnish all labor, tools, materials, skills, equipment and all else necessary to completely construct the project in accordance with the plans and specifications on file with your Clerk and Bonestroo, Rosene, Anderlik & Associates, Inc., 2335 W.Trunk Highway 36, St. Paul, Minnesota 5511.3, as follows: No. Item Unit Qty Unit Price Total Price Part 1 - Fred Sims 1 Furnish & install playground structure with handicap access ramp EA 1 $13,000.00 $13,000.00 2 Furnish and install tire swing EA 1 1,150.00 1,150.00 3 Furnish and install space arch climber EA 1 620.00 620.00 4 Furnish and install 3 leg swing - 2 sections w /2seats /section (1 enclosed tot seat) 8' high EA 1 1,450.00 1,450.00 34142.PRO P -1 No. Item 5 Furnish and install police car 6 Furnish and install backhoe digger 7 Sand cover & spread existing sand 8 Class 5 100% crushed aggregate base 9 Type 41 bit. wear course (2" thick) 10 Bituminous material for mixture 11 Topsoil borrow 12 Sod Total Part 1. - Fred Sims Part 2 - Meadow Lake 13 Remove existing bituminous surface 14 Remove existing playground equipment 15 6" PVC perforated drain pipe w /geotextile fabric Type I & coarse filter aggregate 16 Gcotextile fabric, Type V 17 Common excavation 18 Modular block retaining wall (beige) 19 Class 5 100% crushed aggregate base 20 Type 41 bit. wear course (2" thick) 21 Furnish and install 6' bench w /back 22 Furnish & install playground structure w /handicap access ramp 23 Furnish and install tire swing 24 Furnish and install space arch climber Unit Qty Unit Price Total Price EA 1 $ 820.00 $ 820.00 EA 1 400.00 400.00 CY 60 5.00 300.00 TN 30 25.00 750.00 TN 20 70.00 1,400.00 TN 2 150.00 300,00 CY 15 10.00 150.00 SY 200 4.00 800.00 EA 1 13,000.00 $21,140.00 SY 10 $ 10.00 $ 100.00 LS 1 200.00 200,00 LF 100 5.00 500.00 SY 580 1.00 580.00 LS 1 2,000.00 2,000.00 SF 500 13.00 6,500.00 TN 45 22.00 990.00 TN 20 70.00 1,400.00 EA 2 350.00 700.00 EA 1 13,000.00 13,000,00 EA 1 1,150.00 1,150.00 EA 1 620.00 620.00 34142TRO P-2 No. Item Unit Qty Unit Price Total Price 25 Furnish and install 3 leg swing - 2 sections w /2seats /section (1 enclosed tot seat) 8' high 20 Furnish and install police car 27 Furnish and install backhoe digger 28 Sand cover 29 Topsoil borrow 30 Sod Total Part 2 - Meadow Lake Total Part 1 - Fred Sims Total Part 2 - Meadow Lake Total Base Bid EA 1 $1,450.00 EA 1 820.00 EA 1 400.00 CY 180 15.00 CY 100 10.00 SY 400 3.00 $ 1,450.00 820.00 400.00 2,700.00 1,000.00 $34,310.00 $21,140.00 $34.31 -W $55,450.00 34142TRO P -3 The final amount of the contract shall be determined by multiplying the final measured quantities of the various items actually constructed and installed by the unit prices therefor, in the manner prescribed in the specifications. However, the low bidder shall be determined by adding the sums resulting from multiplying the quantities stated by the unit prices bid therefor. Accompanying this bid is a bidder's bond certified check or cash deposit in the amount of $ five percent (5 %) of amount bid which is at least five percent (5 %) of the amount of my /our bid made payable to the Owner, and the same is subject to forfeiture in the event of default on the part of the undersigned or failure on the part of the undersigned to execute the prescribed contract and bond within fifteen (15) days after its submittal to me /us. In submitting this bid it is understood that the Owner retains the right to reject any and all bids and to waive irregularities and informalities therein and to award the contract to the best interests of the Owner. In submitting this bid, it is understood that payment will be by cash or check. It is understood that bids may not be withdrawn for a period of 45 days after the date and time set for the opening of bids. It is understood that the Owner reserves the right to retain the certified check or bond of the three lowest bidders as determined by the Owner for a period not to exceed 45 days after the date set for the opening of bids. Respectfully submitted, (A Corporation) Arrioni Brothers Company (An Individual) Name of Bidder ( Partnershinl (Signed) Dennis J. Arrigoni Signer President Title Dennis J. Arri oni Printed Name of Signer 34142.PRO P -4 (INDIVIDUAL OR PARTNERSHIP ACKNOWLEDGMENT) STATE OF COUNTY OF ss On the day of ' 19 before me, a Notary Public within and for said county, personally appeared, to me known to be the person(s) described in and who executed the foregoing instrument, as Principal(s), and ac- knowledged to me that ,h executed the same as _h free act and deed. Notary Public, (Notarial Seal) STATE OF M " CORPORATE ACKNOWLEDGMENT COUNTY OF ass On the day of /V E ' 19 -- ,before me personally appeared - t r' , n r to me known, who being by me duly sworn, did depose and say: that he resides in y - t; I" ki that he is the p resident of the r 5 ®n . 1 �a'r (7 the corporation described in and which executed the foregoing instrument; that he knows the seal of said corpo- ration; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the board of directors of said corporation; and that he signed his name ereto by like order. I E . ALLEN L NOTARV Puat.sc - r; ^Rr N'2SCTA my Commission Fxplres duly 17,1 1 4 1 00 - 1 (Notarial Seal) County, My commission expires Notary Public, County, My commission expires ACKNOWLEDGMENT OF CORPORATE SURETY STATE OF Minnesota ) COUNTY OF Ramsey ) ss On this 16th day of June '19 92 _ , before me appeared Kurt e. Lund to me personally known, who being by me duly sworn, did say that he is the aforesaid officer or attorney in fact of the UNITED FIRE & CASUALTY COMPANY a corporation; that.,,the seal affixed to the foregoing instrument is the corporate seal of said corporation, and that said instrument was signed and sealed in behalf of said corpora- tion by the aforesaid officer, by authority of its board of directors; and the aforesaid officer acknowledged said instrumen CpvH8 STI #� M g �@SEN aid corporation. _r ... Rtf iil �.S7t6�Y: M. S��i'9JCSV N OTARY PUBLIC-ftRINNES01A ' 6; A SEY �''�`` Notary Public, p. My colPl!?:issson Exptfes ,U list 19, 199< County, (Notarial Seal) My commission expires UND - 2067 b (9 -78) UNITED FIRE & CASUALTY COMPANY _......_ HOME OFFICE — CEDAR RAPIDS, IOWA CERTIFIED COPY OF POWER OF ATTORNEY . (Original on file at Home Office of ompany — ee er i tca t KNOW ALL MEN BY THESE PRESENTS, That the UNITED FIRE & CASUALTY COMPANY, a corporation duly organized and existing under the laws of the State of Iowa, and having its principal office in Cedar Rapids, State of Iowa, does make, constitute and appoint D.R. Dougherty, or Jack Cedarleaf II, or Jimmy G. Cedarleaf, or R.J. Larsen, or E. Lange, or Christine M. Hansen, or Kurt C. Lundblad, or C.A. Housh, All Individually. of St. Paul, Minnesota its true and lawful Attorneys) -in -Fact with power and authority hereby conferred to sign, seal and execute in its behalf all lawful bonds, undertakings and other obligatory instruments of similar nature as follows: - -Any and all bonds -- and to bind UNITED FIRE & CASUALTY COMPANY thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of UNITED FIRE & CASUALTY COMPANY and all the acts of said Attorney, pursuant to the authority hereby given are hereby ratified and confirmed. The Authority hereby granted shall expire January 8 19 9 unless sooner revoked. This power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the Board of Directors of the Company on April 18, 1973. "Article V — Surety Bonds and Undertakings." Section 2, Appointment of Attorney -in -Fact. "The President or any Vice President, or any other officer of the Company, may, from time to time, appoint by written certificates attorneys -in -fact to act in behalf of the Company in the execution of policies of insurance, bonds, undertakings and other obligatory instruments of like nature. The signature of any officer authorized hereby, and the Corporate seal, may he affixed by facsimile to any power of attorney or special power of attorney or certification of either authorized hereby; such signature and seal, when so used, being adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed. Such attorneys -in -fact, subject to the limitations set forth in their respective certificates of authority shall have full power to bind the Company by their signature and execution of any such instruments and to attach the seal of the Company thereto. The President or any Vice President, the Board of Directors or any other officer of the Company may at any time revoke all power and authority previously given to any attorney -in -fact, IN' WITNESS WHEREOF, the UNITED FIRE & CASUALTY COMPANY has caused these ;4 } "" � _ presents to be signed by its vice president and its corporate seal to be hereto affixed this f CORPORATE` 8th day of January , A.D. 19 92 , BBAL UNITED FIRE & CASUALTY COMPANY By ),� V?cVeAn' State of Iowa, County of Linn, ss: On this 8th day of January 1992 , before me personally came Maynard L. Hansen to me known, who being by me duly sworn, did depose and say: that he resides in Cedar Rapids, State of Iowa; that he is a Vice President of the UNITED FIRE & CASUALTY COMPANY, the corporation described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation. oz ► "' ` °� R.G. HECKROTH Notary Public MY COMMISSION EXPIRES December 10, 1992 i My commission expires Dec. 10 ,19 92 RA W CERTIFICATION I, the undersigned officer of the UNITED FIRE & CASUALTY COMPANY, do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit, and the copy of the Section of the By -Laws of said Company as set forth in said Power of Attorney, with the ORIGINALS ON FILE IN THE HOME OFFICE OF SAID COMPANY, and that the same are correct transcripts thereof, and of the whole of the said originals, and that the said Power of Attorney has not been revoked and is now in full force and effect. � " In testimony whereof 1 have hereunto subscribed my name and affixed the cor- cASU a, r1 ~ ��Y- porate seal of the said E CORPORATE $SAL Company this 16th day of June 19 92 Secretary (INDIVIDUAL OR PARTNERSHIP ACKNOWLEDGMENT) STATE OF COUNTY OF ss ) On the day of , 19 before me, a Notary Public within and for said county, personally appeared, to me known to be the person(s) described in and who executed the foregoing instrument, as Principal(s), and ac- knowledged to me that _he_ executed the same as ,h free act and deed. Notary Public, County, (Notarial Seal) My commission expires. CORPORATE ACKNOWLEDGMENT STATE OF v „ t ) COUNTY OF f ° � - Q °` l ss On the day of "` —� ``— , 19 before me personally appeared ! : A to me known, who being by me duly sworn, did depose and say: that he resides in that he is the p resident of the y Y_ a r a_ the corporation described in and which executed the foregoing instrument; that he knows the seal of said corpo- ration; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the board of directors of said corporation; and that he signed his narn hereto by like order. CORI NE M. ALLEN �i �C}Tl1RY PUBLIC h "9EJ�tStBTA M S COUN �y Commission E -v1res July 17. 599`7 (Notarial Seal) Notary Public, County, My commission expires ACKNOWLEDGMENT OF CORPORATE SURETY STATE OF Minnesota ss COUNTY OF Ramsey ) On this 16th day of June ' 19 92 before me appeared Kurt c. Lundblad to me personally known, who being by me duly sworn, did say that he is the aforesaid officer or attorney in fact of the UNITED FIRE & CASUALTY COMPANY a corporation; that.,the seal affixed to the foregoing instrument is the corporate seal of said corporation, and that said instrument was signed and sealed in behalf of said corpora tion by the aforesaid officer, by authority of its board of directors; and the aforesaid officer acknowledged said instrument to be the free act and deed of said corporation. C1-11-'1ST1i t Iva. ,i.fiti a WARY Pt9�w &� €41f�1�t St�TR Z�� (� P} cb'Ly x:`311 TY MnBt 19 92 UND - 2067 b (9 -78) Notary Public, County, My commission expires UNITED FIRE & CASUALTY COMPANY HOME OFFICE — CEDAR RAPIDS, IOWA - - Un CERTIFIED COPY OF POWER OF ATTORNEY . (Original on file at Home Office of Company — See Certification) KNOW ALL MEN BY THESE PRESENTS, That the UNITED FIRE & CASUALTY COMPANY, a corporation duly organized and existing under the laws of the State of Iowa, and having its principal office in Cedar Rapids, State of Iowa, does make, constitute and appoint D.R. Dougherty, or Jack Cedarleaf II, or Jimmy G.. Cedarleaf, or R.J. Larsen, or E. Lange, or Christine M. Hansen, or Kurt C. Lundblad, or C.A. Housh, All Individually. of St. Paul, Minnesota its true and lawful Attorney(s) -in -Fact with power and authority hereby conferred to sign, seal and execute in its behalf all lawful bonds, undertakings and other obligatory instruments of similar nature as follows: - -Any and all bonds -- and to bind UNITED FIRE & CASUALTY COMPANY thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of UNITED FIRE & CASUALTY COMPANY and all the acts of said Attorney, pursuant to the authority hereby given are hereby ratified and confirmed. The Authority hereby granted shall expire January 8 19 94 unless sooner revoked. This power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the Board of Directors of the Company on April 18, 1973. "Article V — Surety Bonds and Undertakings." Section 2, Appointment of Attorney -in -Fact. "The President or any Vice President, or any other officer of the Company, may, from time to time, appoint by written certificates attorneys -in -fact to act in behalf of the Company in the execution of policies of insurance, bonds, undertakings and other obligatory instruments of like nature. The signature of any officer authorized hereby, and the Corporate seal, may be affixed by facsimile to any power of attorney or special power of attorney or certification of either authorized hereby; such signature and seal, when so used, being adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed. Such attorneys -in -fact, subject to the limitations set forth in their respective certificates of authority shall have full power to bind the Company by their signature and execution of any such instruments and to attach the seal of the Company thereto. The President or any Vice President, the Board of Directors or any other officer of the Company may at any time revoke all power and authority previously given to any attorney -in -fact. IN WITNESS WHEREOF, the UNITED FIRE & CASUALTY COMPANY has caused these presents to be signed by its vice president and its corporate seal to be hereto affixed this CORPORATE 8th day of January A.D. 19 92 SEAL UNITED FIRE St CASUALTY COMPANY oil 666111 By V State of Iowa, County of Linn, ss: On this 8th day of January 19 92 , before me personally came Maynard L. Hansen to me known, who being by me duly sworn, did depose and say: that he resides in Cedar Rapids, State of Iowa; that he is a Vice President of the UNITED FIRE & CASUALTY COMPANY, the corporation described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation. R.G. HECKROTH Notary Public MY COM MISS I ON ember 10, EXPIRES ; M commission e Dec. 10 ,19 92 * • December 10, 1992 y p CERTIFICATION I, the undersigned officer of the UNITED FIRE & CASUALTY COMPANY, do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit, and the copy of the Section of the By -Laws of said Company as set forth in said Power of Attorney, with the ORIGINALS ON FILE IN THE HOME OFFICE OF SAID COMPANY, and that the same are correct transcripts thereof, and of the whole of the said originals, and that the said Power of Attorney has not been revoked and is now in full force and effect. ,N,�:trr►�, In testimony whereof I have hereunto subscribed my name and affixed the cor- AN k''� porate seal of the said �� CORPORATE �� BSAL E Company this 16th day of June 19 92 �+ RYM6• `pip ! !!ltpNP Secretary .i X21 B—esfr.o MEADOW LAKE PARK Flosene MAYMOtM W"OYSAMM Associates SL P..t Uf-f. MY FFONECT No. 405 �n a 1 8 IN r R O ~ o ...... . ... . 251 77 �R CJ J 0 NEW HOPE, MINNESOTA B—esfr.o MEADOW LAKE PARK Flosene MAYMOtM W"OYSAMM Associates SL P..t Uf-f. MY FFONECT No. 405 1! NEW HOPE, MINNESOTA FFM SW PARK R AYCAOM WOVEMEN 8 CRY "M ECP P! 40 Bonesfroo mom Rosene Ander!!k $ Associated 614- n & Archlt-l. B4 PAW, Mlnnsnb Mpwe4 M'Ibdwln q RODUCER Zothschild Bell & Walseth, Inc ?.O. B 7128 3t. Paul, MN 55107 -0128 HONE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. --------------------------------------------------------------------- - - - - -- COMPANIES AFFORDING COVERAGE -------------------- --- --------- ------------------- --------------------------------------------------------------------------- NSURED COMPANY LETTER A Western National Ins. Co. --------------------------------------------------------------------------- krrigoni Brothers Co mpany COMPANY LETTER B )enn i s Arr i gon i - ------------------------------------------------------------------- 317 Vandalia Street COMPANY LETTER C ;t. Paul MN --------------------------------------------------------------------------- i5 114 COMPANY LETTER D COMPANY LETTER E :OVERAGES THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH POLICIES. ------------------------------------------------------------------------------------------------------------------------------- TYPE OF INSURANCE I POLICY NUMBER POLDATEEFF I POLDATEEXP I LIMITS - ------------------------------- GENERAL LIABILITY 1 [XJ COMPREHENSIVE FORM [XI PREMISES /OPERATIONS [ I UNDERGROUND EXPLOSION & COLLAPSE HAZARD [X) PRODUCTS /COMPLETED OPER. EX) CONTRACTUAL [X1 INDEPENDENT CONTRACTORS [XI BROAD FORM PROPERTY DAMAGE CM PERSONAL INJURY . I AUTOMOBILE LIAB rXi AuY AUTO 1[ I ALL OWNED AUTOS (PRIV PASS) I[ I ALL OWNED AUTOS (OTHER THAN PRIV PASS) 1[X1 HIRED AUTOS ([XI NON-OWNED AUTOS [ ) GARAGE LIABILITY I ------------------------------- EXCESS LIABILITY [XI UMBRELLA FORM- [ I OTHER THAN UMBRELLA FORM WORKERS' COMP AND EMPLOYERS' LIAB ------------------------------- OTHER BP 6206 07/01/9207/01/93 --------------- --- -- BODILY INJURY OCC. BODILY INJURY - AGG_ PROP. DAMAGE OCC. PROP. DAMAGE AGG. ------------------- BI & PD COMB. OCC. BI & PD COMB. AGG. HERS. INJURY AGG. BP 6206 --------------------------- BP 6206 BP 6206 BP 6206 07/01/92' 07/01/93 --- ---- ---- ---- ----- --------- 07/01/92 07/01/93 -------- ------- -------- - - - - -- 07/01/92 07/01/93 07/01/92 07/01/93 30DILY INJURY (PER PERSON) ------------------ 30DILY INJURY :PER ACCIDENT) >ROPERTY )AMAGE IODILY INJURY & IROPERTY DAMAGE :OMBINED !ACH OCCURRENCE ' STATUTORY LIMITS ACH ACCIDENT ISEASE-POL. LIMIT ! ISEASE -EACH EMP. -------------- 500,000 500,000 200,000 200,000 ---- ---------- i00, 000 i00, 000 i00, 000 '00, 000 •------ - -- ---- -,000,000 ------- - - - - -- L, 000,000 .00, 000 ;00 00, 000 ------------------------------------------------------------------------------------------------------------------------------ SCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /SPECIAL ITEMS RTIFICATE HOLDER <_ ______________________________> CANCELLATION = SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE_ EX- = PIRATION DATE THEREOF, THE ISSUING COMPANY WILL�D�cXMYOKMAIL 3 0 = DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, it of New Hope = XR45.�4�XX40, 40 Xylon Ave. _ ew Hope MN =------------------------- - - - - -- - - - - -. -. --- �-- ------------------- 5428 = AUTHORIZED REPRESENTATIVE )RD 25 (7/90) _ Kim Brown �/�1 7 r � - COUNCIL Originating Department City Manager Kirk McDonald By : Management Assistant • • M MOTION APPROVING FINAL PAY RE AMOUNT OF $12 FOR FRED SIM EQUIPMENT AND SITE IMPROVMENTS Approved for Agenda Agenda Section Consent Item No. 6.13 TO ARRIGONI BROTHERS CO. IN THE PARK & MEADOW LAKE PARK PLAYGROUND (IMPROVEMENT PROJECT NO. 495) This is the third and Final Pay Request from Arrigoni Brothers Co. in the amount of $12,647.30 for Fred Sims Park & Meadow Lake Park Playground Equipment & Site Improvements (Improvement Project No. 495). The City Engineer reports that the work on this project has been satisfactorily completed and recommends approval of the final payment. The original contract amount was $55,450 and the final amount is about 3.1 % over the contract amount due to minor differences between estimated quantities bid and actual quantities used. Staff recommends approval of a motion approving Final Pay Request to Arrigoni Brothers Co., in the amount of $12,647.30 for the Fred Sims Park & Meadow Lake Park Playground Equipment & Site Improvements (Improvement Project No. 495). • Is : TO: Review: Administration: Finance: December 17, 1992 City of New Hope 4401 Xylon Av N New Hope, MN 55428 Attn: Mr. Larry Watts Finance Director Re: Fred Sims & Meadow Lake Park Playground Equipment & Site Improvements City Project No. 495 File No. 34142 Dear Larry: Michael P. Rau, P.E. Agnes M. Ring, A.I.C.P. Thomas W. Peterson, P.E. Michael C. Lynch, P.E. James R. Maland, P.E. Jerry D. Pertzsch, P.E. Kenneth P Anderson, P.E. Mark R. Rolfs, P.E. Mark A. Seip, PE. Gary W. Morien, P.E. Daniel J. Edgerton, P.E. Daryl K. Kirschenman, PE. Philip J. Caswell, P.E. Mark D. Wallis, P.E. Miles B. Jensen, PE. L. Phillip Gravel III, PE. Karen L. Wiemeri, PE. Gary D. Kristofitz, PE. F. Todd Foster, P.E. Keith R. Yapp, P.E. Shawn D. Gustafson, PE. Cecilio Olivier, P.E. Charles A. Erickson Leo M. Pawelsky Harlan M. Olson James F. Engelhardt Transmitted herewith are three (3) copies of Request for Payment No. 3 & Final along with the required signed Minnesota Withholding Form IC -134 for the above mentioned project. The work on this project has been satisfactorily completed and we recommend payment at this time. The final amount is approximately 3.1 % over the contract amount due to minor differences between estimated quantities bid and actual quantities used. Should you have any questions regarding this project, please feel free to call. Yours very truly, BONE TROD;RO EN E, ANDERLIK & ASSOCIATES, INC. Mark . Hanson MAH:pah:enc 34142.COR 2335 West Highway 36 • St. Paul, Minnesota SS 113 • 612- 636 -4600 Otto G. Bonestroo, PE. Howard A. Sanford P.E. BB ® es &# r®® Joseph C. Ander RE. Robert R. R®sene Marvin L. S P.E. Richard E. Turner, urner, PE. Richard Foster, PE. O. L David oskota. P.E. ® Anderlik & E oyes, PE Thomas E Jerry AC Bourdon, RE, A ssociates Robert G. Schunicht. P.E. Susan M. Eberlin, C.PA. Mark A. Hanson, P.E. Michael T Rautmann, P.E. "Senior Consultant Ted K. Field, P.E. Engineers & Architects Thomas R. Anderson, A.I.A. Donald C. Burgardt, P.E. Thomas E. Angus, P.E. Ismael Martinez, P.E. December 17, 1992 City of New Hope 4401 Xylon Av N New Hope, MN 55428 Attn: Mr. Larry Watts Finance Director Re: Fred Sims & Meadow Lake Park Playground Equipment & Site Improvements City Project No. 495 File No. 34142 Dear Larry: Michael P. Rau, P.E. Agnes M. Ring, A.I.C.P. Thomas W. Peterson, P.E. Michael C. Lynch, P.E. James R. Maland, P.E. Jerry D. Pertzsch, P.E. Kenneth P Anderson, P.E. Mark R. Rolfs, P.E. Mark A. Seip, PE. Gary W. Morien, P.E. Daniel J. Edgerton, P.E. Daryl K. Kirschenman, PE. Philip J. Caswell, P.E. Mark D. Wallis, P.E. Miles B. Jensen, PE. L. Phillip Gravel III, PE. Karen L. Wiemeri, PE. Gary D. Kristofitz, PE. F. Todd Foster, P.E. Keith R. Yapp, P.E. Shawn D. Gustafson, PE. Cecilio Olivier, P.E. Charles A. Erickson Leo M. Pawelsky Harlan M. Olson James F. Engelhardt Transmitted herewith are three (3) copies of Request for Payment No. 3 & Final along with the required signed Minnesota Withholding Form IC -134 for the above mentioned project. The work on this project has been satisfactorily completed and we recommend payment at this time. The final amount is approximately 3.1 % over the contract amount due to minor differences between estimated quantities bid and actual quantities used. Should you have any questions regarding this project, please feel free to call. Yours very truly, BONE TROD;RO EN E, ANDERLIK & ASSOCIATES, INC. Mark . Hanson MAH:pah:enc 34142.COR 2335 West Highway 36 • St. Paul, Minnesota SS 113 • 612- 636 -4600 JAY eoriestroo ® Rosene Owner City of New Hope, 4401 Xylon Av N, New Hope, MN 55428 Date December 11, 1992 For Period October 1 1992 to December 1 1992 Request No. 3 &Final s Anderm & Assoclates ` " $1. P-4 min- Contractor Arrigoni Brothers Co., 817 Vandalia St, St. Paul, MN 55114 REQUEST FOR PAYMENT Fred Sims & Meadow Lake Park Playground Equipment & Site Improvements Project No. 495 File No. 34142 SUMMARY 1 Original Contract Amount 2 Change Order - Addition $ 3 Change Order - Deduction $ 4 Revised Contract Amount 5 Value Completed to Date 6 Material on Hand 7 Amount Earned 8 Less Retainage 9 Sub -Total 10 Less Amount Paid Previously 11 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. 3 & Final $ 55,450.00 $ 55,450.00 $ 57,189.00 $ 0.00 $ 57,189.00 $ 0.00 $ 57,189.00 $ 44,541.70 $ 12,647.30 Approved by Owner: CITY OF NEW HOPE, MN Specified Contract Completion Date: August 28, 1992 Date: 34142. RFP No. Item Part 1 - Fred Sims 1 Furnish & install playground structure with handicap access ramp 2 Furnish and install tire swing 3 Furnish and install space arch clnnber 4 Furnish and install 3 leg swing - 2 sections w/2 seats /section (1 enclosed tot seat) 8' high 5 Furnish and install police car 6 Furnish and install backhoe digger 7 Sand cover & spread existing sand 8 Class 5 100% crushed aggregate base 9 Type 41 bit. wear course (2" thick) 10 Bituminous material for mixture 11 Topsoil borrow 12 Sod Total Part 1 - Fred Sims Part 2 - Meadow Lake 13 Remove existing bituminous surface 14 Remove existing playground equipment 15 6" PVC perforated drain pipe w /geotextile fabric Type I & coarse filter aggregate 16 Geotextile fabric, Type V 17 Common excavation 18 Modular block retaining wall (beige) 19 Class 5 100 % crushed aggregate base 20 Type 41 bit. wear course (2" thick) 21 Furnish and install 6' bench w/back 22 Furnish & install playground structure w/handicap access ramp 23 Furnish and install tire swing 24 Furnish and install space arch climber 25 Furnish and install 3 leg swing - 2 sections w/2 seats /section (1 enclosed tot seat) 8' high 34142.RFP Contract Unit Quantity Amount Unit Quantity Price To Date To Date EA 1 13,000.00 1 13,000.00 EA 1 1,150.00 1 1,150.00 EA 1 620.00 1 620.00 EA 1 1,450.00 1 1,450.00 EA 1 820.00 1 820.00 EA 1 400.00 1 400.00 CY 60 5.00 60 300.00 TN 30 25.00 30 750.00 TN 20 70.00 20 1,400.00 TN 2 150.00 3.84 576.00 CY 15 10.00 10 100.00 SY 200 4.00 125 50000 EA 1 13,000.00 1 13,000.00 $21,066.00 SY 10 10.00 10 100.00 US 1 200.00 1 200.00 LF 100 5.00 100 500.00 SY 580 1.00 580 580.00 I .S 1 2,000.00 1 2,000.00 SF 500 13.00 417 5,421.00 TN 45 22.00 66 1,4.42.00 TN 20 70.00 34 2,380.00 EA 2 350.00 2 700.00 EA 1 13,000.00 1 13,000.00 EA 1 1,150.00 1 1,150.00 EA 1 620.00 1 620.00 EA 1 1,450.00 1 RP -1 1,450.00 Quantity Amount To Date To Date 1 820.00 1 Contract Unit No. Item Unit Quantity Prig 26 Furnish and install police car EA 1 820.00 27 Furnish and install backhoe digger EA 1 400.00 28 Sand cover CY 180 15.00 29 Topsoil borrow CY 100 10.00 30 Sod SY 400 3.00 Total Part 2 - Meadow Lake Total Part 1 - Fred Sims Total Part 2 - Meadow Lake Total Work Completed to Date Quantity Amount To Date To Date 1 820.00 1 400.00 180 2,700.00 85 850.00 600 1,900 00 $36,123.00 21,066.00 36, 123-00 $57,189.00 34142.RFP RP -2 PROJECT PAYMENT STATUS Owner City of New Hope Project Playground Equip. & Site Improv. Project No. 495 File No. 34142 Contractor Arrigoni Bros. Co. CHANGE ORDER No. Date Amount 1 2 3 Total Change Orders - Add PAYMENT SUMMARY $57,189.00 Original Contract $55,450.00 No. Period Payment Retainage Completed 1 Start 9 -1 -92 $23,508.70 $1,237.30 $24,746.00 2 9 -1 -92 10 -1 -92 21,033.00 2,344.30 46,886.00 3 10 -1 -92 12 -1 -92 12,647.30 0.00 57,189.00 4 5 6 7 8 9 10 Total Payment to Date $57,189.00 Original Contract $55,450.00 Retainage, Payment No. 3 & Final 0.00 Change Orders 0.00 Total Value Completed $57,189.00 Revised Contract $55,450.00 34142.RFP RP -3 us' ego Trust Tax v Fonn ' `Minnesota Department ofRevenue |C-134 Rev. 9/89 Withholding Affidavit for Contractors This affidavit must be approved by the Minnesota Department of Revenue before the State o' Minnesota or any of its subdivisions can make final payment to contractors. Company name Address Cit DEC "��� / , / 199p &RRZ COMPANY 817 Vao6aliu Street St yaoI State Mn z* ,-^551I4 Minnesota ID number Month/year work began Month/year work ended Total contract amount: Telephone number Amount still due: Did you have employees work on this project? Project number: 495 Yes If none, explain who did the work: Project location: City of New Hope Project owner: i �ty_ of New Hope Address Check the box that describes your iinvolvement in the project and fill in all information requested in that category: El Sole contractor [] Subcontractor If you are a subcontractor, fill in the name and address of the contrac that hired you: EX Prime Contractor If you subcontracted out any work on this project, all of your subcontractors must file their own IC-1 34 affidavits and have them certified by the Department of Revenue before you can file your affidavit. For each subcontractor you had, fill in the business information below, and attach a copy of each subcontractor's certified IC-134. (If you need more space, attach a separate sheet.) Business name Address — Owner/Officer — Asphalt Specialties Box 838 Lakeland MN 55043 Erik PgteLrson I declare I that all information I hcve filled in on this form is true and I complete to the best of my knowledge and belief. I authorize the Department of Revenue to disclose pertinent information relating to this project, including sending copies of this form, Title Date kCont -c x For certification, mail to: Minnesota Department of Revenue, Business Trust Tax Section Mail Station 6610, St. Paul, MN 55146-6610 Certificate of Compliance with Minnesota Income Tax Withholding Law Based on records of the Minnesota Department of Revenue, i certify that the contractor who has signed this certificate has fulfilled all the requirements of Minnesota Statutes 2UO.82and 29O.87 concerning the withholding of Minnesota income tax from wages paid to employees relating to contract services with the s te of Minnesota and/or its subdivisions. 3 Uimeo Try 10 Fo rm Minnesota Department of Revenue j Withholding C 1 Rev. 9/89 This affidavit must be approved by the Minnesota Department of Revenue before the State of Minnesota or any of its subdivisions can make final payment to contractors. Company name Minnesota ID number METRO LANDSCAPING (D3 1 6 y Address Month /year work began 624 FERNDALE ST. OCT. 92 City State Zip Code Month /year work ended MAPLEWOOD MN 55119 OC T 92 Total contract amount: 1087.00 Telephone number Amount still due: ( 612) 735 9 364 50.00 Did you have employees work on this project? Project number: 495 If none, explain who did the work: YES Project location: CITY OF NEW HOPE Project owner: CTTY nF NF.W H(lPF Address 4401 XYLON AV. Check the box that describes your involvement in the project and fill in all information requested in that category: ❑ Sole contractor Subcontractor If you are a subcontractor, fill in the name and address of the contractor that hired you: ARRIGONI BROS. COMPANY 817 VANDALIA ST ST. PAUL MN 55114 ❑ Prime Contractor If you subcontracted out any work on this project, all of your subcontractors must file their own IC -134 affidavits and have them certified by the Department of Revenue before you can file your affidavit. For each subcontractor you had, fill in the business information below, and attach a copy of each subcontractor's certified IC -134. (If you need more space, attach a separate sheet.) Business name Address Owner /Officer I declare that all information 1 have filled in on this form is true and complete to the best of my knowledge and belief. I authorize the Department of Revenue to disclose pertinent information relating to this project, including sending copies of this form, to the prime contractor if I am a subcontractor, and to any subcontractors if I am a prime contractor, and to the contracting agency. Contractor's signature Title Date ri _ For certification, mail to: Minnesota Department of Revenue, Business Trust Tax Section Mail Station 6610, St. Paul, MN 55146 -6610 Certificate of Compliance with Minnesota Income Tax Withholding Lawn Based on records of the Minnesota Department of Revenue, I certify that the contractor who has signed this certificate has fulfilled all the requirements of Minnesota Statutes 290.92 and 290.97 concerning the withholding of Minnesota income tax from w ages p aid to employees relating to contract services with the state of Minnesota and /or its subdivisions. Signature of authorized Department of Revenue official Da .^ l ? A s 0 bEC 17 1992 Company name Address e )c F City State Zip Code BSc) Please type or print clearly above. This will be your mailina lab el for returnina the completed form. Minnesota ID number 5pecll*,17C 0. , Month /year work began Month /year work ended o 17, Total contract amount: a Amount still due: ; , _ Telephone number ( 6f, ) ' 1-36 -- .' ?J Did you have employees work on this project? If none, explain who did the work: I 0 M Project location: Q 6 °y P 1= )A. Project owner: ' 7 a 1 4Z Address, Check the box that describes your involvement in the project and fill in all information requested in that category: ❑ Sole contractor Subcontractor If you are a subcontractor, fill in the name and address of the contractor that hired you: ❑ Prime Contractor If you subcontracted out any work on this project, all of your subcontractors must file their own IC -134 affidavits and have them certified by the Department of Revenue before you can file your affidavit. For each subcontractor you had, fill in the business information below, and attach a copy of each subcontractor's certified IC -134. (If you need more space, attach a separate sheet.) Business name Address Owner /Officer I declare all forma' I h ve filled in on this form is true and complete to the best of my knowledge and belief. I authorize t epa ent of venue o disclose pertinent information relating to this project, including sending copies of this form, to a or' contractor' I am Aulilcontractor, and to any subcontractors if I am a prime contractor, and to the contracting agency. Contractor's For certification, mail original and one copy to: Minnesota Department of Revenue, Business Trust Tax Section Mail Station 6610, St. Paul, MN 55146 -6610 Date Certificate of Compliance with Minnesota Income Tax Withholding Law Based on records of the Minnesota Department of Revenue, I certify that the contractor who has signed this certificate has fulfilled all the requirements of Minnesota Statutes 290.92 and 290.97 concerning the withholding of Minnesota income tax from wages paid to employees relating to contract services nith th se of Minnesota and /or its subdivisions. Signature of authorized Date DEC' 17 492 5000134