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Imp. Proj. #489-21 1 ti ° f � $ � 1 ri I x Wj Ig AET JOB NO. Q ')— '7 0 ') DA TE 4/ PA GE TIN . G PARKING STAL-Lg 1 .6 — e" w.. AET JOB NO: 92-792 LOG OF BORING NO. _ I of 2) PROJECT: CITY HALL ADDITION; NEW HOPE, MDINESOTA DEPTH IN SURFACE ELEVATION: 917. 1 GEOLOGY N MC SAMPLE REC. FIELD & LABORATORY TESTS WC DEN LL PL Qu FEET MATERIAL DESCRIPTION 7.4 5.5 TYPE IN. 3/30/92 Fill, mostly clayey sand with a little gravel, 26.0 24.5 11 M 23.1 SS 16 1:43 26.0 0.0 24.0 17.3 black and brown COMPLETED: 3/30/92 FILL 1 1 1 1 1 CC: KS CA: SV Rig: 24 1 2 - 1 1 1 THIS LOG 3 - Organic lean clay, black, firm (OL) (may be TOPSOIL 9 M SS 8 fill) OR FILL 4 - 3 SS 13 21 6 7 - TW Clayey sand with a little gravel, brown 14 125 911 8 — mottled, very soft to firm (SC) z ps- 9 - 10 - 11 W SS 16 TILL 18 M SS 14 13 - 14 - 15 20 M SS 0 16 - Clayey sand with a little gravel, grayish brown to gray, hard to firm (SC) 17 18 19 20 14 M 1 SS is 21 DEPTH: DRILLING METHOD WATER LEVEL MEASUREMENTS I NOTE: REFER TO 0-24.5 2.25" HSA DATE TIME SAMPLED DEPTH DEPTH DEPTH DEPTH DRILLING FLUID LEVEL WATER LEVEL THE ATTACHED 3/30/92 12:00 9.0 7.0 7.4 5.5 SHEETS FOR AN EXPLANATION OF 3/30/92 1:15 26.0 24.5 25.1 23.1 BORING 3/30/92 1:43 26.0 0.0 24.0 17.3 TERMINOLOGY ON COMPLETED: 3/30/92 1 1 1 1 1 CC: KS CA: SV Rig: 24 1 1 1 1 THIS LOG 4/90 AMERICAN ENGINEERING TESTING, INC. •' :! AET JOB NO: 92 -792 LOG OF BORING NO. 1 (p. 2 of 2) PROJECT: CITY HALL DITI ®N, NEW HOPE, MUiNESOTA DEPTH GEOLOGY N MC SAMPLE REC. FIELD &LABORATORY TEST FEET MATERIAL DESCRIPTION I I I I TYPE IN. WC I DEN I LL I PL I Q. R1 24 25 Clayey sand with a little gravel, brown, very hard (SC) 26 END OF BORING 0014 36 1 M M SS 1 12 4/90 AMERICAN ENGINEERING TESTING, INC. Boom= "1101*ltu I'll AET JOB NO: 92-792 LOG OF BORING NO. 2 (p. 1 of 2) PROJECT: CITY HALL ADDITION; NEW HOPE, A111'4NMOTA NOTE: REFER TO DEPTH IN SURFACE ELEVATION: 917.5 GEOLOGY N I MC SAMPLE REC. FIELD & LABORATORY TESTS WC DEN LL PL Qu FEET MATERIAL DESCRIPTION DEPTH FLUID LEVEL TYPE IN. Fill, mostly sand with silt and a little gravel 3:18 26.0 2 M SS 16 NONE SHEFrS FOR AN EXPLANATION OF 3/30/92 3:30 26.0 and concrete, brown, a layer of black silt at 8.1 FILL NONE BORING COMPLETED: 3/30/92 the surface CC: KS CA: SV Rig: 24 -----L --------- THIS LOG Y 8 M SS 10 13 3 4 11 M SS 12 6 7 Clayey sand with a little gravel, brown mottled to grayish brown, soft to hard to firm, 16 M SS is 8 a few laminations of sand (SC) 9 10 TILL 16 M SS 14 12 13 M SS 14 13 14 - 15 — Y 11 M SS 14 16 17 Clayey sand with a little gravel, gray, firm to very hard (SC) 18 19 20 11 M SS 16 zl DEPTH: DRILLING METHOD WATER LEVEL MEASUREMENTS NOTE: REFER TO DATE TIME SAMPLED CASING I CAVE-IN DRILLING WATER THE ATTACHED 0-24.5 3.25" HSA DEPTH DEPTH DEPTH FLUID LEVEL LEVEL 3/30/92 3:18 26.0 24.5 26.0 NONE SHEFrS FOR AN EXPLANATION OF 3/30/92 3:30 26.0 0.0 8.1 NONE BORING COMPLETED: 3/30/92 TERMINOLOGY ON CC: KS CA: SV Rig: 24 -----L --------- THIS LOG 4/90 AMERICAN ENGINEERING TESTING, INC. ACE G I1 AET JOB NO: 92 -792 LOG OF BORING NO. _ 2 (p. 2 of 2) PROJECT: CITY HALL ADDITION, N W HOPE, MMNNESOTA DIIN H GEOLOGY N MC SAMPLE REC. FIELD &LABORATORY TEST FEET MATERIAL DESCRIPTION TYPE IN. WC DEN LL PL Qu 23 24 TILL 25 34 M SS 22 26 OF BORING 4190 SECTION 00800. SUPPLEMENTARY CONDITIONS PART 1 - GENERAL 1.01 SECTION INCLUDES A. The Supplementary Conditions modify, delete or add to the Conditions of the Contract. PART 2 - AMENDMENTS TO THE GENERAL CONDITIONS 2.01 AMENDMENT TO ARTICLE 1.14 ENGINEER A. The term "Engineer" shall be taken to mean "Engineer or Architect ". The "Engineer /Architect" shall be the authorized representative of the entity named in the Contract Documents. The terms "Engineer" and "Architect" can be used interchangeably. 2.02 AMENDMENTS TO ARTICLE 2.2 INTERPRETATION OF QUANTITY ESTIMATES A. This article shall be deleted. There shall be no Quanity Estimates as part of this project. 2.03 AMENDMENTS TO ARTICLE 2.10 EVALUATION OF PROPOSALS A. Delete all references to unit prices and unit price Proposals. There shall be no unit prices as part of this project. 2.04 AMENDMENTS TO ARTICLE 4.2 ORDER OF PRECEDENCE A. To clarify the Order of Precedence, the Agreement shall have the high- est priority followed by the other documents in the order listed. 2.05 AMENDMENTS TO ARTICLE 6.6 WARNING SIGNS AND BARRICADES A. Delete references to the need for colored lights and night protection by colored signal lights. 2.06 AMENDMENTS TO ARTICLE 7.1 ENGINEER'S STATUS AND AUTHORITY A. Amend paragraph 3 as follows: 1. Delete references to "resident project representative ". A full - time Resident Project Representative will not be required on this project. ;� i IrI�ZI7i 3414651 2.07 AMENDMENTS TO ARTICLE 7.4 ASSIGNMENT OF CONTRACT A. The Contractor shall not be required to "...perform with his own organization, work amounting to not less than 50 percent of the total original contract price ". 2.08 AMENDMENTS TO ARTICLE 8.1 QUALITY OF EQUIPMENT AND MATERIALS A. Substitutions will only be allowed by prior written approval during the bidding process or as otherwise noted in Section 01600 Material and Equipment. 2.09 AMENDMENTS TO ARTICLE 9.1 DETAILED BREAKDOWN OF CONTRACT AMOUNT A. Delete reference to unit prices. 2.10 AMENDMENTS TO ARTICLE 9.2 REQUEST FOR PAYMENT A. Delete reference to unit prices. 2.11 AMENDMENTS TO ARTICLE 9.9 FINAL INSPECTION A. The date of Final Inspection must occur on or before the Completion Date specified in the Contract Documents or liquidated damages shall be enforced. All deficiencies listed during the Engineer /Architect's Final Inspection must be completed within fourteen (14) days after the date of Final Inspection or liquidated damages shall be enforced. 2.12 AMENDMENTS TO ARTICLE 11.2 CHANGE IN CONTRACT PRICE A. Amend paragraph 1 as follows: 1. Delete references to unit prices. 2.13 AMENDMENTS TO FORM OF AGREEMENT A. Amend Article III as follows: 1. Delete reference to unit prices and the schedule of quantities. B. Amend Article IV as follows: 1. Component parts of Specifications shall be: a. Bid Documents (Advertisement for Bids, Addenda, Instructions to Bidders, Bid Forms - Proposal, Bid Bond). b. Conditions of the Contract c. Supplementary Conditions rfflr+ 3414651 d. Agreement e. Performance Bond £. Labor and Material Payment Bond g. Technical Specifications (Div. 1 -16) h. Detail Plates and other drawings attached to the Specifications End of Section 00800 -3 3414651 ACKNOWLEDGMENT OF PRINCIPAL (Individual) STATE OF COUNTY OF t ss.: On this day of in the year 19 , before me personally come(s) to me known and known to me to be the person(s) who (is) (are) described in and who executed the foregoing instrument and acknowledge(s) to me that he executed the same. NOTARY PUBLIC ACKNOWLEDGMENT OF PRINCIPAL (Partnership) STATE OF ss.: COUNTY OF On this day of in the year 19 , before me personally come(s) a member of the co- partnership of to me known and known to me to be the person who is described in and who executed the foregoing instrument, and acknowledges to me that he executed the same as and for the act and deed of the said co- partnership. NOTARY PUBLIC ACKNOWLEDGMENT OF PRINCIPAL (Corporation) STATE OF ss.: COUNTY OF 1 On this day of in the year 19 , before me personally come(s) to me known, who, being by me duly sworn, deposes and says that he resides in the City of that he is the of the the corporation described in and which executed the foregoing instrument; that he knows the seal of the said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed by the order of the Board of Directors of said corporation, and that he signed his name thereto by like order. NOTARY PUBLIC ACKNOWLEDGMENT OF SURETY STATE OF Minnesota COUNTY OF_ Ramsey ss.: On this 31st day of July in the year 19 92 , before me personally come(s) Kurt C. Lundblad Attorneys) -in -Fact of Firemen's Insurance Company of ewar , NJWith whom I am personally acquainted, and who, being by me duly sworn, says that he reside(s) in t. Paul, MN that he is (are) the Attorneys) -in -Fact of Firemen nsurance Gompany of Newark, NJ the company described in and which executed the within instrument; that he know(s) the corporate seal of such Company; and that the seal affixed to the within instrument is such corporate seal and that it was affixed by order of the Board of Directors -� V of said Company, and that he sign said m trut at '��x y ct of the said Company by like order. 3 MARY Pt§gl O-MM I id ` SEY Ct3U0Y My Commission Expires NOTARY PUBLIC F.9713 — 8/81 ite ii Firemen's Company Newark, •, J ersey Know all men by these Presents, That the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY has made, constituted and appointed, and by these presents does make, constitute and appoint KURT C. LUNDBLAD OF SAINT PAUL, MINNESOTA its true and lawful attorney, for it and in its narne, place, and stead to execute on behalf of the said Company, as surety, bonds, undertakings and contracts of suretyship to be given to ALL OBLIGEES provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed in amount the sum of TEN MILLION (10,000,000) DOLLARS This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY at a meeting duly called and held on the 13th day of January, 1989: "RESOLVED, that the Chairman of the Board, the Vice Chairman of the Board, the President, an Executive Vice President or a Senior Vice President or a Vice President of the Company, be, and that each or any of them hereby is, authorized to execute Powers of Attorney qualifying the attorney named in thegiven Power of Attorney to execute in behalf of the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY, bonds, undertakings and all contracts of suretyship; and that an Assistant Vice President, a Secretary or an Assistant Secretary be, and that each or any of them hereby is, authorized to attest the execution of any such Power of Attorney, and to attach thereto the seal of the Company. FURTHER RESOLVED, that the signatures of such officers and the seat of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and anysuch Powerof Attorney orcertificate bearing such facsimile signatures or facsimile seal shall be valid and binding upon the Company when so affixed and in the future with respect to any bond, undertaking or contract of suretyship to which it is attached." In Witness Whereof, the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY has caused its official seal to be hereunto affixed, and these presents to be signed by one of its Vice Presidents and attested by one of its Assistant Vice Presidents this26 day of J N E 19 90 Attest: FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY By D.L. Banta, Assistant Vice President STATE OF CONNECTICUT COUNTY OF HARTFORD Emil B. Askew, Vice President On this 26day of JUNE , 1990, before me personally came Emil B. Askew, to me known, who being by me duly sworn, did depose and say that he is a Vice President of the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY, the corporation described in and which executed the above instrument; that he knows the seal of the said corporation; that the seal affixed to the 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 thereto by like order. l ' tAOTARY GLORIA D. SEEKINS NOTARY PUBLIC CERTIFICATE My Commission Expires March 31, 1993 I, the undersigned, an Assistant Vice President of the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY, a New Jersey corporation, DO HEREBY CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked; and furthermore that the Resolution of the Board of Directors, set forth in the said Power of Attorney, is now in force. Signed and sealed at the town of Farmington, the State of Connecticut. Dated the 31st da of July 1992 r J. Dennis Lane, Assistant Vice President 21 BOND 4315L { '; %r, - °;;+ PrintPtt in 11 9 A ACKNOWLEDGMENT OF PRINCIPAL (Individual) STATE OF COUNTY OF ss.: On this day of in the year 19 , before me personally come(s) to me known and known to me to be the person(s) who (is) (are) described in and who executed the foregoing instrument and acknowledge(s) to me that he executed the same. NOTARY PUBLIC ACKNOWLEDGMENT OF PRINCIPAL (Partnership) STATE OF l ss.: COUNTY OF j On this day of in the year 19 before me personally come(s) a member of the co- partnership of to me known and known to me to be the person who is described in and who executed the foregoing instrument, and acknowledges to me that he executed the same as and for the act and deed of the said co- partnership. NOTARY PUBLIC ACKNOWLEDGMENT OF PRINCIPAL (Corporation) STATE OF ss.: COUNTY OF 1 On this day of in the year 19 , before me personally comes) to me known, who, being by me duly sworn, deposes and says that he resides in the City of that he is the of the the corporation described in and which executed the foregoing instrument; that he knows the seal of the said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed by the order of the Board of Directors of said corporation, and that he signed his name thereto by like order. NOTARY PUBLIC ACKNOWLEDGMENT OF SURETY STATE OF Minnesota COUNTY OF_ Ramsey ss.: On this 31st day of July in the year 19 9 , before me personally come(s) Kurt C. Lundblad Attorneys) -in -Fact of Firemen's Insurance Company of ewar , 'Lith whom I am personally acquainted, and who, being by me duly sworn, says that he reside(s) in t. Paul, MN that he is (are) the Attorneys) -in -Fact of Firemen assurance C ompany of ewar J the company described in and which executed the within instrument; that he know(s) the corporate seal of such Company; and that the seal affixed to the within instrument is such corporate seal and that it was affixed by order of the Board of Directors of said Company, and that he sign salda, truir e t, s3 Q , ct of the said Company by like order. RX-ASEY COUNTY P4y C6El mis gp s ,r i � m ( E x pires NOTARY PUBLIC F.4713 -- 8/81 Firemen's Insurance C Know all men by these Presents, That the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY has made, constituted and appointed, and by these presents does make, constitute and appoint KURT C. LUNDBLAD OF SAINT PAUL, MINNESOTA its true and lawful attorney, for it and in its name, place, and stead to execute on behalf of the said Company, as surety, bonds, undertakings and contracts of suretyship to be given to ALL OBLIGEES provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed in amount the sum of TEN MILLION (10,000,000) DOLLARS This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY at a meeting duly called and held on the 13th day of January, 1989: "RESOLVED, that the Chairman of the Board, the Vice Chairman of the Board, the President, an Executive Vice President or a Senior Vice President or a Vice President of the Company, be, and that each orany of them hereby is, authorized to execute Powers o(Attorney qualifying the attorney named in the given Power of Attorney to execute in behalf of the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY, bonds, undertakings and all contracts of suretyship; and that an Assistant Vice President, a Secretary or an Assistant Secretary be, and that each or any of them hereby is, authorized to attest the execution of any such Power of Attorney, and to attach thereto the seal of the Company. FURTHER RESOLVED, that the signatures of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and anysuch Power of Attorney or certificate beating such facsimile signatures or facsimile seal shall be valid and binding upon the Company when so affixed and in the future with respect to any bond, undertaking or contract of suretyship to which it is attached." In Witness Whereof, the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY has caused its official seal to be hereunto affixed, and these presents to be signed by one of its Vice Presidents and attested by one of its Assistant Vice Presidents this26 day of JUNE 19 90 Attest: FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY By • r d! • f D.L. Banta, Assistant Vice President STATE OF CONNECTICUT COUNTY OF HARTFORD u.: Emil B. Askew, Vice President On this 26day of JUNE , 1590, before me personally came Emil B, Askew, to me known, who being by me duly sworn, did depose and say that he is a Vice President of the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW )ERSEY, the corporation described in and which executed the above instrument; that he knows the seal of the said corporation; that the seal affixed to the 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 thereto by like order. O P�P, NoTARy + C}� GLORIA D. SEEKINS NOTARY PUBLIC CERTIFICATE My Commission Expires March 31, 1993 1, the undersigned, an Assistant Vice President of the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY, a New Jersey corporation, DO HEREBY CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked; and furthermore that the Resolution of the Board of Directors, set forth in the said Power of Attorney, is now in force. Signed and sealed at the town of Farmington, the State of Connecticut, Dated the 31st da of July 1992 L Dennis Lane, Assistant Vice President 21 BOND 4315E Or °iil� printpri in 11 t A n STATE OF_ COUNTY OF ss.: On this day of in the year 19 , before me personally come(s) to me known and known to me to be the person(s) who (is) (are) described in and who executed the foregoing instrument and acknowledge(s) to me that he executed the same. NOTARY PUBLIC ACKNOWLEDGMENT OF PRINCIPAL (Partnership) STATE OF ss.: COUNTY OF On this day of in the year 19 , before me personally come(s) a member of the co- partnership of to me known and known to me to be the person who is described in and who executed the foregoing instrument, and acknowledges to me that he executed the same as and for the act and deed of the said co- partnership. NOTARY PUBLIC ACKNOWLEDGMENT OF PRINCIPAL (Corporation) STATE OF ss.: COUNTY OF 1 On this day of in the year 19 , before me personally come(s) to me known, who, being by me duly sworn, deposes and says that he resides in the City of that he is the of the the corporation described in and which executed the foregoing instrument; that he knows the seal of the said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed by the order of the Board of Directors of said corporation, and that he signed his name thereto by like order. NOTARY PUBLIC ACKNOWLEDGMENT OF SURETY STATE OF Minnesota COUNTY OF_ Ramsey ss.: On this 31st day of July in the year 19 " before me personally come(s) Kurt C. Lundbl Attorneys) -in -Fact of Firemen's Insurance Company of ewar , Nwith whom I am personally acquainted, and who, being by me duly sworn, says that he reside(s) in t. Paul, MN that he is (are) the Attorneys) -in -Fact of Firemen Insurance Company of Newark, NJ the company described in and which executed the within instrument; that he know(s) the corporate seal of such Company; and that the seal affixed to the within instrument is such corporate seal and that it was affixed by order of the Board of Directors of said Company, and that he signed f"stmrnentvvAttgm& 4vHvmRa f the said Company by like order. ACKNOWLEDGMENT OF PRINCIPAL (individual) H S E N I�0�ii� f �b IE�r'iiS'[r� A bra e B (� fi �iVIS'EY Vj'i. i� l Ji NOTARY PUBLIC F.9713 — e/81 -� 8 t6 "y� �'`�, � •� Firem I nsurance ; , N 11 1 Know all men by these Presents, That the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY has made, constituted and appointed, and by these presents does make, constitute and appoint KURT C. LUNDBLAD OF SAINT PAUL, MINNESOTA its true and lawful attorney, for it and in its name, place, and stead to execute on behalf of the said Company, as surety, bonds, undertakings and contracts of suretyship to be given to ALL OBLIGEES provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed in amount the sum of TEN MILLION (10,000,000) DOLLARS This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY at a meeting duly called and held on the 13th day of January, 1989: "RESOLVED, that the Chairman of the Board, the Vice Chairman of the Board, the President, an Executive Vice President or a Senior Vice President or a Vice President of the Company, be, and that each oranyof them hereby is, authorized to execute Powers of Attorney qualifying the attorney named in the given Powerof Attorney to execute in behalf of the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY, bonds, undertakings and all contracts of suretyship; and that an Assistant Vice President, a Secretary or an Assistant Secretary be, and that each or any of them hereby is, authorized to attest the execution of any such Power of Attorney, and to attach thereto the seal of the Company. FURTHER RESOLVED, that the signatures of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be valid and binding upon the Company when so affixed and in the future with respect to any bond, undertaking or contract of suretyship to which it is attached." In Witness Whereof, the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY has caused its official seal to be hereunto affixed, and these presents to be signed by one of its Vice Presidents and attested by one of its Assistant Vice Presidents this26 day of J N E 19 90 Attest: FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY By D.L. Banta, Assistant Vice Resident STATE OF CONNECTICUT COUNTY OF HARTFORD C ', �- )s . AJ-Lj� Emil B. Askew, Vice President On this 26day of JUNE , 1580, before me personally came Emil B. Askew, to me known, who being by me duly sworn, did depose and say that he is a Vice President of the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY, the corporation described in and which executed the above instrument; that he knows the seal of the said corporation; that the seal affixed to the 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 thereto by like order. r w,^ S �pop..�... . ' ppTARy s . GLORIA D. SEEK NOTARY PUBLIC CERTIFICATE My Commission Expires March 31, 1993 I, the undersigned, an Assistant Vice President of the FIREMEN'S INSURANCE COMPANY OF NEWARK, NEW JERSEY, a New Jersey corporation, DO HEREBY CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked; and furthermore that the Resolution of the Board of Directors, set forth in the said Power of Attorney, is now in force. Signed and sealed at the town of Farmington, the State of Connecticut. Dated the 31st day of July 1992 _. J. Dennis lane, Assistant Vice President 21 BOND 4315E ° ' , +`'• Printed in U.S.A. COUNCIL M-A Originating Department Parks and Recreation Shari French By: Approved for Agenda 9/28/92 Agenda Section Consent Item No. 6.13 RESOLUTION APPROVING CHANGE ORDER #1 FOR IMPROVEMENT PROJECT NO. 489 (CITY HALL IMPROVEMENTS) IN THE AMOUNT OF $2,340.00 Change order #1 includes a deduct of $325 because the contractor is using electrical power from the City and not providing their own. It also included an additional $2,665 because existing soils found under the footings in the main entryway were unstable and contaminated with construction debris. The contractor was ordered to remove this material and replace it with granular fill. The total for change order #1 is an addition of $2,340-00 to the contract. The contract is now at $855,940.00. Staff recommends approval of change order #1. 1W Review: Administration: Finance: SECOND BY CITY OF NEW HOPE RESOLUTION NO. 92- 165 RESOLUTION APPROVING CHANGE ORDER #1 FOR IMPROVEMENT PROJECT NO. 489 (CITY HALL IMPROVEMENTS) IN THE AMOUNT OF $2340.00 WHEREAS, the City of New Hope authorized on July 27, 1992, Improvement Project No. 489, for the contractual sum of $853,600.00; and WHEREAS, it has become necessary to include additional work for the project which consists of: Change order #1: Use of City electrical power: ($325.00) Remove existing soils and bring in granular fill: $2,665.00 Total: $2,340.00 NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of New Hope approves change order no. 1 to the contract with G. W. Olsen Construction in the amount of $2,340.00 as part of Improvement Project No. 489 which brings the total contract to $855,940.00. Adopted by the City Council of the City of New Hope, Hennepin County, Minnesota, this 28th day of September, 1992. J /-Q�e C_4r. 0Z Mayor Attest : CCU City Clerk Engfn4mrs & Architects SL Paul ® MIMPukrr Fax 612-638-1311 • • TO: 4jjZZt Arj mL&JrjJ Fax Numbe i a t .. _ art■ �- a a _J # r Remarks: airy .. _ .maw 16 or rr + • a + r , 81 19nea at your earliest convenlenoe. Thank You. TO'cl 'OSSb 2 OOi�1SSN09 TTET 929 ET9 ST :OT ESST —SE-60 71 ? , P - , 6- 1 i . ^ 1� !JAL' =,EPI ® I ' s TRI Ip T 7 �.�1 t !E B T Ft t A 19 6 CI C T 4i T R >wP 4 +a. P. 2 Ir e 1 Past�`t'" br�hd t;�X tra, rbm rr RIM. o 'OSSV T MJISSNO9 sonestroo ' R y tt� A I t I MOOMQRre it ArC +a. P. 2 Ir e 1 Past�`t'" br�hd t;�X tra, rbm rr RIM. o 'OSSV T MJISSNO9 TT2T 929 ZT9 ST:OT 666T —SZ -60 I t TT2T 929 ZT9 ST:OT 666T —SZ -60 UtVKUt VV. ULZOtN �Jju CONSTRUCTION CO., INC. LEETTEEM OF IrMUMMITMUL 0 Box 20 1902 S. Greeley St. STILLWATER, MN 55082-0020 Phone 439-5410 TO City of New Hope 4401 Xylon Ave. No. New Hope, MN 55428 DATE 01 October 8. 19-92 920a3 ATTENTION Shari RE: NPTJ Nnno City Hall RpTnnaplin New Hope, MN > WE ARE SENDING YOU KXAttached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter )9 Change order ❑ COPIES DATE NO. Approved as submitted ❑ Resubmit copies for approval DESCRIPTION 4 ❑ Approved as noted Change Order #1 ❑ Returned for corrections ❑ Return -corrected prints ❑ For review and comment XX Signed by GWO ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US Nowarm ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return -corrected prints ❑ For review and comment XX Signed by GWO ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US COPY T PRODUCT240-2 L_1V=6_&S M. Groton, Mass. 0101 It enclosures are not as noted, kindly notify 4401 Xy /on Avenue North New Hope, Minnesota 55428 Phone: 531 -5100 FAX (612) 531 -5174 October 12, 1992 G.W. Olson Construction Box 20 Stillwater, MN 55082 -0020 SUBJECT: CHANGE ORDER NO. 1 - IMPROVEMENT PROJECT 489 Enclosed are two fully executed copies of the above - referenced Change Order for your records. Please forward one copy to your bonding company. The change order was approved on September 28, 1992, by the New Hope City Council. If you have any questions, please contact me. Sincerely, Valerie Leone City Clerk enc. cc: City Engineer Family Styled City For Family Living CO UNCIL � • DP�110�13 • • • Change Order #2 includes a total addition of $29,183.00. The 13 items included in this change order are on the addendum attached. With change order #1 and #2 the contract is now at $885,123.00. Staff recommends approval of change order #2. MOTION BY SECOND BY TO: Review: Administration: Finance: RFA-001 CITY OF NEW HOPE RESOLUTION NO. 92- 206 RESOLUTION APPROVING CHANGE ORDER #2 FOR IMPROVEMENT PROJECT NO. 489 (CITY HALL IMPROVEMENTS) IN THE AMOUNT OF $29,183.00 WHEREAS, the City of New Hope authorized on July 27, 1992, Improvement Project No. 489, for the contractual sum of $853,600.00; and WHEREAS, the City of New Hope authorized on 9/28/92 change order #1 in the amount of $2,340; and WHEREAS, it has become necessary to include additional work for the project which is outlined on the addendum in the amount of $29,183.00. NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of New Hope approves change order no. 2 to the contract with G. W. Olsen Construction in the amount of $29,183.00 as part of Improvement Project No. 489 which brings the total contract to $885,123.00. Adopted by the City Council of the City of New Hope, Hennepin County, Minnesota, this 14th day of December, 1992. -- /Mayor Attest: _ City Clerk CITY HALL REMODELING PROJECT #489 CHANGE ORDER #2 12/14/92 #1 Increase Electric service: $ 4,387 #2 Modify fire alarm system: $ 947 #3 Lower corridor floor tile: $ 1,122 #4 Replace quarry tile between elevator and chambers as well as in Police entry and retile with new porcelain tile plus add decorative border: $ 8,860 #5 Replace existing lobby carpeting: $ 1,156 #6 Raise existing manhole 1 1 : $ 803 #7 Slope new slab at garage floor to drain: $ 5,453 #8 Replace existing 4 11 water service: $ 2,658 #9 Replace brick veneer at garage columns: $ 5,830 #10 Leave existing garage door (west side): <$457> #11 P&R counter door change: <$551> #12 Block type change at elevator: <$391> #13 Delete 75 lin. ft. drain tile at plaza: <$750> Total: $29,183.00 December 10, 1992 City of New Hope 4401 Xylon. Ave. No. New Hope, MN 55428 Attn: Shair French Re: New Hope City Hall Remodeling New Hope, MN Dear Shari: We are enclosing herewith four (4) copies of signed Change Order #2. Our records indicate that item #11 should be a credit of $390.00 (Three Hundred Ninety Dollars) in lieu of $551.00 (see attached transmittal). We suggest the $161.00 difference be made up on a future Change Order rather than re-issuing this one. Also, this Change Order will extend completion time, this also can be included in a future Change Order. As always, if you have any questions, feel free to contact me. Sincerely, GEORGE W. OLSEN CONSTRUCTION CO., INC. < �teeterson JP /mw Encl: CC: Milt Powell W CONSTRUCTION CO., INC. Box 20 1902 S. Greeley St. STILLWATER, MN 55082 -0020 Phone 439 -5410 TO BeoUstroo , Rosene, Anderlik & Assoc. 2335 W. Highway 36 St. Paul, MN 55113 LETTE OF TRANSIYI101 DATE ' October 16, 1992 .108 NO. 92033 ATTENTION Milt Powell New Hope City Remodeling New Hope, MN ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use > WE ARE SENDING YOU [RXAttached ❑ Under separate cover via the following items: Yg Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION 5 Revised Coiling poor THESE ARE TRANSMITTED as checked below: OXFor approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distributiop > ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS Please be advised there would be a credit in the amount of $390.00 for this non rated shutter. COPY TO SIGNED:, PRODUCT 240.2 B i,, cmW, hl� man. If enclosures are not as noted, kindly notify us at once. �'� I CITY OF NEW HOPE REVENUE AND EXPENDITURES- COMPARED TO BUDGET CITY HALL EXPANSION PROJECT DECEMBER 10, 1992 ---- ------- --- -- --- --- ----- - - - - -- ----- - - -- -- ------ --- - - ---- ------ - - - - - -- -- --- -- - - -- TOTAL EXPENDITURESx ----- - - - - -- ----- - - - - -- ----- - - - --- ----- - - - - -- --------- - - - - -- ----- --- - - - -- ---- - - - - - -- ORIGINAL ADJUSTED ACTUAL RECEIVABLES/ BUDGET DESCRIPTION ----------------------- -- ----- -- -- -- BUDGET - -- - ---- --- - -- ADJUSTMENT -- --- - - - - -- BUDGET - ---- - - ---- TO DATE ENCUMBRANCES TOTAL BALANCE REVENUE: ----- - -- - -- --- ------ - - ---- - ------ - - - --- ---- ------- COMMUNITY BLOCK GRANT FUNDS 367,000 50,000 417,000 0 417,000 1992 CIP ALLOCATIONS - LANDSCAPING 2,500 2,500 2,500 2,500.00 0 REMODELING 50,000 50,000 50,000 50,000.00 0 CIP SURPLUS 50,000 50,000 50,000 50, 000.00 0 SINKING FUND TRANSFERS - PARK & SWIMMING POOL BONDS 111,403 9,808 121,211 121,211 121,211.00 0 1968 PARK BONDS 100,340 3,933 104,273 104,273 104,273.00 0 BOND NO. 4 95,382 4,618 100,000 100,000 100,000.00 0 CIP SURPLUS TO BALANCE 200,035 --- -- - - - - -- -- -- - - ---- 200,035 0.00 200,035 TOTAL REVENUE - ---- - - - - -- ----- -- - - -- - ----- --- - ----- ------- - - - --- -- --- - - - - -- X F. _ t EXPENDITURES: ---- - - - GENERAL CONSTRUCTION COSTS - GEORGE W. OLSEN CONST CO. 853,600 31,523 885,123 144,638 144,638.20 740,485 ARCHITECTURAL /ENGINEERING 120,360 120,360 78,606 78,606.00 41,754 SOIL TESTING 1,600 1,600 2,282 2,282.00 (682) PUBLISHING 100 89 189 189 189.00 0 STAFF SUPPORT 6,367 6,367 6,367 6 0 LEGAL 1,000 1,000 491 491.00 509 LEAD REMOVAL IN OLD FIRING RANGE 6,700 6,700 6,700 6,700.00 0 ASBESTOS REPORT 1,569 1,569 1,569 1,569.00 0 SAC CHARGE 700 700 700 700.00 0 CONTINGENCIES 21,411 21,411 0.00 21,411 ---- ------- --- -- --- --- ----- - - - - -- ----- - - -- -- ------ --- - - ---- ------ - - - - - -- -- --- -- - - -- TOTAL EXPENDITURESx ----- - - - - -- ----- - - - - -- ----- - - - --- ----- - - - - -- --------- - - - - -- ----- --- - - - -- ---- - - - - - -- 4401 Xylon Avenue North New Hope, Minnesota 55428 Phone: 531-5100 FAX (612) 531-5174 December 17, 1992 G.W. Olsen Construction Box 20 Stillwater, MN 55082-0020 SUBJECT: Change Order No. 2 - Project 489 Enclosed are two fully executed copies of the above-referenced change order for your records. Please forward one to your bonding company. The change order was approved on December 14, 1992, by the New Hope City Council. If you have any questions, please contact Shari French at 531-5152. Sincerely, Valerie Leone, CMC City Clerk enc. cc: City Engineer Shari French Family Styled City ml�p For Family Living d Originating Department Parks and Recreation By: Shari French 0 Approved for Agenda 25/93 Agenda Section C Item No. 6.5 RESOLUTION APPROVING CHANGE ORDER #3 FOR IMPROVEMENT PROJECT NO. 489 (CITY HALL IMPROVEMENTS) IN THE AMOUNT OF $2,338.00 Change Order #3 includes a total addition of $2,338.00. The 6 items included in this change order are: #1 Wrap treads on north stair with carpet: $ 610 #2 Add add'1 fire extinguisher cabinets, reduce size: $ <33> #3 Relocate door & add window in room 409: $ 518 #4 Alter counter in P &R for ADA: $ 229 #5 Add'1 key work; add locksets to offices: $ 496 #6 Raise unit heater in PD entrance 3 11 : $ 518 Total: $ 2,338 With change orders #1, #2 and #3 the contract is now at $887,461.00. Staff recommends approval of change order #3. MOTION BY SECOND BY Lit s G Vfh- TO: Review: Administration: Finance: COUNCIL 1 0 ,101 0 111 0 . 0 1 . CITY OF NEW HOPE RESOLUTION NO. 93 -I6 RESOLUTION APPROVING CHANGE ORDER #3 FOR IMPROVEMENT PROJECT NO. 489 (CITY HALL IMPROVEMENTS) IN THE AMOUNT OF $2,338.00 WHEREAS, the City of New Hope authorized on July 27, 1992, Improvement Project No. 489, for the contractual sum of $853,600.00; and WHEREAS, the City of New Hope authorized on 9/28/92 change order #1 in the amount of $2,340; and WHEREAS, the City of New Hope authorized on 12/14/92 change order #2 in the amount of $29,183.00; and WHEREAS, it has become necessary to include additional work for ,the project which includes: #1 Wrap treads on north stair with carpet: $ 610 #2 Add add °1 fire extinguisher cabinets, reduce size: $ <33> #3 Relocate door & add window in room 409: $ 518 #4 Alter counter in P &R for ADA: $ 229 #5 Add °1 key work; add locksets to offices: $ 496 #6 Raise unit heater in PD entrance 3 11 : $ 518 Total: $ 2,338 NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of New Hope approves change order no. 3 to the contract with G. W. Olsen Construction in the amount of $2,338.00 as part of Improvement Project No. 489 which brings the total contract to $887,461.00. Adopted by the City Council of the City of New Hope, Hennepin County, Minnesota, this 25th day of January, 1993. Mayor Attest: City Clerk UtVKUlt VV. VLOLN CONSTRUCTION CO., INC. Box 20 1902 S. Greeley St , STILLWATER, MN 55082-002p' Phone 439-5410 TO City of New Hope 4401 Xylon Ave, No New Hope, YIN 55428 WE ARE SENDING YOU XXAttached ❑ Under separate cover via— ❑ Shop drawings ❑ Prints ❑ Plans ❑ Copy of letter X[k Change order ❑ — the following items: ❑ Samples ❑ Specifications wafflWA I I- ` ; NEEK11ITZEMIGIM ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return — corrected prints ❑ For review and comment Signed by GWO ❑ FOR BIDS DUE 19_0 PRINTS RETURNED AFTER LOAN TO US RE DATE January 25,. 1993 JOB NO. 92033 ATTENTION Shari French RE: New Hope City Ha1.1 Remodeling New Hope, MN COPY TO Milt Powe11 SIGNED: PRODUCT240-2 J� Inc GTOK Mon, 01471 If enclosures are not as noted, kindly notify us at Inc. 4401 Xylon Avenue North New Hope, Minnesota 55428 Phone: 531 -5100 FAX (612) 531 -5174 February 1, 1993 George W. Olsen Construction Co. Box 20, 1902 S. Greeley St. Stillwater, MN 55082 -0020 SUBJECT: CHANGE ORDER NO. 3 - IMPROVEMENT PROJECT 489 Enclosed are two fully executed copies of the above - referenced Change Order for your records. Please forward one copy to your bonding company. The change order was approved on January 25, 1993, by the New Hope City Council. If you have any questions, please contact me. Sincerely, Valerie Leone City Clerk enc. cc: Robert Russek Shari French Family Styled City For Family Living COUNCIL • • • Originating Department Parks and Recreation By: Shari French Lo Approved for Agenda 3/Z2/93 Agenda Section Consent Item No. 6.9 RESOLUTION APPROVING CHANGE'ORDER #4 FOR IMPROVEMENT PROJECT NO. 489 (CITY HALL IMPROVEMENTS) IN THE AMOUNT OF $3,144.00 Change Order #4 includes a total addition of $3,144.00. The 3 items included in this change order are: #1 Replace bolts in water /sewer piping: $1,013 #2 Rerouting electrical conduits in stair area of garage addition: $1,917 #3 Extra to main sign for outside corner: $ 214 Total: $ 3,244 With change orders #1, #2, #3, and #4 the contract is now at $890,605.00. Staff recommends approval of change order #4. wo SECOND BY Review: Administration: Finance: ' f1 A CITY OF NEW HOPE RESOLUTION NO. 93 -48 RESOLUTION APPROVING CHANGE ORDER #4 FOR IMPROVEMENT PROJECT NO. 489 (CITY HALL IMPROVEMENTS) IN THE AMOUNT OF $3,144.00 WHEREAS, the City of New Hope authorized on July 27, 1992, Improvement Project No. 489, for the contractual sum of $853,600.00; and WHEREAS, the City of New Hope authorized on 9/28/92 change order #1 in the amount of $2,340; and WHEREAS, the City of New Hope authorized on 12/14/92 change order #2 in the amount of $29,183.00; and WHEREAS, the City of New Hope authorized on 1/25/93 change order #3 in the amount of $2,338.00; and WHEREAS, it has become necessary to include additional work for the project which includes: #1 Replace bolts in water /sewer piping: $1,013 #2 Rerouting electrical conduits in stair area of garage addition: $1,917 #3 Extra to main sign for outside corner: $ 214 Total: $ 3,144 NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of New Hope approves change order no. 4 to the contract with G. W. Olsen Construction in the amount of $3,144.00 as part of Improvement Project No. 489 which brings the total contract to $890,605.00. Adopted by the City Council of the City of New Hope, Hennepin County, Minnesota, this 22nd day of March, 1993. Mayor Attest: City Clerk GEORGE W. OLSEN CONSTRUCTION CO., INC. Box 20 1902 S. Greeley St. STILLWATER, MN 55082-0020 TO CITY OF NEW HOPE 4401 Xvlon Ave. N. New Hope, MN 55428 > WE ARE SENDING YOU [K Attached ❑ Under separate cover via— ❑ Shop drawings ❑ Prints ❑ Plans ❑ Copy of letter X1 Change order r — LETTER OF TRANS ITTAL DATE March 22, 1993 I JOB No. ATTENTION Shari French RE: New Hope City Ha Ri-TnInelp"! ing For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ■ . !� following items: ❑ Specifications THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution > ❑ As requested ❑ Returned for corrections ❑ Return —corrected prints ❑ For review and comment M Signed by GWO ❑ FOR BIDS DUE 190 PRINTS RETURNED AFTER LOAN TO US COPY T SIGNED.� PRODUCT240-2 �Are Inc., Won, Mm 01471 If enclosures are not as noted, kindly notify us at nce. I t 4401 Xylon Avenue North New Hope, Minnesota 55428 Phone: 531 -5100 FAX (612) 531 -5174 March 31, 1993 George W. Olsen Construction Co. Box 20, 1902 S. Greeley St. Stillwater, MN 55082 -0020 SUBJECT: CHANGE ORDER NO. 4 - IMPROVEMENT PROJECT 489 Enclosed are two fully executed copies of the above - referenced Change Order for your records. Please forward one copy to your bonding company. The change order was approved on March 22, 1993, by the New Hope City Council. If you have any questions, please contact me. Sincerely, z'� Valerie Leone City Clerk enc. cc: Robert Russek Shari French Family Styled City For Family Living I COUNCIL Originating Department Parks and Recreation Shari French By: M Approved for Agenda /10/93 Agenda Section Consent Item No. 6.4 RESOLUTION APPROVING CHANGE ORDER #5 FOR IMPROVEMENT PROJECT NO. 489 (CITY HALL IMPROVEMENTS) IN THE AMOUNT OF $10,470.00 Change Order #5 includes a total addition of $10,470.00. There are 13 items included in this change order (see addendum attached). With the five change orders the contract is now at $901,075.00. Staff recommends approval of change order #5. z•r•► :r TO Review: Administration: M610300 Finance: # CITY OF NEW HOPE RESOLUTION NO. 93-71 RESOLUTION APPROVING CHANGE ORDER #5 FOR IMPROVEMENT PROJECT NO. 489 (CITY HALL IMPROVEMENTS) IN THE AMOUNT OF $10,470.00 WHEREAS, the City of New Hope authorized on July 27, 1992, Improvement Project No. 489, for the contractual sum of $853,600.00; and WHEREAS, the City of New Hope authorized on 9/28/92 change order #1 in the amount of $2,340; and WHEREAS, the City of New Hope authorized on 12/14/92 change order #2 in the amount of $29,183.00; and WHEREAS, the City of New Hope authorized on 1/25/93 change order #3 in the amount of $2,338.00; and WHEREAS, the City of New Hope authorized on 3/22/93 change order #4 in the amount of $3,144.00; and WHEREAS, it has become necessary to include additional work for the project which is itemized on the attached addendum for a total of $10,470.00. NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of New Hope approves change order no. 5 to the contract with G. W. Olsen Construction in the amount of $10,470.00 as part of Improvement Project No. 489 which brings the total contract to $901,075-00. Adopted by the City Council of the City of New Hope, Hennepin County, Minnesota, this 10th day of May, 1993. -- -,- ��e- --� 4ma r Attest: ��L City Clerk 14: we b1zl b3t5 11511 t9UNC5 I KUU & AbbU. H. ie Oamtroo OWneer City of New Hope, 4401 Xylon AV N, Now Hope, MN 554211 Date April 29, 199.1 Gyntralctor (i,W. +( kOn Construction, Box 20, Stillwater, MN 55092-(1X)20 Change t)rtlor No. 5 Hand Co. t."edatrleaf & C odarleaaf, Kurt Lundbla d, 340 W Laarpentear Av, St. Paul, MN 55113 CHANGE ORDER NO, 5 City Half Remodeling File No. 34146 -3 EWIR 6111 0 r1C Unit Nr% C94W U411 Amougt Change Order No. 5 394.00 1 $witch for elevator lights LS 2 I ;lava ►tor control panel conductors I..S 3 Install 2 additionatl lights for main 1,874,00 $1,874.00 City Han sign LS 4 Install light at :police sign LS 5 Coiling fain credit I's 6 Install ono flow fitting at Mech Room 2,884.04 $2,884.00 instead of each hvitter LS 7 Add 2 hour door to elevator equipment room LS 8 Extra mesh & concrete at office floor L8 9 Acid masonry piers at existing entry LS 10 Instull guard rail at roof hatch LS I l Move flatmmathle waste trap vent L8 12 Money awed on P & R coiling door from Change Order No. 2 Lc; 13 Do-watering a►rou for sump pump LS Total C'hatnge Order No. 5 Cmul x Unit 1 11"I 0watity NOV Amougt 1 394.00 $394.00 1 108.00 $108.00 ! 1,503.00 $1,503.00 1 1,874,00 $1,874.00 1 (95.00) ($95.00) 1 (141.00) ($141.00) 1 487.00 $487.00 1 2,884.04 $2,884.00 1 $31.00 $831.00 1 738.00 ;$738.00 1 924.00 $ 924.00 1 161.00 $141.00 1 802.00 $ 802.00 $10,470.00 34146.0IA (10 -1 CITY OF NEW HOPE REVENUE AND EXPENDITURES - COMPARED TO BUDGET CITY HALL EXPANSION PROJECT MAY 7, 1 993 DESCRIPTION ----------------------------------- REVENUE: COMMUNITY BLOCK GRANT FUNDS 1992 CIP ALLOCATIONS - LANDSCAPING REMODELING CIP SURPLUS REIMBURSEMENT DUE FROM ROSENE SINKING FUND TRANSFERS - PARK & SWIMMING POOL BONDS 1968 PARK BONDS BOND NO. 4 ORIGINAL ADJUSTED ACTUAL RECEIVABLES/ 7,520 BUDGET BUDGET ---- - - - - -- ADJUSTMENT ----- - - - - -- BUDGET ----- - - - - -- TO DATE ENCUMBRANCES ----- - - - - -- --------- - - - - -- ------- TOTAL - - - - -- BALANCE ----- - - - - -- 367,000 50,000 417,000 - - - - -- ----- - - - - -- ----- - - - - -- --------- - - - - -- ------- - - - - -- ----------- 576,661 1;930 1�,96 #) ,S4QI) $9(#,461 0 417,000 2,500 2,500 2,500 2,500.00 0 50,000 ----- 50,000 50,000 50,000.00 0 50,000 50,000 50,000 50,000.00 0 946 946 47,475 901,075 94.6 111,403 9,808 121,211 121,211 121,211.00 0 100,340 3,933 104,273 104,273 104,273.00 0 95,382 4,618 100,000 100,000 100,000.00 0 INTEREST REVENUE 7,520 7,520.00 (7,520) CIP SURPLUS TO BALANCE 200,035 ----- - - - - -- ----- 200,035 0.00 200,035 TOTAL REVENUE - - - - -- ----- - - - - -- ----- - - - - -- --------- - - - - -- ------- - - - - -- ----------- 576,661 1;930 1�,96 #) ,S4QI) $9(#,461 ----- - - - - -- ----- - - - - -- EXPENDITURES: ----- - - - - -- ----- - - - - -- --------- - - - - -- ------- - - - - -- ----- - - - - -- GENERAL CONSTRUCTION COSTS - GEORGE W. OLSEN CONST CO. 853,600 47,475 901,075 753,971 39,682 793,653.00 107,422 ARCHITECTURAUENGINEERING 120,360 120,360 107,876 107,875.90 12,484 SOIL AND CONCRETE TESTING 1,600 1,600 1,665 1,665.00 (65) PUBLISHING 100 89 189 189 189.00 0 STAFF SUPPORT 6,367 6,367 6,920 6,920.00 (553) LEGAL 1,000 1,000 671 671.00 329 LEAD REMOVAL IN OLD FIRING RANGE 6,700 6,700 8,280 8,280.00 (1,580) ASBESTOS REPORT 1,569 1,569 1,569 1,569.00 0 SAC CHARGE 700 700 700 700.00 0 WIRE/CABLE FOR TV ROOM 7,550 7,550 402 402.00 7,148 YARD LIGHT 339 339 339 339 0 COMPUTER/CABLE WIRING 1,517 1,517 1,517 1,517 0 RAILING TO NORTH STAIRS 749 749 0 749 WATER COOL IN POLICE DEPT & LOBBY 2,280 2,280 0 2,280 TOTAL EXPENDITURES ----- - - - - -- ----- - - - - -- ----- - - - - -- ----- - - - - -- --------- - - - - -- ------- - - - - -- ----- - - - - -- ORIGINAL CONTINGECY FIGURE WAS $50,000. BUDGET DEFICIT (6,030) APR - rHU 1:3 :!50 DO "E= R 00 & 2336 West Highway 36 St. Paul, MN 66 113 612-636-4600 Fax 612-636-1311 Date. Our File No.:MLL prom m EL)O—Kc Pages To Follow: Original Will Follow In Mal: Yes_ No Copy To: SlIgnel Noto To Addressee: if you did not receive all of the pages in good condition, please advise sender at your earliest convenienm Thank You. 34146,CHA ( I ()- I 4401 Xylon Avenue North New Hope, Minnesota 55428 Phone: 531 -5100 FAX (612) 531 -5174 May 12, 1993 George W. Olsen Construction Co. Box 20, 1902 S. Greeley St. Stillwater, MN 55082 -0020 SUBJECT: CHANGE ORDER NO. 5 - IMPROVEMENT PROJECT 489 Enclosed are two fully executed copies of the above - referenced Change Order for your records. Please forward one copy to your bonding company. The change order was approved on May 10, 1993, by the New Hope City Council. If you have any questions, please contact me. Sincerely, A Valerie Leone City Clerk enc. cc: Milt Powell Shari French 0 Family Styled City For Family Living COUNCIL I' D1411V RESOLUTION APPROVING CHANGE ORDER #6 FOR IMPROVEMENT PROJECT NO. 489 (CITY HALL IMPROVEMENTS) IN THE AMOUNT OF $3,388.00 Change Order #6 includes a total addition of $3,388.00. There are 5 items included in this change order: 1. Asbestos the removal: $400 2. Closer for lunch room door: $241 3. Addl. locust tree, planted: $246 4. Elevator breaker: $2,002 5. Elevator room lighting change: $499 With the six change orders the contract is now at $904,463.00. Staff recommends approval of change order #6. Review: Administration: SECOND BY Finance: mm�� RFA-001 CITY OF NEW HOPE RESOLUTION NO. 93- 89 RESOLUTION APPROVING CHANGE ORDER #6 FOR IMPROVEMENT PROJECT NO. 489 (CITY HALL IMPROVEMENTS) IN THE AMOUNT OF $1,386.00 WHEREAS, the City of New Hope authorized on July 27, 1992, Improvement Project No. 489, for the contractual sum of $853,600.00; and WHEREAS, the City of New Hope authorized on 9/28/92 change order #1 in the amount of $2,340; and WHEREAS, the City of New Hope authorized on 12/14/92 change order #2 in the amount of $29,183.00; and WHEREAS, the City of New Hope authorized on 1/25/93 change order #3 in the amount of,$2,338.00; and WHEREAS, the City of New Hope authorized on 3/22/93 change order #4 in the amount of $3,144.00; and WHEREAS, the City of New Hope authorized on 5/10/93 change order #5 in the amount of $10,470.00; and WHEREAS, it has become necessary to include additional work for the project including asbestos tile removal, a door closure, a tree, and a lighting change for the elevator room for a total of $1,386.00. NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of New Hope approves change order no. 6 to the contract with G. W. Olsen Construction in the amount of $1,386.00 as part of Improvement Project No. 489 which brings the total contract to $902,461.00. Adopted by the City Council of the City of New Hope, Hennepin County, Minnesota, this 14th day of June, 1993. Attest: City Clerk Mayor vJti- UU -1JJ3 1e: 45 ble b6b 1611 bUNtS I HUU & A66U. F. Ue �' irQO 0►amt+ar City of New Hope, 4401 Xylon Av N, New Hope, MN 55428 Date June 8, 1 993 mum a Contractor O.W. Olsen Construction, Box 20, Stillwater, MN 55082 -0020 Change Order No. 6 Bond Co. Cedarleaf &. CedarleaL Kurt Lundblad, 3+60 W Larpenteur Av, St. Paul, MN 55113 CHANGE ORDER NOS. 6 City Hall Remodeling File No. 34146 D ' tioa of Work 0 mull Unit TOW Nm item Unit Quantity Prim Amount Change Order No. 6 1 Asbestos the removal LS 1 400.00 400.00 2 Door closer at Room 102 LS 1 24.1.00 241.00 3 Add skyline locust tree @ planter LS 1 246.00 246.00 4 Upgrade elevator breaker LS 1 2,002.00 2,002.00 5 Elevator room light change LS 1 499.00 499,00 Total Change Order No. 6 $3,388.00 Original Contract Amount $ $53,600,00 Previous Change Orders 47,475.00 This Change Order No. 6 - ADD 3,388.00 Revised Contract Amount (including this Change Order) $ 904,463.00 .14146.ctia CO -1 Ia. "0 UX= 0-10 11.)I1 C "J..11-.. I- Recommended for Approval by: BO"LT-,(j [tw"AW03 1�i Coj z S1 I 1 11A V (S) Approved by Owner: Cr1rY OF NEW HOPE, MN Date: Distribution I - Owner I - Contractor I - Engineer I - Bond Co, 34146.CHA CO-2 UtUnUt VV. ULZOLN CONSTRUCTION CO., INC. Box 20 1902 S. Greeley St. STILLWATER, MN 55082-0020 TO New Hope City Hall 4401 Xylon Ave North New Hope, Mn 55428 > WE ARE SENDING YOU X Attached ❑ Under separate cover via— ❑ Shop drawings ❑ Prints ❑ Plans ❑ Copy of letter [K Change order ❑ — DATE June 14, 1993 NO. ATTENTION Shari French RE: New Hope City Hall Remodeling ❑ Approved as submitted ❑ For your use ❑ the following items: ❑ Samples ❑ Specifications THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ For your use ❑ Approved as noted > ❑ As requested ❑ Returned for corrections ❑ For review and comment X] Signed by GWO ❑ FOR BIDS DUE ---19—El PRINTS RETURNED AFTER LOAN TO US REMARKS PRODUCT 240-2 'Ix, Won, Mm 01471 SIGNED:= If enclosures are not as noted, kindly notify us at a ce. COUNCIL Originating Department Parks and Recreation Shari French By: D1 01 11 pi3 19 10 Ile kl M- Approved for Agenda 1/10/94 Agenda Section Consent Item No. 6.15 RESOLUTION APPROVING CHANGE ORDER #6 FOR IMPROVEMENT PROJECT NO. 489 (CITY HALL IMPROVEMENTS) IN THE AMOUNT OF $2,110.00 Change Order #6 includes a total addition of $2,110.00. There are 8 items included in this change order: 1. Asbestos tile removal: $400 2. Closer for lunch room door: $241 3. Addl. locust tree, planted: $246 4. Elevator breaker: $2,002 5. Elevator room lighting change: $499 6. Credit for sewer ejector: ($263.00) 7. Misc. electric work: $432 8. Credit for returned drop box: ($1,447) With the six change orders the contract is now at $903,185.00. Staff recommends approval of change order #6. MOTION BY ? SECOND BY TO: A /f PC1 !2 cl __ Review: Administration: Finance: "C 7y sioz CITY OF NEW HOPE RESOLUTION NO. 94- 10 RESOLUTION APPROVING CHANGE ORDER #6 FOR IMPROVEMENT PROJECT NO. 489 (CITY HALL IMPROVEMENTS) IN THE AMOUNT OF $2,110.00 WHEREAS, the City of New Hope authorized on July 27, 1992, Improvement Project No. 489, for the contractual sum of $853,600.00; and WHEREAS, the City of New Hope authorized on 9/28/92 change order #1 in the amount of $2,340; and WHEREAS, the City of New Hope authorized on 12/14/92 change order #2 in the amount of $29,183.00; and WHEREAS, the City of New Hope authorized on 1/25/93 change order #3 in the amount of $2,338.00; and WHEREAS, the City of New Hope authorized on 3/22/93 change order #4 in the amount of $3,144.00; and WHEREAS, the City of New Hope authorized on 5/10/93 change order #5 in the amount of $10,470.00; and WHEREAS, it has become necessary to include additional work for the project including asbestos tile removal, a door closure, a tree, upgrding the elevator breaker, miscellaneous electrical work, a credit for the drop box, a credit for a sewage ejector, and a lighting change for the elevator room for a total of $2,110.00. NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of New Hope approves change order no. 6 to the contract with G. W. Olsen Construction in the amount of $2,110.00 as part of Improvement Project No. 489 which brings the total contract to $903,185.00. Adopted by the City Council of the City of New Hope, Hennepin County, Minnesota, this 10th day of January, 1994. Mayo Attest: City Clerk January 5, 1994 Ms. Shari French City of New Hope 4401 Xylon Ave. N. New Hope, MN 55428 Re: City Hall Remodeling Pay Request No. 11 / Change Order No. 6 Our File No. 34146 Dear Ms. French: Miles B. Jensen, PE. L. Phillip Gravel, P.E. Karen L. Wiemeri, P.E. Gary D. Kristofitz, P.E. F. Todd Foster, P.E. Keith R. Yapp, PE. Douglas J. Benoit, P.E. Shawn D. Gustafson, P.E. Cecilio Olivier, P.E. Paul G. Heuer, P.E. John P Gorder, PE, Charles A. Erickson Leo M. Pawelsky Harlan M. Olson James F. Engelhardt Attached are Change Order No. 6 and Pay Request No. 11 for the City Hall Remodeling project in New Hope. Change Order No. 6 covers all outstanding issues not included on previous Change Orders. All of the work related to this Change Order has been completed. We recommend the City approve the Change Order. Pay Request No. 11 reduces retainage on this project to $10,000.00. The following corrective items have not been completed to date: 1. Discolored concrete at front entry has been rejected and will require replacement this Spring. The Contractor has suggested holding $2,196.00, which he claims is twice the value to replace the discolored concrete. We believe the entire front walkway could be replaced for $8,000.00. 2. Several cooling units have not operated through a cooling season yet. This is a concern, but the equipment is installed and should be paid for. The units are covered under the one -year warranty period, should any corrective work be required. 3. Other miscellaneous heating issues have been worked on by the Contractor. These on -going adjustments will continue as the City and HVAC contractor continue to learn and study the new control system. 4. Several cracked tiles in the entry and some sloppy vinyl work in the Council chambers will be repaired by the Contractor. 2335 West Highway 36 « St. Paul, MN 55113 612- 636 -4600 Otto G. Bonestroo, P.E. Howard A. Sanford, PE. Agnes M. Ring, A.I.C.P TA S onestroo Robert W. Rosene, BE.* Keith A. Gordon, PE. Philip J. Pyne, PE. Joseph C. Anderlik, P.E. Robert R. Pfefferle, P.E. Thomas W. Peterson, P.E. Rosene Marvin L. Sorvala, P.E. Richard W Foster, P.E. Michael C. Lynch, P.E. MEN Richard E. Turner, P.E. David O. Loskota, P.E. James R. Maland, P.E. r Glenn R. Cook, PE, Robert C. Russek, A.I.A. Jerry D. Pertzsch, P.E. e ! i Thomas E. Noyes, P.E. Jerry A. Bourdon, P.E. Scott J. Arganek, P.E. ¢ tes Susan Robert G. Schunicht, P.E. M. Eberlin, C.PA. Mark A. Hanson, PE, Michael T Rautmann, P.E. Kenneth P Anderson, P.E. Mark R. Rolls, P.E. *Senior Consultant Ted K, Field, P.E. Mark A. Seip, P.E. Engineers & Architects Thomas R. Anderson, A.I.A. Gary W. Morien, P.E. Donald C. Burgardt, P.E. Daniel J. Edgerton, P.E. Thomas E. Angus, P.E. A. Rick Schmidt, P.E. Ismael Martinez, P.E. Philip J. Caswell, P.E. Michael P Rau. P.E. Mark D. Wallis. P.E. January 5, 1994 Ms. Shari French City of New Hope 4401 Xylon Ave. N. New Hope, MN 55428 Re: City Hall Remodeling Pay Request No. 11 / Change Order No. 6 Our File No. 34146 Dear Ms. French: Miles B. Jensen, PE. L. Phillip Gravel, P.E. Karen L. Wiemeri, P.E. Gary D. Kristofitz, P.E. F. Todd Foster, P.E. Keith R. Yapp, PE. Douglas J. Benoit, P.E. Shawn D. Gustafson, P.E. Cecilio Olivier, P.E. Paul G. Heuer, P.E. John P Gorder, PE, Charles A. Erickson Leo M. Pawelsky Harlan M. Olson James F. Engelhardt Attached are Change Order No. 6 and Pay Request No. 11 for the City Hall Remodeling project in New Hope. Change Order No. 6 covers all outstanding issues not included on previous Change Orders. All of the work related to this Change Order has been completed. We recommend the City approve the Change Order. Pay Request No. 11 reduces retainage on this project to $10,000.00. The following corrective items have not been completed to date: 1. Discolored concrete at front entry has been rejected and will require replacement this Spring. The Contractor has suggested holding $2,196.00, which he claims is twice the value to replace the discolored concrete. We believe the entire front walkway could be replaced for $8,000.00. 2. Several cooling units have not operated through a cooling season yet. This is a concern, but the equipment is installed and should be paid for. The units are covered under the one -year warranty period, should any corrective work be required. 3. Other miscellaneous heating issues have been worked on by the Contractor. These on -going adjustments will continue as the City and HVAC contractor continue to learn and study the new control system. 4. Several cracked tiles in the entry and some sloppy vinyl work in the Council chambers will be repaired by the Contractor. 2335 West Highway 36 « St. Paul, MN 55113 612- 636 -4600 Ms. Shari French City of New Hope January S, 1994 We believe that $10,000.00 is a sufficient amount to withhold from the Contractor for these unfinished items. We recommend the City also approve Pay Request No. 11 at this time. If you have any questions about the above items, please call me at 636 -4600. Yours very truly, BONESTROO, ROSENE, ANDERLIK & ASSOCIATES, INC. E)4 4�'� Daryl L. Kirschenman MM Encl. 4401 Xylon Avenue North Telephone: 612- 531 -5100 City Hall Fax: #612 - 531 -5131 New Hope, Minnesota 55428 -4898 TDD Line: 612 - 531 -5109 Police Fax: #612 - 531 -517 Public, Works Fax: #612- 533 -7651 January 13, 1994 George W. Olsen Construction Box 20 Stillwater, MN 55082 -0020 SUBJECT: REVISED CHANGE ORDER NO. 6 - IMPROVEMENT PROJECT 489 Enclosed are two fully executed copies of the above - referenced Change Order for your records. Please forward one copy to your bonding company. The change order was approved on January 10, 1994, by the New Hope City Council. If you have any questions, please contact me. Sincerely, Valerie Leone City Clerk enc. cc: Dayrl Kirschenman Shari French Family Styled City mli� For Family Living COUNCIL • 111 1,14 DIPIIV�-'Y-d W1111 • 1 0 The engineers and staff recommend that the City Hall Remodeling Project 489 be accepted and final payment be made to the contractor, G. W. Olsen Construction Company. The final amount due on the project is the $30,000.00 retainage which has been held by the City until the punch list items were completed. All punch list items have been completed. The IC-134 forms for this project have been submitted to the City. Staff recommends approval and final payment to the contractor. MOTION BY SECOND BY TO: Review: Administration: Finance: WrITSM Bonestroo, Rosene, Anderlik and Associates Inc. is an Affirmative Action /Equal Opportunity Employer August 16, 1994 Ms. Shari French City of New Hope 4401 Xylon Avenue N. New Hope, MN 55428 Otto G. Bonestroo. PE, Howard A. Sanford, P.E. Michael P. Rau, PE, Mark D. Wallis, PE, Robert W. Rosene, RE* Keith A. Gordon, PE. Agnes M. Ring, A.I.C.P Miles B. Jensen, PE. Joseph C. Anderlik, PE. Robert R. Pfefferle, PE, Thomas W. Peterson, P.E. L. Phillip Gravel, P.E. Marvin L. Sorvala, PE. Richard W Foster, P.E. Michael C. Lynch, P.E. Karen L. Wiemeri, PE. Richard E. Turner, PE. David O. Loskota, P.E. James R. Maland, PE. Gary D. Kristofitz, P.E. Glenn R. Cook, P.E. Robert C. Russek, A.I.A. Jerry D. Pertzsch, P.E. Keith R. Yapp, P.E. Thomas E. Noyes, P.E. Jerry A. Bourdon, P.E. Scott J. Arganek, P.E. Douglas J. Benoit, P.E. Robert G. Schunicht, P.E. Mark A. Hanson, P.E. Kenneth P Anderson, PE. Shawn D. Gustafson, P.E. Susan M. Eberlin, C.PA. Michael T. Rautmann, PE. Mark R. Rolls, P.E. Cecilio Olivier, PE. *Senior Consultant Ted K. Field, P.E. Mark A, Seip, PE. Paul G. Heuer, P.E. Thomas R. Anderson, A.I.A. Gary W. Morien, P.E. John P. Corder, P.E. Donald C. Burgardt, P.E. Paul J. Gannon, A.1 ,A, Charles A. Erickson Thomas A. Sy =fko, P.E. Daniel J. Edgerton, P.E. Leo M. Pawelsky Frederic J. Stenborg, PE, A. Rick Schmidt, PE, Harlan M. Olson Ismael Martinez, PE. Philip J. Caswell, RE, James E Engelhardt Re: City Hall Remodeling Project Pay Request No. 11 and Final File 34146 Dear Ms. French: Enclosed is the final Pay Request No. 12 for the New Hope City Hall project. This pay request releases the $30,000.00 retainage which has been held by the City until punch list items were completed. All punch list items have now been completed by G. W. Olsen Construction Company. As this time, we recommend that the City accept this project and pay G. W. Olsen the final amount due. The IC -134 forms for this project have previously been submitted to the City. If you have any questions about this project please call me at 636 -4600. Yours very truly, BONESTROO, ROSENE, ANDERLIK & ASSOCIATES, INC. Daryl Kirschenman DK:lk Enclosure 2335 West Highway 36 o St. Paul, MN 55113 o 0« Bonestroo Rosen Anderlik & Associates EngJ � s MCtdwU st. P.W. Mgv.esou Owner City of New Hope, 4401 Xylon Av N, New Hope, MN 55428 Date August 15, 1994 For Period December 31, 1993 to August 15, 1994 Request No. 12 & Final Contractor G.W. Olson Constructi 1902 S Greeley St, Box 20, Stillwater, MN 55082 REQUEST FOR PAYMENT City Hall Remodeling Project No. 92033 File No. 34146 SUMMARY I 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 as stated 9 Sub -Total 10 Less Amount Paid Previously 11 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. Recommended for Approval by: BONESTROO, ROSENE, ANDERLIK & .ASSOCIATES, INC. Approved by Contractor: G. W. OLSON CONSTRUCTION Approval stated on A.I.A. document Specified Contract Completion Date: 150 Calendar Days 34146. RFP $ 49,585.00 12 & Final $ 853,600.00 $ 903,185.00 $ 903,185.00 $ 0.00 $ 903,185.00 $ 0.00 $ 903,185.00 $ 873,185.00 $ 30,000.00 Approved by Owner: CITY OF NEW HOPE, MN Date: r� APPLICATION AND CERTIFICATE FOR PAYMENT A/A DOCUMENT G702 ADDITIONS 49,585.00 DEDUCTIONS Approved this Month (Instructions on reverse side) PAGE ONE OF 4' PAGES TO (OWNER): CITY OF NEW HOPE PROJECT: CITY HALL REMODELING APPLICATION NO: G -12 Distribution to: 4401 Xylon Avenue NEW HOPE, MN FINAL ❑ OWNER New Hope, MN PERIOD TO: 8 -15 -94 ❑ ARCHITECT FROM (CONTRACTOR): GEO. W. OLSEN CONST. CO. VIA (ARCHITECT): BONESTR00, ROSENE, ANDERLIK lX1XXC)5X ❑ CONTRACTOR ❑ 1902 S. Greeley St. –Box 20 2335 W. Trunk Highway 36 PROJECT NO: 92033 ❑ Stillwater, MN 55082 St. Paul, MN 55113 CONTRACT FOR: GENERAL C ONSTRUCTION CONTRACT DATE: Jul_v 31 _ 19A2 CHANGE ORDER SUMMARY Change Orders approved in previous months by Owner TOTAL ADDITIONS 49,585.00 DEDUCTIONS Approved this Month (Line 4 less Line 5 Total) Number Date Appr oved PAYMENT (Line 6 from prior Certificate) ......... $ 873, 185.00 TOTALS + 49 585.00 9. BALANCE TO FINISH, PLUS RETAINAGE ............. Net change by Change Orders + 49, 585.00 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: GEORGE W. OLSEN CONSTRUCTION CO., INC. By: Date: August 15, 1994 Application is made for Payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document G703, is attached. 1. ORIGINAL CONTRACT SUM ....................... $ 853, 600.00 2. Net change by Change Orders ..................... $ 49, 585.00 3. CONTRACT SUM TO DATE (Line 1 - ± - 2) .............. $ 903, 185.00 4. TOTAL COMPLETED & STORED TO DATE............ $ 903 ,185.00 (Column G on G703) 5. RETAINAGE: a. _ % of Completed Work $ --- (Column D + E on G703) b. — % of Stored Material $ --- (Column F on G703) Total Retainage (Line 5a +5b or Total in Column I of G703) ..................... $ - -- 6. TOTAL EARNED LESS RETAINAGE ................... $ 903, 185.00 (Line 4 less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) ......... $ 873, 185.00 8. CURRENT PAYMENT DUE .......................... $ 30, 000.00 9. BALANCE TO FINISH, PLUS RETAINAGE ............. $ --- (Line 3 less Line 6) State of: Minnesota W gton �64?ft�?ff^ Vt (g 'h Subscribed an s rn t ARY pHNSO Aug. 19 94 o Notary Public: �� .o Mie4iY-har My Commission expires r V M. Expires July 11, 1996 ARCHITECT AMOUNT CERTIFIED $ _„30 000, 00 (Attach explanation if amount certified differs from the amount applied for.) In accordance with the Contract Documents, based on on -site observations and the ARCHITECT: BONESTRO ROSENE, ANDERLIK & ASSOCIATES data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as B © Date: indicated, the quality of the Work is in accordance with the Contract Documents, and This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only the Contractor is entitled to payment of the AMOUNT CERTIFIED. g p y y to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702 ° APPLICATION AND CERTIFICATE FOR PAYMENT < MAY 1983 EDITION > AIA' • C 1983 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 6702 -1983 WARNING: Unlicensed photocopying violates U.S. copyright laws and is subject to legal prosecution. CONTINUATION SHEET AIA DOCUMENT 6 PAGE 2 OF ___________________________________________________ AIA Document 6702 APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: Contractor's signed Certification is attached, APPLICATION BATE: In tabulations below, amuunts are stated to the nearest dollar. PERIOD FROM: Use Column [ on Contracts where variable retaioage for line items may apply. TO- ARCHITECT'S PROJECT NO: 4 PAGES ------------- G-i2 FINAL 8-15-91 i-4-94 B-15-94 92033 --------------------------------------------------------------------------------------------------- � A � B / (-______|______�_______|_______|__________/________�________� C � D | E | F ---------- ___ WORK COMPLETED ( TOTAL | � � � � ITEM 1 DESCRIPTION OF WORK SCHEDULED -~----------------------| COMPLETED | | BALANCE | RETAINAGE 1 VALUE 1 This Application AND ST DRED | % | TO FINISH ( | �---------------1 TO DATE �(8/C). (C-G) | � \ { � 1 Previous | Work in Stared | (D+E+F ) | ( | | ( | ( !Application |______| | Place | Materials i 0000 _____________|_______ !GENERAL CONDITIONS | 54390 � _______|______| 54390 � 0 ( ______________|_______| | 5439O | 1OO | V | � | 01000 |MO8l IDRIOW | 8536 ( 8538 1 8536 ( 100 O � | | 02950 :DEMOLITION | 21082 | 21082 | O | 2 : too | 0 | 03050 1E%CAVATIDN | 24560 ( 24560 V | | 24560 | 100 ( O | � | 03170 !SODDING 3878 { 3870 V | | 3870 ( 100 | V ( | | 03190 :LANDSCAPING | 3144 | 3144 | V 3144 1 100 | | O3A3V ISITE UTILITIES 14645 | 14645 ( O 14645 | 100 | 0 | 03500 |BLACKTDP | 340 0 | 3400 ( V 340 01 ( 100 | O | | | 04000 11F0TlNGG | 9059 | 9059 | 0 | | 9059 iVO 1 0 | | | 05000 1 CQNCRETE WALL | 24217 24217 � V i 202D | 100 1 O ( | | 0 !CONCRETE FLOOR | 2697 | 2697 / V | i 2697 | 100 | V | ( | 0 ,8510 :CONCRETE TOPPING | 6612 | 6612 ( 0 } 6612 | 100 | O | 08200 !SIDEWALKS 6373 | 6373 | V 1 / 6 100 | O | � | 09950 !MISC. CONCRETE | 13838 | 13830 0 | | 138, | 1OV | A | � | 13000 :BLOCKS BELOW GRADE | 4954 4954 | 0 i 4954 | 100 / 0 | � | 15000 ;MASONRY ABOVE GRADE | 123908 ( 123906 | O 123908 | 100 | O | | | 16000 !PRECAST SPECIALTIES | 3033 3033 | V 3033 > 100 | V | | | 17000 |REINF7MESH-MATER }AL | 4847 4847 | V | / 4847 ( 100 | 17050 !MISC. METALS-MATERIAL 33992 | 33992 O | | 33992 ( 100 | 0 � ( 1 17610 |REINRM[SH- AB08 2188 ( 2188 | V | 7 2188 ( 100 V ( ( � 17650 !MISC. METALS-LABOR 400 | 400 | 0 | i 400 | l0O | O ( � � 17750 :STEEL ERECTION | 9070 ( 9870 O 907 0 100 | O | � | 18350 :PRECAST PLANK | 3055 3055 | O | | 3055 | 180 | V | } | 19V30 (SISNAGE | 4852 4852 | 0 | | 485 | 100 | 0 | | � 19050 | lAL | 400 400 | V | | 400 | 100 f V | | | 19050 t | D8 ( 80 | 0 | | 8A : 108 | 0 | � � 19150 1ElEV#T8R 33546 | 33546 1 O f 33546 ( 100 V | | | 19168 :FIRE [XAT.-MATERIAL | 35-6 | 356 < 0 356 | 100 1 0 < | 1 | 19160 :FIRE EXT.-LABOR |_ | 49 1 49 0 | | 49 | 100 | V | | ( | � | �_______ | _________|_________|__________|___________ 421145 | 42U45 � O | V _____|_________�_________| 421145 | ) 0 i U | AIA DOCUMENT _|_______�______(_______ 6701 * CONTINUATION SHEET * APRIL B78 EDITION ______|________ * SUBSTITUTE ------------------ _______� T E AMERICAN INS"I'ITUTE OF ARCHITECTS, 17 CONTINUATION SHEET _________________________________________________________________________________________________ 0IA DOCUMENT G703 PAGE 3 OF 4 PAGES AlA Document 6702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: 6-12 FINAL Contractor's Signed Certification is attached. APPLICATION DATE: D-15-94 In tabulations below, amounts are stated to the nearest dollar. PEKl[0 FROM: 1-4-Y4 Use Column [ on Contracts *here variable retainage for line items may apply. TO; 8-15-94 ARCHITECT'S PROJECT NO. 9203 __________________________________________________________________ � A |___-_-|_____________�________|_______)__________|_________�____________� B | C i D | E | F / | � ( WORK CUMPLETED | TOTAL 1 ( | | | lDB { DESCRIPTION OF WORK | SCHEDULED |--------------------------| COMPLETED i | BALANCE 1 0ETAlMAGE | | No. | < VALUE | | This Application | AND STORED ( % | T0 FINISH | i | | | | �------~---------------| TO DATE |(G/C): (C-6) � | | | | | PreviOUa | Work in | Stored | (0+E+F> | | | | | |_________|_____________________| | � :Application | Place | Materials | | 19250 �LOOVERS-MA�RIAL ( ______ | ___ _________| 397 | _ 397 ( _____---_-� ------------ O | i__-___-�--_--�--__-__--_---_-------| ( 397 | 100 | V | / 1 19250 !LOUVERS-LABOR 00 ( O | � | 19290 �SITE EQUlP-MATERIAL 2663 | 2663 1 O | | 2663 | 100 V | | | 19290 :SITE EQUIP-LABOR | 168 / 160 | 0 | | 160 ( lVO 8 ( � | 19310 |FOLQ}NG DOORS 5825 | 5825 | V / | 5825 | 180 | V � | | 19320 !COILING DOORS ( 1824 1 1 ,824 | V | | 1824 1 100 | U | | � 1934 0TRANCE MAT-MATERIAL | 703 1 703 / O / i 703 f 100 V | | � 19340 |ENTRANCE MAT-LABOR | 70 | 7O | O | � 70 < lOV | 0 ( � ( 19380 |T0lBT PARTlTIONS-MAT.� 718 718 | O | ( 718 | 100 i U � ( 1 19380 !TOILET P&RTITIOMS-LAB.� 220 ( 220 | 0 220 | 100 | 0 ( | | 19390 |TOlLE ACCESS-MAT. �ESS-MAT. 155 155 | 0 155 | 10O 0 < [ | 19390 �T0LE7 ACCESS-LABOR | 66 66 | V | | 66 | 100 / 0 ( � | 19470 !MOVIE SCREEN-MATERIAL | 1369 | 1369 > 0 i i 1369 { 100 f O | � | 1947O �MOVlE SCREEN-LA8OR | 8V � 8O | 0 | | 8* | {8O | 0 ( | | 2010 !HOLLOW METAL-LABOR | 742 | 742 | O | ( 742 | 10V | V | 20950 |H.M./FlN.HDW.-MAT. | 18638 18638 | V | | 18638 | 100 | V | | | 22610 :WINDOWS-LABOR | 620 1 620 / O | i 620 | f08 ( 0 | < | 22950 IWINDOW8-MATERIAL < 8547 | 8547 | V 8547 / 100 | 0 | � ( 23950 |RODF/SHEET METAL / 4228 / 42088 | 0 � | 42088 / 100 | V � 24950 (CAULKING 4040 ( 4840 4840 | lOO � 25000 :CARPENTRY f 21712 | 21712 | O | / 21712 1 100 ( V | � | 25000 �TEDLAR | 3819 | 0 | 3819 ( | 3819 | 100 | O | | 1 26610 610 !MILLWORK-LABOR ( 323 � | 32J | O | � '2 | 100 | O � | | 2695V � |MlULWORK-MA TER�AL | J317 | 331T O � | 3317 ( �00 | O i | | 27010 |CERAMIC/gUAHRY [TILE | 5945 1 5945 0 | | 5945 | 100 ( 0 ( | | 27040 !CARPET / 14629 0 | 1 14629 180 ( O � | 1 28950 !DRYWALL 24480 | 24480 | O | | 24480 | 100 | 0 ( � 1 31950 |GLASS & GLAZING [ 2 ? 1 31 | 29131 | V | | 2 9131 i lV0 i O i � i 32950 � |ACOUBTIC TILE | ) 7725 | 7725 | V 7725 | 100 | V | | | ! ________ | | |-- |______� __|___||________�______� _ 621962 | __ __ ------------ 61O143 | _ _ 3819 | 0 __ _ | 621962 | ------------ � � ------------ V | 0 f AlA DOCUMENT -- _ G7O3 * CONTINUATION SHEET ___ _ _____|| * APRIL _ __ ------------ ------------ 1970 EDITION * SUBSTITUTE !__________ ________�____ __ _ _ -- | THE AMERICAN INCTTT UTE OF ARCHITECTS, 1 NEW Y ORK AVE, %N, WASHINGTON, DX 2"0006 G703 -_ 1?78 CONTINUATION --------------------------- SHEET ------------------------------------------------------------------------------------------- AlA DOCUMENT 6703 PAGE 4 OF 4 PAGES AlA Docutent G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: ----------------- 6-12 FINAL Contractor's signed Certification is attached. APPLICATION DATE/ 8-15-94 In tabulations below, amounts are stated to the nearest dollar. PERIOD FROM. 1-4-94 Use Column T on Contracts where variable retainaga for line items may apply. TD: 8-15-94 ARCHITECT'S PROJECT NO; 92033 __________________________________________________________________ �_____ C | |------------ D ( �___--_-__-|______�---_______-|__--___|___-__--� E | F / 8 | H ___________ ------------ WORK COMPLETED ( TOTAL | | � | | ITEM DESCRIPTION OF WORK | SCHEDULED |-------------------i COMPLETED BALANCE | RETAlNAGE 1 | VALUE | | This Application | AND STORED | % | TO FINISH |-------------| TO DATE |(61C)| (C-6) | | Previous 1 Work in 1 Stored f (D+E+F) | | | ( !Application | Place | Materials |______� ___|_______�_______:_______|______ � 33�N !FINISH NDWE-LABOR | J114 1 3114 | O f _______|___�______|_______� | 310 / iOO | 0 | 34950 1PAlNTING/VlNYl | 14, | 14309 ( 14309 100 { | 36950 flR£ PROTECTION | 18422 | 18422 | 0 18422 | 100 | O | � | 31 |HVAC | 135400 | 135400 | A | } 135400 | 100 | 0 | � | 39950 �ELECTRI0LI | 49750 | 49750 | 0 | | 49750 | 100 | V | | � 97500 |RUlLBlNS PERMIT 426 / 426 | V | | 426 | 100 | O ( | | 97700 28N8 | 10217 | 10217 | 0 10217 | 100 ( 0 | � | !CHANGE ORDERS V | O i | V | | O | � � 8-1 !ELECTRICAL/SOIL � 2340 | 2340 / O | 2340 | 100 | 0 | | | 6-2 (MISCELLANEOUS / 25 2903 } O / | 2918J | 100 | V i � f G-3 !MISCELLANEOUS | 2338 1 2338 | O | | 2338 | 188 | V � | 1 6-4 !MISCELLANEOUS 3144 | V 3144 | 108 | 0 | 6-5 |HlSCELLANE0QS | 10470 | 10470 V i | l0470 | 100 it V | | | 6-6 :MISCELLANEOUS | 2110 10 | 100 ( 0 � | O| O O| / O� | V| O< ( 0| | 0| | | | | | O| V� Vi O| ( O� 0| | | | | V| O| � A 8| 0| | | | | O| Vi 0| | V( ( | | | | O| Vi Vi ( O| ( O| � A� | | ( |____________________|____________|_-----__--|-_-__-----1_-_--_----|-----__--_|_--_�__'-_------|-------| | | V O| ( O | � | | | | | 90 | 899366 � 3819 � 0 | 903185 | | V i 0 � DOCUMENT -_________i ________|_________|_ 6703 1 �TINUATlON SH[ET * APRIL 1978 CONTINUATION _ EDITION _ ______| * SUBSTITUTE ------------ |____( _______|_______ THE AMEFT ,CAN INSTITUTE OF ARCHITECTS, 1 NEW YORK AVE, N.W., WASHINGTON, D.C. 20006 81 -- 1978 PRO ECT PAYME STATUS Owner City of New Hope Project City Hall Remodeling Project No. 92033 File No. 34146 Contractor G.W. Olson Construction CHANGE ORDERS No. Date 1 9 -23 -92 Use City - furnished electricity; replace contaminated soil w /granular fill 2 12 -8 -92 Various changes 3 1 -15 -93 Various changes 4 3 -15 -93 Replace bolts, reroute electrical, increase logo 5 4 -29 -93 Various changes 6 12 -30 -93 Various changes Total Change Orders - Add PAYME SUMMARY No. Period Payment 1 Start 9 -10 -92 $24,035.00 2 9 -10 -92 9 -30 -92 52,140.00 3 9 -30 -92 10 -30 -92 68,463.00 4 10 -30 -92 12 -1 -92 127,704.00 5 12 -1 -92 1 -28 -93 129,018.00 6 1 -28 -93 2 -25 -93 138,184.00 7 2 -25 -93 3 -22 -93 116,214.00 8 3 -22 -93 3 -31 -93 98,213.00 9 3 -31 -93 5 -27 -93 63,872.00 10 5 -27 -93 6 -24 -93 25,364.00 11 6 -24 -93 12 -31 -93 29,978.00 12 12 -31 -93 8 -15 -94 30,000.00 Total Payment to Date $903,185.00 Retainage, Payment No. 12 & Final 0.00 Total Value Completed $903,185.00 Retainage $1,264.00 4,009.00 7,613.00 14,333.00 21,124.00 28,397.00 34,513.00 39,682.00 43,044.00 44,379.00 30,000.00 0.00 Original Contract Change Orders Revised Contract Amount $2,340.00 $29,183.00 $2,338.00 $3,14400 $10,470.00 $2,110.00 $49,585.00 Completed $25,299.00 80,184.00 152,251.00 286,675.00 422,484.00 567,941.00 690,271.00 793,653.00 860,887.00 887,586.00 903,185.00 903,185.00 $853,600.00 49,585.00 $ 903,185.00 34146. RFP I RP -2 Form Minnesota Department of Revenue IC -134 Rev. 9/89 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 payment to contractors. Company na Minnesota ID number GEORGE W. OLSEN CONSTRUCTION CO., INC. 8634864 Address Month /year work began 1902 S. Greeley St. P.O. Box 20 August 1992 City State Zip Code Month /year work ended Stillwater MN 55082 July 1993 Total contract amount: 904,463.00 Telephone number Amount still due: ( 612) 439 -5410 61,256.00 Did you have employees work on this project? Yes Project number: 92033 CITY HALL REMODELING If none, explain who did the work: Project location: New Hope, MN Project owner: City of New Hope Address 4401 X on Ave. N. New Ho e, MN 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 SEE ATTACHED 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. Vice President August 5, 1993 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 M' nesota statute s 290.92 and 290.97 concerning the withholding of Minnesota income tax from W; I ee lat4i e ac se ces with the state of Minnesota and /or its subdivisions. Signature auth n Date �. 1953 KREMER & DAVIS, INC. MOLIN CONCRETE PRODUCTS P.O. Box 21031 415 Lilac St. 3900 Jefferson St., N.E. Lino Lakes, MN 55014 Minneapolis, MN 55421 JACOBSEN EXCAVATING & TRUCKING MASTER ASPHALT CO. 3173 Spruce St. 10939 - 89th Ave. N. Little Canada, MN 55117 Maple Grove, MN 55369 FIRE -GUARD SPRINKLER SERVICE, INC. JANNING`S ACOUSTICS, INC. 212 E. Commercial St. 10715 County Road 24 Stillwater, MN 55082 Watertown, MN 55388 KMH ERECTORS, INC. PREMIER MECHANICAL, INC. Box 37 6550 W. River Rd. Maple Plain, MN 55359 Minneapolis, MN 55430 JULIAN M. JOHNSON CONSTR. CORP. ROYAL ELECTRIC CO., INC. 10610 N.E. Nassau St. 7401 Central Ave., N.E. Blaine, MN 55440 Minneapolis, MN 55432 CRAWFORD DOOR SALES COMPANY DROELS CAULKING COMPANY 1641 Oakdale Ave. P.O. Box 25094 West St. Paul, MN 55118 Woodbury, MN 55125 SPECIAL COATINGS & TILE CO INC WITT- MILLER, INC. 7617 Peltier Lake Drive 10940 Brockton Lane Hugo, MN 55038 Maple Grove, MN 55068 ADVANCE INTERIORS NORTHERN PAINTING, INC. 12150 Paris Ave. P.O. Box 60 Stillwater, MN 55082 Stacy, MN 55079 SIGN SOLUTIONS LAGERQUIST CORPORATION 655 - 19th Ave., N.E. P.O. Box 582239 Minneapolis, MN 55418 Minneapolis, MN 55458 -2239 MARGOLIS BROTHERS CO. 1171 W. Larpenteur Ave. Roseville, MN 55113 TJ CONSTRUCTION 8520 Duluth St. Golden Valley,MN 55427 ANDERSEN CABINET, INC. 2500 N. Charles St. North St. Paul, MN 55109 FRANKLIN DRYWALL, INC. 2825 Country Dr. St. Paul, MN 55117 W.L. HALL CO. 14800 Martin Dr. Eden Prairie, MN 55344 KUNZ CONSTRUCTION 2668 Eldridge North St. Paul, MN 55109 Telephone number 1 ip /d ) /,00 - Q 6 ,;;3 Did you have employees work on this project? 1 If none, explain who did the work: Amount still due: Address 92033 CITY Ne Hope, MN Citv_ of New ' 4401 XXy on A New Hope, MN 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: 'GEORGE W. OLSEN CONSTRUCTION CO., INC. P.O. Box 20 1 Stillwater, MN 55082 ❑ 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 keclare that all information I have filled in on thi orm is true and complete to the best of my knowledge and belief. I authorize e Department of Revers isclose pertinen information relating to this project, including sending copies of this form, the p contractor' m a subco ractor, and to ny subcontractors if I am a prime contractor, and to the contracting aaencl M For certification, cftif original and on4kopy to: / � innesota 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 of auth z D rtm e I egr9f Revenus$ffioial � � y Stock No. 5000134 Form 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 Minnesota or any of its subdivisions can make final paym to contractors. Company name Minnesota ID number MOLIN CONCRETE PRODUCTS 8248951 Address Month/year work began 4T5 LILAC STREET 08/92 city State Zip Code Month /year work ended LINO LAKES MN 55014 11/92 Please type or print clearly above. This will be your Total contract amount: mailing label for returning the completed form. 3055.00 Telephone number Amount still due: (612 ) 786 -7722 3055.00 Did you have employees work on this project? YES Project num 92033 CITY HALL REMODELING If none, explain who did the work: i Project location: New Hope, MN Proinctt- .vnor- Citv of New Ho-De Address 1 44ui Ay-Lon ave . N. New Hoye. MN 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: GEORGE W. OLSEN CONSTRUCTION CO., INC. P.O. Box 20 Stillwater. MN 55082 ❑ 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 prime contractor if I am a subcontractor, and to any subcontractors if I am a prime contractor, and to the contractino aoencv. contractors signature Title Date r PRESIDENT 12/21/92 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 pajoAq employees relating to contract services with the state of Minnesota and/or its subdivisions. Telephone numbers ) ,!' �✓ Amount still due: ^y Did you have employees work on this project? ( Project num If none, explain who did the work: Project l r_; _U Project owner: C f i'Y Address aj 4'01 X )Q 3 ^ ',,4ce ,. sue• "'°'_ Po d ` 2 �./ 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 1111illill IN 111 1 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 contracw; -,if I am a subcontractor, and to any subcontractors if I am a prime contractor, and to the contracting agency, Contr ctors � e Title Date fs 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 of authorized Department of Revenue official s 0 Date No. � RE Form IC -134 Minnesota Department of Revenue Rev. 11/90 Withholding Affidavit for Contractors E I 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. 4 (° `� � � _= Company name Minnesota ID number J ces z4 S �' R v � rc G ��2� k7 �� 7 5 Monthtyear work began Address ' 31 73 Month /year work ended city State Zip Code Please type or print clearly above. This will be your Total contract amount: mailing label for retur ning the completed form. 14 S" • 43 Telephone numbers ) ,!' �✓ Amount still due: ^y Did you have employees work on this project? ( Project num If none, explain who did the work: Project l r_; _U Project owner: C f i'Y Address aj 4'01 X )Q 3 ^ ',,4ce ,. sue• "'°'_ Po d ` 2 �./ 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 1111illill IN 111 1 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 contracw; -,if I am a subcontractor, and to any subcontractors if I am a prime contractor, and to the contracting agency, Contr ctors � e Title Date fs 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 of authorized Department of Revenue official s 0 Date No. Form FEB 17 IM Department of Revenue Minnesota De lC -134 p Rev. 11/90 Withholding Affidavit for Contractors This affidavit must be approved by the Minnesota Department of Revenue before the RE Ct.to of Min --tn nr —, of itc enhrlivicinnc — —1— finol --- + +n — +— +— City State ip Code Month /year work ended 1I -55M Please type or print clearly above. This will be your Total contract amount: mailing label for returning the completed form. T lephone number Amount still due: r i ` 4 \ Did you have employees work on this project? Proiect num ber: 92 CITY HALL REMODELING If none, explain who did the work: Project location: New Hoge , MN _ Proiec own er: e City_of New Ho Address 1 Xy o� N. 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: GEORGE W. OLSEN CONSTRUCTION CO., INC. P.O. Box 20 Stillwater, MN 55082 ❑ 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, ( t the rime contractor if I am a subcontractor, and to an subcontractors if I am a prime contractor, and to the contracting agency. (ontrac`iQr's signatu ,.1 A Title ,.� Date I I 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 th' a �,ertificate has fulfilled all the requirements of Minnesota Statutes 290.92 and 290.97 concerning the withhdi 1 g (afhfe ofa income tax from wages paid to employees relating to contract services with the state of Minnesota and /or its dMMI;ions. Signature of a t izecqV e rtment Reven official V I , e Stock No. 5000134 Form Minnesota Department of Revenue ic Rey. toes Withholding Affidavit for Contractors This affidavit must be approved by the Minnesota Department of Revenue before the Stale of Minnesota or any of Its subdivisions can make final payment to contrac corr"I Arse FIRE -GUARD Sprinkler Service, Inca A4040rasr 212 East Commercial Street Stillwater, Mn. 55082 Did you have empioyess work on this project? It node, t+xpfaln who did the work: YES ID nm*w 2843052 Month/yoar work bogan January 1993 MonrVyrar work ended Al2ril, 1993 Total W*60 amood'. 118.422. MoovOl $ss 4000: $ 2,414.00' Project number: 34146 Prujact;ocotion: 4401 Xylon Ave. N. , Proiectowner: City of New Hope___ Address .4401 Xylon .Ave. N., w hope, inn. Check the box that describes your Involvement In the project and fill in alt Information requested In that category: ❑ Sole contractor 0 Subcontractor II yoware a subcontractor. fill in the name and address of the contractor that hired you: G.W. Olsen - Construction Co., Inc., 1902 So. Greeley St., Stillwater, Mn. 55082 ❑ 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, till 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.) - - susi —ce name Address Owner"icer 1 declare that all intormation i have Mad to on INs form is true and comptele to the best of my kr,owtedgo and ballet. 1 authorize the oepsldment of Revonut to disclose pertinent informatton totaling to this project, ktoludinq sending oopies of this form. r., rh..v"fe antractor it t am a suboontractor. and to an subooniractors N f am a {time contractor, and to the oonkactino agency. President 5 -3 -93 Dave Lindstro M, 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 290.92 and 290.97 concerning the withholding of Minnesota Income tax from wages paid employees r lating to contract s rvIces with the state of Minnesota and/or its subdivisions. Sip kas of r0rasrM or As+iorwe y eau w rope, mn &fit 3 ,., Form Y IC•134 Minnesota Department of Revenue Rev. 11/90 Withholding Affidavit for Contractors Janning's, Acoustics, Address '10715 County Road 24 City State Watertown, MN This affidavit must be approved by the Minnesota Department of Revenue before the State of Minnesota or of its subdivisions can make final payment to contractors. Company name Minnesota ID number Inc. m Month /year work began Zip Code I Month /year work ended 55388 • .. Please type or print clearly above. This will be your Total contract amount: mailing label for returning the completed form. $7,725.00 Telephone number Amount still due: (612 ) 446 -1262 5,371.00 Did you have employees work on this project? Project number: 92033 CITY HALL REMODELING If none, explain who did the work: Project location: New Hope , MN Pro' ct owner: City of New Hope Address 44UI Xy on Ave, N. impollill New Ho e MN 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: GEORGE W. OLSEN CONSTRUCTION CO. INC. P.O. Box 20 Stillwater MN 55082 El 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 prime contractor if 1 am a subcontractor, and to any subcontractors if I am a prime contractor, and to the contracting agency. Contractors signature Title Date 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 of authorized Department of Revenge official Date 1 Stcllk No. 5000134 t� Form IC -134 Rev. 11/90 Minnesota Department of Revenue W ithholding Affidavit for Contractors This affidavit must be approved by the Minnesota Department of Revenue before the State of Minnesota or anv of its subdivisions can make fi nal Davment to contrantors_ Company name KMH ERECTORS, INC. Address + Box 37 city State Zip Code M aple Plain, MN 55359 RECEIVED JUN 17 199 Minnesota ID number 3408495 Month /year work began November 19 Month /year work ended May 1993 Please type or print clearly above. This will be your Total contract amount: mailing label for returning the completed form. $11,670.00 Telephone number I Amount still due: ( 6 479 -2022 1 $ 3,190.00 Did you have employees work on this project? yes Project number: 92033 CI If none, explain who did the work: Project location: New Hope , MN ELING Project owner: Cit v of New Ho Address 1 44Ui Xy on Ave. Ne Hoye. MN 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: GEORGE W. OLSEN CONSTRUCTION CO. INC. P. Box 20 Stillwater, MN 55082 ❑ 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 prime contractor if I am a su bcontractor, and to any subcontractors if I am a prime contractor, and to the contracting ao enev. cgatractor's Title Date // _ dQ Vice- president 6 -14 -93 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 emp relating to contr s e rvi ces with the state of Minnesota and /or its subdivisions. Signature or autnonzed uepartment of rtevenup ottical Date No.5000134 Form Form Minnesota Department of Revenue IC-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 any of its subdivisions can make final payment to contractors. Company name Minnesota ID number P� f � tj tc 1A[ l 6)(00 i 03 Address � � Month /year work began /0 f q City f r P A Sate Zip Code Month /year work ended /J Please type or print clearly above. This will be your Total contract amount. � mailing label for returni the completed form. I,* Telephone number Amount still due: Did you have employees work on this project? Project number: , 92033 CITY HALL REMODELING If none, explain who did the work: Project location: New Hope, MN -. / 1 � Proie wner,._Cit of New Hop 1 Address Xy Ave. N. 1 New Hope, MN 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: GEORGE W OLSEN CONSTRUCTION CO., INC. P.O. Box 20 Stillwater, MN 55082 ❑ 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 prime contractor if I am a subcontractor, and to any subcontractors if I am a prime contractor, and to the contracting agency. h4l-i2 6Z LM� a // Sew ATf,--Os 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 employe relating to contract se rvices with the state of Minnesota and /or its subdivisions. Signatuje of authored Department of Revenue official uac No. 5000134 Please type or print clearly above. This will be your Total contrct amount: . mailing label for returning the completed form. Y7 Telephone number Did you have employees work on this project? If none, explain who did the work: — 11"i Amount still due: Protect number: 92033 CITY HALL B Project lo cation: New Hope, MN Proiec owner: Cit o f New H ope _ Address - -440 1 Xy owe . N. New Hope, MN Check the box that describes your involvement in the project and fill in all information requested in that category: ❑ Sole contractor FX Subcontractor If you are a subcontractor, fill in the name and address of the contractor that hired you: GEORGE W. OLSEN CONSTRUCTION CO., INC. P.O. Box 20 1 Stillwater, MN 55082 ❑ 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 O /O 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 i(Tfn a subcontractor, and to any subcontractors if I am a prime contractor, and to the contracting agency. r......�.....d�1,.,��r,,.m Title.. Date 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 co n t ract services with the state of Minnesota and /or its subdivisions. Signature of authorized Department of Revenue official Date Stock JUN 16 10 I `_ RECEIVED 'i. a > C� � t d� F orm Minnesota' Department of Revenue J 10 t Rev. 11/90 Withholding Affidavit for Cone cr k93 i 42 p p This affidavit must be approved by the Minnesota Department of Reve the State of Minnesota or any of its subdivisions can make final payment to�'contrac ors. r "a Minnesota ID number Company name Royal Electric Co., Inc. ` 5733067`` Address Month /year work began 7401 Central Ave. N.E. 9/8/92 city Mp I S . state MN zip code 55432 Month /year work ended 64,906.1 Please type or print clearly above. This will be your Total contract amount: mailing label for returning the completed form. 6 11 / 9 . Telephone number Amount stilt due. ( 612 784 -4646 $21,769.18 Did you have employees work on this project? Project num 92033 CITY HALL REMODELING ;f none. vhc did the wor Pro ject location: New Hope, MN ❑ Sole contractor ® Subcontractor If you are a subcontractor, fill in the name and address of the contractor that hired you: GEORGE W. OLSEN CONSTRUCTION CO., INC. P .O. Box 20 Stillwater, MN 55082 ❑ 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 Jill 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 t he contracting agency. Contractor's signatur o Title Date President 6/14/93 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, 1 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 t . ployees relating to contract services with the state of Minnesota and /or its subdivisions. Signature of t d De gent ot&,ven *e official Stock No. 5000134 ' Check the box that describes your involvement in the project and fill in all information requested in that category: JUN 17 19,93, ,,juiv ! 8 � 9b Form IC -134 Minnesota Department of Revenue Rev. 11 /90 W ithh o lding Affidavit for Contractors This affidavit must be approved by the Minnesota Department of Revenue before tho State of Minnesota or any of its subdivisions can make final payment to contractors: Company name Minnesota ID number RECE Crawford Door Sales Company 9046070 Address Month /year work began 1641 Oakdale Avenue January 1993 city State Zip Code Month /year work ended West St Paul, MN 55118 May 1993 Please type or print clearly above. This will be your Total contract amount: mailing label for returning the completed form. $1 ,204.00 Telephone number Amount still due: ( 612) 455 -1221 120.00 Did you have employees work on this project? Project number: 92033 CITY HALL REMODELING If none, explain who did the work: yes Project loc New Hope, MN Proiect owner: City of New Hope Address 1 4 4UI Ay on Ave. N. New HODe. MN 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: GEORGE W. OLSEN CONSTRUCTION CO. INC. P.O. Box 20 Stillwater MN 55082 ❑ 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 evenue to disclose pertinent information relating to this project, including sending copies of this form, to the prime contractor i I am a subcontractor, and to any subcontractors if I am a prime contractor, and to the contracting agency Contractor s s nature � Title Date President June 14 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 of author Department of Revenue official Date Stock No. 5000134 Form IC -134 Rev. 11/90 i f �w; r Minnesota Department of Revenue W it hholding Affidavit f 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 I Minnesota ID number Droels Caulking Company Address P.O. Box 25094 City State Zip Code 26 2259 Month /year work began March 1993 Month /year work ended March 1 993 Please type or print clearly above. This will be your Total contract amount. mailin label for returning the completed form. $1,104.00 Telephone number Amount still due: ( 612)731 -8661 $100.00 Did you have employees work on this project? yes Project number: 92033 CITY HALL REMODELING If none, explain who did the work: Project location: New Hope, 10 Address 1 44UL Xylon Ave. A . New Hope, MN 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: GEORGE W OLSEN CONSTRUCTION CO., INC. P.O. Box 20 Stillwater, MN 55082 El 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 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 pre June 14, 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 of authorized Department of Revenue official Date Poo 3 5 n No. 5000134 R / Form IC -134 Rev. 11/90 P F 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 anv of its subdivisions can make final oavment to contractors. Company name SPECIAL COATINGS & TILE CO INC Address 7617 PELTIER LK DR city HUGO MN State zip code 5 5 0 3 8 Please type or print clearly above. This will be your mailina label for returnina the completed form. Telephone number ( 612 ) 4297903 Did you have employees work on this project? If none, explain who did the work: Minnesota ID number 2469224 Month /year work began 4 -18 -93 Month /year work ended 4 -30 -93 Total contract amount: $12.860.00 Amount still due: $ 4275.00 Project num 92033 CITY H. Project location: New Hope, MN Address , 44U1 Xylon Ave. 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: GEORGE W. OLSEN CONSTRUCTION CO., INC. P.O. Box 20 Stillwater, MN 55082 ❑ 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 11 Jil 11 11 11 ill 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. Contractor's signature ( Title Date VICE PRESIDENT 6 -14 -93 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. Slgn$ture or autnonzed'pepartment otj.ievenue otticial Date Stock No. 5000134 Please type or print clearly above. This will be your Total contract amou t. mailing label for returning the completed form. Telephone number Amount still du Did you have employees work on this project? Project num 92033 CITY HALL REMODELING If none, explain who did the work: Project location: New Hope, MN f CC. Project owner: City of New Hope 1 d Address 4401 nylon Ave. N. New HODe . MN. 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: GEORGE W. OLSEN CONSTRUCTION CO., INC. P.O. Box 20 Stillwater, MN 55082 ❑ 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 prime contractor if I am a subcontractor, and to any subcontractors if I am a prime contractor, and to the contracting agency. Contractors signature Title Date 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 MinrIWW income tax from wages paid to employ relating to contract services with the state of Minnesota and /o its subdivisions. -yn u. �� nceu pan r�01 (wlclal , W ate a Stock No. 5000134 Form IC -134 Rev. 11/90 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: GEORGE W. OLSEN CONSTRUCTION CO. INC. P.O. Box 20 Stillwwater, MN 550$2 ❑ 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 A...., a ... t a t IUD 2 1 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 anv of its subdivisions can make fin payment to contractors. I declare that all information I have fi ' on this fo is true and complete to the best of my knowledge and belief. I authorize the Department of Revenue t l ose penin information relating to this project, including sending copies of this form, to the ract I a ontractor d to any subcontractors if I am a prime contractor, and to the contracting agency. Contractor's signal Title Date 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 of author D Reve t partm�gl of u�.oHicial ., s �" \ Stock No. 5000134 Form IC -134 , UP 2 4 ;:393 Minnesota Department of Revenue Rev. ,1 /90 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 yment to contractors. Company name Minnesota ID number 3222658 Northern Painting, Inc. Address Month /year work began P.O. Box 60 2/1/93 city Stacy, MN Zip Code 55079 Month /year work ended4 3 1 9 3 Please type or print clearly above. This will be your Total contract amount: $ 13,981.00 mailing label for returning the complet form. Telephone number Amount still due: $ 1,693.00 (612) 462 -1105 Did you have employees work on this project? Yes Project num 92033 CITY HALL REMODELING If none, explain who did the work: Project location: New Hope, MN Project owner: City of New Hope Address 1 Xy on Ave. N. New Ho e i m 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: GEORGE W. OLSEN CO CO., INC. P.O. Box 20 Stillwater, MN 55082 ❑ 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 th rtment of Revenue to disclose pertinent information relating to this project, including sending copies of this form, to pri gAtractor V I am a subcontractor, and to any subcontractors if I am a prime contractor, and to the contracting agency. Contractor's sionat Title,. -7 .tea nara For certification, rrfail 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 pal tp employeeq relating to contract services with the state of Minnesota and /or its subdivisions. Signature of a nt of`4ven -VffictaI p PoSp ( Date w Stock No. 5000134 j J Form IC -134 ,SUN 24 k � 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 any of its subdivisions can make final payment to contractors. Company name Minnesota ID number Address on Ave. N. 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: GEORGE W. OLSEN CONSTRUCTION CO., INC. P.O. Box 20 Stillwater, MN 55082 ❑ 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 Oclare t t all info ation I have filled in on this form is true and complete to the best of my knowledge and belief. I authorize the p*partmenybf Revenue to disclose pertinent information relating to this project, including sending copies of this form, o the me contra6tor if I am a subcontractor, and to any subcontractors if I am a prime contractor, and to the contracting agency. Contractor's 7u,e & Title Date 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 of authorized D artment of Revenue official m � D t No. 50001 JUN 2 1 1993 Form IC -134 Minnesota Department of Revenue Rev. 11 /90 W ithholding 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 payment to contractors. Company name it I Minnesota lDnumber i7 N r.,,/n A-� n r Did you have employees work on this project? Project num 92033 CITY HALL REMODELING If none, explain who did the work: Project location: New Hope, MN Project owner: City of New Hope Address 440 Xy on Ave. N. New Hope MN 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: GEORGE W. OLSEN CONSTRUCTION CO., INC. P.O. Box 20 Stillwater, MN 55082 ❑ 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 knowl6dg' and belief. I authorize the Department of Revenue to disclose pertinent information relating to this project, including sendi g copies of this form, t the 'rime contractor if I am a subcontractor, and to an subcontractors if I am a rime contractor a to the contracting agency. Co tra or's signatu Title f ,\� � � Date For certificat;r5n�ail original and one copy to: ; J Minnesota Departmeevenue, Business Trust Tax Section Mail Station , 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 of u hor'z Depart nt of R enue official Date s 4M 2 Stock No. 5000134 Form IC -134 Rev. 11/90 °'i � Minnesota Department of Revenue Withholding Affidavit for Contractors `q' 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 Q Margolis Brothers Co. 41- 0662175 (9 Address Y city 1171 W. Larpenteur Ave. Month/year Y work began 1993 Ro s evi 11 a to Zip Code Monthlyear work ended MN 55113 July 1993 Please type or print clearly above. This will be your Total contract amount: mailing label for returning the completed form. $8,53 Telephone number Amount still due: 612/488 -7258 $8,536.45 Did you have employees work on this project? yes If none, explain who did the work: location: New CITY HALL ope,_M of Ne Ho Xvfon Ave. Address -- New 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: GEORGE W. OLSEN CONSTRUCTION CO., INC. P.O. Box 20 Stillwater, 55082 ❑ 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 l5rime contractor if I am a subcontractor, and to any subcontractors if I am a prime contractor, a to the con tractin a enc . Coptragor'ssignature Title Date �y For certification, mail original and one copy to: c 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 toLnployees relating to contract services with the state of Minnesota and /or its subdivisions. Signature of wAho i�,edP ep &t bf tr4nu#`o iqt I Date Stock No. 5000134 1,,. IC1 -34 Minnesota Department of Revenue Rev. 11/90 W ith h olding Affidavit for Contractors This affidavit must be approved by the Minnesota Department of Revenue before the State of Minnesota or any of its subdivis can make final payment t o contractors. Company name Franklin Drywall, Inc. Address 3260 FanUm Road city Vadnai Heightg""a' MN z'p 55110 Please type or print clearly above. This will be your mailino label for returning the completed form. Telephone number ,612, 481 -0811 Did you have employees work on this project? If none, explain who did the work: Minnesota 10 number 2551492 Month/year work began 12/92 Monttvyear work ended 4/93 Total contract amount: $24,480.00 Amount still due: 1,230.00 Pro' numb 92033 CITY HALL R Project location: New Hope, MN Project owner: Cit of New Ho pe Address 744 "' lon Ave New HO'De, MN 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: GEORGE W. OLSEN CONSTRUCTION CO., INC. P.O. Box 20 Stillwater, MN 55082 ❑ 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, Ilk Ito the drime contractor if I amasubconttaMr, and to any subcontractors if I am a prime contractor, and to the contracting agency. Contractor i lure /'� Title Date President 6/15/93 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 290.2 and 290.97 concerning the withholding of Minnesota income tax from wages paid employees relating to contract servi *s lWith the state of Minnesota and /or its subdivisions. Signature a w dth?n d Dip `rtmygt of F�6venuq Nficial •% ",k D to 1 9 93 Stock No. 5000134 m «d> Form " T.;9 10 IC -134j' Minnesota Department of Revenue Rev. 9189 Withholding Affidavit for Contract 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 to number TJ Y ; -3 - S"G - ()'? Address Month/year work began `dS� -O #xJ tJ7"� S'1 city State Zip Code Month/year*ork ended S3 7 kJO /l P Telephone number Did you have employees work on this project? if none, explain wha did the work: C � Total contract amount: y '/ (, Amount still due: , 4/ Project number: Proiect location: Project owner: 0 CIz V V lam_ L ll4 JV /, t 1 Address lfUJ kyJvn f}�'2. N m rm fmlmnf� m Check the box that describes your Involvement In the project and fill In all Information requested In that category: ❑ Sole contractor -- Subcontractor If yo are subcon tractor, fill i n the name and address of the contractor that hired you: 5 PLC1.tr l �Qr L PV a /4 /7� I U 2- 2 4 ❑ Prime C tractor 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 prime contractor if I am a subcontractor, and to any subcontractors if I am a prime contractor, and to the contracting a encY. Contractor's signature Title Date 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 290.92 and 290.97 concerning the withholding of Minnesota income tax from wages paid to employees relating to contract serv with the state of Minn and /or its subdivisions. Signature of authorized Department of Revenue official Date r ,� fi �C Form 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 Minnesota or any of its subdivisions can make final payment to contractors. Company name W.L. Hall Co. Minnesota to number 6882796 Address 14800 Martin Drive Month year work began • August, 1992 City Eden Prairie stateMN ZipCodCD5344 Month /year work ended July, 1993 Please type or print clearly above. This will be your Total contract amount: mailing label for returning the completed form. $29268.00 Telephone number Amount still due: ( 612)937 -8400 2826.00 Did you have employees work on this project? yes Project number: 92033 CITY HALL REMODELING If none, explain who did the work: Project location: New Hope , MN Proiec owner: City of New Hope Address :yeon Ave. N. New Ho 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: GEORGE W OLSEN CONSTRUCTION CO., INC. P.O. Box 20 Stillwater, MN 55082 ❑ 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 Stock No. 5000134 0 Form' IC -134 Minnesota Department of Revenue 'hev.11 /90 Withholding Affidavit for Contr This affidavit must be approved by the Minnesota Department of Revenue ore the State of Minnesota or anv of its subdivisi can m ake final payment to contractors. Minnesota ID Month /year work began 3 - i Telephone number —7 °� +^7 '--p t 1a) d / I l Did you have employees work on this project? If none, explain who did the work: Month /year work ended Total contract amount: Amount still due: s __. - -- I Pro ject number: 92033 C Project location: New Hope PrnIP.Ct owner- City Of 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: GEORGE W. OLSEN CONSTRUCTION CO., INC. , P.O. Box 20 Still MN 55082 IX 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 Jill III Jill 111 111 11 1 1 1 1 1,1 1 1 1 1 11 111 1 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 De ment of Revenue to disclose pertinent information relating to this project, including sending copies of this form, tnAka ririv6 r tr ctnr U4 am a�utxnntractor. and to anv subcontractors if I am a orime contractor, and to the contracting agency. 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 o ho ' Depa ant of venue official JU Tate .xr t �. , v. I Address Q Stock No. 5000134 x t { Form IC-1134 Rev. 11/90 Minnesota Dep rt6lent' Aevenue 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 ayment to contractors. Minnesota to number Company name K U N Ia C C) N ST f ( )e- , r l 0 N Address 2 66'8 EtagIo6e City State Zip Code IV ST. L Please type or print clearly above. This will be your maainn Iahei for returnina the completed form. Telephone number Did you have employees work on this project? I Pro if none, explain who did the work: Pro Address r: 92033 n: N ew Hop -- Xy New Hop MN on Ave. N. 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: GEORGE W. OLSEN CONSTRUCTION CO. INC. P.O. Box 20 1 Stillwater MN 55082 ❑ 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 rime contractor if I ama sub co n tractor, and to any subcontractors if I am a prime contractor, and to the co agency. Contractor atuf � ` Titl e Date .Ice 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. �i Y Stock No. 5000134 !I S3 8 el Iz Month/year work began Month /year work ended ^ q 3 Total contract amount: Amount stilt due: g ®x) ��pp��--�� o0 (!D '^ JUN Date l COUNCIL 1• ! ! 0 MOTION APPROVING ARCHITECTURAL AGREEMENT FOR CITY HALL REMODELING/ ADDITION PROJECTS BETWEEN BONESTROO, ROSENE, ANDERLIK AND ASSOCIATES, INC. AND CITY OF NEW HOPE, IMPROVEMENT PROJECT NOS. 472 AND 489 Per the direction of the City Council, the staff has pursued an architectural agreement for the City Hall remodeling /addition projects with Bonestroo, Rosene, Anderlik, and Associates. Inc. and the proposed agreement is attached. This is the American Institutue of Architects' standard form of agreement between owner and architect. The compensation for basic services is described in Article 12 and would obligate the City to pay Design Service fees of $39,000, plus reimbursable expenses, up to the time that bids are opened. This fee reflects a credit for previous work that has been completed. The scope of the project is outlined in Appendix A. The City Manager and City Engineer will be reviewing the agreement with the Council and address specific questions at the meeting. Staff recommends approval of a motion approving Architectural Agreement for City Hall Remodeling /Addition Projects Between Bonestroo, Rosene, Anderlik, and Associates, Inc. and City of New Hope, Improvement Project Nos. 472 and 489. TO: Q� C OMM • ! S Review: Administration: Finance: tf Otto G. Bonestroo, P.E. Keith A. Gordon. P.E. James R. Maland, RE. Rene C. Plumart, A.LA. Joseph C. Anderlik, P.E. Richard W. Foster, PE. Kenneth P. Anderson, P.E. Agnes M. Ring, A.I.C.R. Marvin L. Sorvala, P.E. Jerry A. Bourdon, P.E. Mark R. Rolfs, P.E. Jerry D. Pertzsch, P.E. Richard E. Turner, P.E. Mark A Hanson, P.E. Thomas E. Angus, P.E. Cecilio Olivier, PE. Glenn R. Cook, P.E. David O. Loskota, P.E. Daniel J. Edgerton, P.E. Gary W. Morien, P.E. Thomas E. Noyes, PE, Robert C. Russek, A.I.A. Mark A. Seip, P.E. Karen L. Wiemefi, PE. Robert G. Schunicht, PE. Howard A. Sanford, P.E. Philip J. Caswell, P.E. Keith R. Yapp, P.E. Susan M. Eberlin, C.P.A. Donald C. Burgardt, P.E. Ismael Martinez, P.E. Michael P Rau, PE. Ted K. Field, P.E. Mark D. Wallis, P.E. Charles A. Erickson Michael 7. Rautmann, P.E. Thomas R. Anderson, A.I.A. Leo M. Pawelsky Robert R. Pfefferle, P.E. Gary F Rylander, P.E. Harlan M. Olson Thomas W. Peterson, PE. Miles B. Jensen, P.E. Michael C. Lynch, P.E. L. Phillip Gravel III, P.E. March 11, 1992 Mr. Daniel J. Donahue City Manager 4401 Xylon Avenue N. New Hope, MN 55428 -4898 Dear Dan: Enclosed are two copies of a proposed architectural agreement for the City Hall remodel - ing/addition projects. For architectural projects, we customarily use the American Institute of Architects' standard form of agreement between owner and architect. If you have any questions, please feel welcome to call Bob Russek, our Chief Architect, or Dave Loskota, who coordinates the preparation of our contracts. The Architectural Studio looks forward to helping the City complete this work. We appreci- ate this opportunity to further demonstrate our architectural capabilities to New Hope. Sincerely, 2335 West Highway 36 9 St. Paul, Minnesota 55113 • 612 - 636 -4600 T H E A hi E R I C A N M I N S T I T U T E O F A R C H C 1' E G T AIA Do&ument B141 - reement Between Standard Form of A Owner and Architect THIS DOCUMENT HAS IMPORTANT LEGAL CONSEQUENCES, CONSULTATION WITH ANA TTORNEY IS ENCOURAGED WITH RESPECT TO ITS COMPLETION OR MODIFICATION. AGREEMENT made as of the day of Nineteen Hundred and Ninety -two BETWEEN the Owner: City of New Hope (Name and address) 4401 Xylon Avenue North New Hope, MN 55428 -4898 and the Architect: Bonestroo, Rosene, Anderlik & Associates, Inc. (Nante and address) 2335 W. Trunk Highway 36 St. Paul, MN 55113 For the following Project: (Include detailed description of Project, location, address and scope.) See Appendix "A ". in the year of The Owner and Architect agree as set forth below. Copyright 1917, 1926, 1948, 1951, 1953, 1958, 1961, 1963, 1966, 1967, 1970, 1974, 1977, ©1987 by The American institute of Architects, 1735 New York Avenue, N.W., Washington, D.C. 20006. Reproduction of the material herein or substantial quotation of its provisions without written permission of the AIA violates the copyright laws of the United States and will be subject to legal prosecution. AIA DOCUMENT 8141 - OWNER-ARCHITECT AGREEMENT - FOURTEENTH EDITION - AIA® - 01987 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 141 -1987 1 M TERMS AND CONDITIONS OF AGREEMENT BETWEEN OWNER AND ARCHITECT ARTICLE 1 ARCHITECT'S RESPONSIBILITIES 1.1 ARCHITECT'S SERVICES 1.1.1 The Architect's services consist of those services per- formed by the Architect, Architect's employees and Architect's consultants as enumerated in Articles 2 and 3 of this Agreement and any other services included in Article 12. 1.1.2 The Architect's services shall be performed as expedi- tiously as is consistent with professional skill and care and the orderly progress of the Work. Upon request of the Owner, the Architect shall submit for the Owner's approval a schedule for the performance of the Architect's services which may be adjusted as the Project proceeds, and shall include allowances for periods of time required for the Owner's review and for approval of submissions by authorities having jurisdiction over the Project. Time limits established by this schedule approved by the Owner shall not, except for reasonable cause, be exceeded by the Architect or Owner. 1.1.3 The services covered by this Agreement are subject to the time limitations contained in Subparagraph 11.5.1. ARTICLE 2 SCOPE OF ARCHITECT'S BASIC SERVICES 2.1 DEFINITION 2.1.1 The Archit ct's Basic Services consist of those described in Paragraphs 2r24hrough 2.6 and any other services identified in Article 12 as part of Basic Services, and include normal struc- tural, mechanical and electrical engineering services. 2.2 SCHEMATIC DESIGN PHASE 2.2.1 The Architect shall review the program furnished by the Owner to ascertain the requirements of the Project and shall arrive at a mutual understanding of such requirements with the Owner. 2.2.2 The Architect shall provide a preliminary evaluation of the Owner's program, schedule and construction budget requirements, each in terms of the other, subject to the limita- tions set forth in Subparagraph 5.2.1. 2.2.3 The Architect shall review with the Owner alternative approaches to design and construction of the Project. 2.2.4 Based on the mutually agreed -upon program, schedule and construction budget requirements, the Architect shall prepare, for approval by the Owner, Schematic Design Docu- ments consisting of drawings and other documents illustrating the scale and relationship of Project components. 2.2.5 The Architect shall submit to the Owner a preliminary estimate of Construction Cost based on current area, volume or other unit costs. 2.3 DESIGN DEVELOPMENT PHASE 2.3.1 Based on the approved Schematic Design Documents and any adjustments authorized by the Owner in the program, schedule or construction budget, the Architect shall prepare, for approval by the Owner, Design Development Documents consisting of drawings and other documents to fix and describe the size and character of the Project as to architectural, struc- tural, mechanical and electrical systems, materials and such other elements as may be appropriate. 2.3.2 The Architect shall advise the Owner of any adjustments to the preliminary estimate of Construction Cost. 2.4 CONSTRUCTION DOCUMENTS PHASE 2.4.1 Based on the approved Design Development Docu- ments and any further adjustments in the scope or quality of the Project or in the construction budget authorized by the Owner, the Architect shall prepare, for approval by the Owner, Construction Documents consisting of Drawings and Specifica- tions setting forth in detail the requirements for the construc- tion of the Project. 2.4.2 The Architect shall assist the Owner in the preparation of the necessary bidding information, bidding forms, the Condi- tions of the Contract, and the form of Agreement between the Owner and Contractor. 2.4.3 The Architect shall advise the Owner of any adjustments to previous preliminary estimates of Construction Cost indi- cated by changes in requirements or general market conditions. 2.4.4 The Architect shall assist the Owner in connection with the Owner's responsibility for filing documents required for the approval of governmental authorities having jurisdiction over the Project. �• �- • • 2.5.1 The Architect, following the Owner's approval of the Construction Documents and of the latest preliminary estimate of Construction Cost, shall assist the Owner in obtaining bids or negotiated proposals and assist in awarding and preparing contracts for construction. 2.6 CONSTRUCTION PHASE — ADMINISTRATION . OF THE CONSTRUCTION CONTRACT 2.6.1 The Architect's responsibility to provide Basic Services for the Construction Phase under this Agreement commences with the award of the Contract for Construction and terminates at the earlier of the issuance to the Owner of the final Certificate for Payment or 60 days after the date of Substantial Completion of the Work, unless extended under the terms of Subparagraph 10.3.3. 2.6.2 The Architect shalt provide administration of the Con- tract for Construction as set forth below and in the edition of AIA Document A201, General Conditions of the Contract for Construction, current as of the date of this Agreement, unless otherwise provided in this Agreement. 2.6.3 Duties, responsibilities and limitations of authority of the Architect shall not be restricted, modified or extended without written agreement of the Owner and Architect with consent of the Contractor, which consent shall not be unreasonably withheld. AIA DOCUMENT 8141 • OWNER - ARCHITECT AGREEMENT • FOURTEENTH EDITION • AIA° • ©1987 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 2.6.4 The Architect shall be a representative of and shall advise and consult with the Owner (1) during construction until final payment to the Contractor is due, and (2) as an Additional Ser- vice at the Owner's direction from time to time during the cor- rection period described in the Contract for Construction. The Architect shall have authority to act on behalf of the Owner only to the extent provided in this Agreement unless otherwise modified by written instrument.. 2.6.5 The Architect shall visit the site at intervals appropriate to the stage of construction or as otherwise agreed by the Owner and Architect in writing to become generally familiar with the progress and quality of the Work completed and to determine in general if the Work is being performed in a man- ner indicating that the Work when completed will be in accor- dance with the Contract Documents. However, the Architect shall not be required to make exhaustive or continuous on -site inspections to check the quality or quantity of the Work. On the basis of on -site observations as an architect, the Architect shall keep the Owner informed of the progress and quality of the Work, and shall endeavor to guard the Owner against defects and deficiencies in the Work. (More extensive site representation may be agreed to as an Additional Service, as described in Paragraph 3.2.) 2.6.6 The Architect shall not have control over or charge of and shall not be responsible for construction means, methods, techniques, sequences or procedures, or for safety precautions and programs in connection with the Work, since these are solely the Contractor's responsibility under the Contract for Construction. The Architect shall not be responsible for the Contractor's schedules or failure to carry out the Work in accor- dance with the Contract Documents. The Architect shall not have control over or charge of acts or omissions of the Contrac- tor, Subcontractors, or their agents or employees, or of any other persons performing portions of the Work. 2.6.7 The Architect shall at all times have access to the Work wherever it is in preparation or progress. 2.6.8 Except as may otherwise be provided in the Contract Documents or when direct communications have been spe- cially authorized, the Owner and Contractor shall communicate through the Architect. Communications by and with the Archi- tect's consultants shall be through the Architect. 2.6.9 Based on the Architect's observations and evaluations of the Contractor's Applications for Payment, the Architect shall review and certify the amounts due the Contractor. 2.6.10 The Architect's certification for payment shall consti- tute a representation to the Owner, based on the Architect's observations at the site as provided in Subparagraph 2.6.5 and on the data comprising the Contractor's Application for Pay- ment, that the Work has progressed to the point indicated and that, to the best of the Architect's knowledge, information and belief, quality of the Work is in accordance with the Contract Documents. The foregoing representations are subject to an evaluation of the Work for conformance with the Contract Documents upon Substantial Completion, to results of subse- quent tests and inspections, to minor deviations from the Con- tract Documents correctable prior to completion and to spe- cific qualifications expressed by the Architect. The issuance of a Certificate for Payment shall further constitute a representation that the Contractor is entitled to payment in the amount certi- fied. However, the issuance of a Certificate for Payment shall not be a representation that the Architect has (1) matte exhaus- tive or continuous on -site inspections to check the quality or quantity of the Work, (2) reviewed construction means, meth- ods, techniques, sequences or procedures, (3) reviewed copies of requisitions received from Subcontractors and material sup- pliers and other data requested by the Owner to substantiate the Contractor's right to payment or (4) ascertained how or for what purpose the Contractor has used money previously paid on account of the Contract Sum. 2.6.11 The Architect shall have authority to reject Work which does not conform to the Contract Documents. Whenever the Architect considers it necessary or advisable for implementa- tion of the intent of the Contract Documents, the Architect will have authority to require additional inspection or testing of the Work in accordance with the provisions of the Contract Docu- ments, whether or not such Work is fabricated, installed or completed. However, neither this authority of the Architect nor a decision made in good faith either to exercise or not to exer- cise such authority shall give rise to a duty or responsibility of the Architect to the Contractor, Subcontractors, material and equipment suppliers, their agents or employees or other per- sons performing portions of the Work. 2.6.12 The Architect shall review and approve or take other appropriate action upon Contractor's submittals such as Shop Drawings, Product Data and Samples, but only for the limited purpose of checking for conformance with information given and the design concept expressed in the Contract Documents. The Architect's action shall be taken with such reasonable promptness as to cause no delay in the Work or in the con- struction of the Owner or of separate contractors, while allow- ing sufficient time in the Architect's professional judgment to permit adequate review. Review of such submittals is not con- ducted for the purpose of determining the accuracy and com- pleteness of other details such as dimensions and quantities or for substantiating instructions for installation or performance of equipment or systems designed by the Contractor, all of which remain the responsibility of the Contractor to the extent required by the Contract Documents..The Architect's review shall not constitute approval of safety precautions or, unless otherwise specifically stated by the Architect, of construction means, methods, techniques, sequences or procedures. The Architect's approval of a specific item shall not indicate approval of an assembly of which the item is a component. When professional certification of performance characteristics of materials, systems or equipment is required by the Contract Documents, the Architect shall be entitled to rely upon such certification to establish that the materials, systems or equip- ment will meet the performance criteria required by the Con- tract Documents. 2.6.13 The Architect shall prepare Change Orders and Con- struction Change Directives, with supporting documentation and data,if deemed necessary by the Architect as provided in Subparagraphs 3.1.1 and 3.3.3, for the Owner's approval and execution in accordance with the Contract Documents, and may authorize minor changes in the Work not involving an adjustment in the Contract Sum or an extension of the Contract Time which are not inconsistent with the intent of the Contract Documents. 2.6.14 The Architect shall conduct inspections to determine the date or dates of Substantial Completion and the date of final completion, shall receive and forward to the Owner for the Owner's review and records written warranties and related documents required by the Contract Documents and assem- bled by the Contractor, and shall issue a final Certificate for Pay- ment upon compliance with the requirements of the Contract Documents, AiA DOCUMENT 8141 • OWNER-ARCIIITF,CT AGREEMENT • FOURTEENTH EDITION • AIA® • ©1987 3 8141 -1987 TILE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 2(Xft 2.6.15 The Architect shall interpret and decide matters con- cerning performance of the Owner and Contractor under the requirements of the Contract Documents on written request of either the Owner or Contractor. The Architect's response to such requests shall be made with reasonable promptness and within any time limits agreed upon. 2.6.16 Interpretations and decisions of the Architect shall be consistent with the intent of and reasonably inferable from the Contract Documents and shall be in writing or in the form of drawings. When making such interpretations and initial deci- sions, the Architect shall endeavor to secure faithful perfor- mance by both Owner and Contractor, shall not show partiality to either, and shall not be liable for results of interpretations or decisions so rendered in good faith. 2.6.17 The Architect's decisions on matters relating to aesthe- tic effect shall be final if consistent with the intent expressed in the Contract Documents, 2.6.18 The Architect shall render written decisions within a reasonable time on all claims, disputes or other matters in ques- tion between the Owner and Contractor relating to the execu- tion or progress of the Work as provided in the Contract Documents. 2.6.19 The Architect's decisions on claims, disputes or other matters, including those in question between the Owner and Contractor, except for those relating to aesthetic effect as pro- vided in Subparagraph 2,6.17, shall be subject to arbitration as provided in this Agreement and in the Contract Documents. ARTICLE 3 ADDITIONAL SERVICES 3.1 GENERAL 3.1.1 The services described in this Article 3 are not included in Basic Services unless so identified in Article 12, and they shall be paid for by the Owner as provided in this Agreement, in addition to the compensation for Basic Services. The services described under Paragraphs 3.2 and 3.4 shall only be provided if authorized or confirmed in writing by the Owner. If services described under Contingent Additional Services in Paragraph 3.3 are required due to circumstances beyond the Architect's control, the Architect shall notify the Owner prior to com- mencing such services. If the Owner deems that such services described under Paragraph 3.3 are not required, the Owner shall give prompt written notice to the Architect. If the Owner indicates in writing that all or part of such Contingent Addi- tional Services are not required, the Architect shall have no obli- gation to provide those services. 3.2 PROJECT REPRESENTATION BEYOND BASIC SERVICES 3.2.1 if more extensive representation at the site than is described in Subparagraph 2.6.5 is required, the Architect shall provide one or more Project Representatives to assist in carry- ing out such additional on -site responsibilities. 3.2.2 Project Representatives shall be selected, employed and directed by the Architect, and the Architect shall be compen- sated therefor as agreed by the Owner and Architect. The duties, responsibilities and limitations of authority of Project Representatives shall be as described in the edition of AIA Document B352 current as of the date of this Agreement, unless otherwise agreed. 3.2.3 Through the observations by such Project Represen- tatives, the Architect shall endeavor to provide further protec- tion for the Owner against defects and deficiencies in the Work, but the furnishing of such project representation shall not modify the rights, responsibilities or obligations of the Architect as described elsewhere in this Agreement. 3.3 CONTINGENT ADDITIONAL SERVICES 3.3.1 Making revisions in Drawings, Specifications or other documents when such revisions are: .1 inconsistent with approvals or instructions previously given by the Owner, including revisions made neces- sary by adjustments in the Owner's program or Proj- ect budget; .2 required by the enactment or revision of codes, laws or regulations subsequent to the preparation of such documents; or .3 due to changes required as a result of the Owner's fail- ure to render decisions in a timely manner. 3.3.2 Providing services required because of significant changes in the Project including, but not limited to, size, qual- ity, complexity, the Owner's schedule, or the method of bid- ding or negotiating and contracting for construction, except for services required under Subparagraph 5.2,5, 3.3.3 Preparing Drawings, Specifications and other documen- tation and supporting data, evaluating Contractor's proposals, and providing other services in connection with Change Orders and Construction Change Directives. 3.3.4 Providing services in connection with evaluating substi- tutions proposed by the Contractor and making subsequent revisions to Drawings, Specifications and other documentation resulting therefrom. 3.3.5 Providing consultation concerning replacement of Work damaged by fire or other cause during construction, and fur- nishing services required in connection with the replacement of such Work. 3.3.6 Providing services made necessary by the default of the Contractor, by major defects or deficiencies in the Work of the Contractor, or by failure of performance of either the Owner or Contractor under the Contract for Construction. 3.3.7 Providing services in evaluating an extensive number of claims submitted by the Contractor or others in connection with the Work. 3.3.8 Providing services in connection with a public hearing, arbitration proceeding or legal proceeding except where the Architect is party thereto. 3.3.9 Preparing documents for alternate, separate or sequential bids or providing services in connection with bidding, negotia- tion or construction prior to the completion of the Construc- tion Documents Phase. 3.4.1 Providing analyses of the Owner's needs and program- ming the requirements of the Project. 3.4.2 Providing financial feasibility or other special studies. 3.4.3 Providing planning surveys, site evaluations or com- parative studies of prospective sites, AiA DOCUMENT 8141 ® OWNER - ARCHITECT AGREEMENT ® FOURTEENTH EDITION • AiAM • 01487 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 8141 -1957 4 3.4.4 Providing special surveys, environmental studies and submissions required for approvals of governmental authorities or others having jurisdiction over the Project. 3.4.5 Providing services relative to future facilities, systems and equipment. 3.4.6 Providing services to investigate existing conditions or facilities or to make measured drawings thereof. 3.4.7 Providing services to verify the accuracy of drawings or other information furnished by the Owner. 3.4.8 Providing coordination of construction performed by separate contractors or by the Owner's own forces and coordi- nation of services required in connection with construction performed and equipment supplied by the Owner. 3.4.9 Providing services in connection with the work of a con- struction manager or separate consultants retained by the Owner. 3.4.10 Providing detailed estimates of Construction Cost. 3.4.11 Providing detailed quantity surveys or inventories of material, equipment and labor. 3.4.12 Providing analyses of owning and operating costs. 3.4.13 Providing interior design and other similar services required for or in connection with the selection, procurement or installation of furniture, furnishings and related equipment. 3.4.14 Providing services for planning tenant or rental spaces. 3.4.15 Making investigations, inventories of materials or equip- ment, or valuations and detailed appraisals of existing facilities. 3.4.16 Preparing a set of reproducible record drawings show- ing significant changes in the Work made during construction based on marked -up prints, drawings and other data furnished by the Contractor to the Architect. 3.4.17 Providing assistance in the utilization of equipment or systems such as testing, adjusting and balancing, preparation of operation and maintenance manuals, training personnel for operation and maintenance, and consultation during operation. 3.4.18 Providing services after issuance to the Owner of the final Certificate for Payment, or in the absence of a final Cer- tificate for Payment, more than 60 days after the date of Sub- stantial Completion of the Work, 3.4.19 Providing services of consultants for other than archi- tectural, structural, mechanical and electrical engineering por- tions of the Project provided as a part of Basic Services, 3.4. Providing any other services not otherwise included in this Agreement or not customarily furnished in accordance with generally accepted architectural practice. • A w,� 4.1 The Owner shall provide full Information regarding requirements for the Project, including a program which shall set forth the Owner's objectives, schedule, constraints and cri- teria, including space requirements and relationships, flexi- bility, expandability, special equipment, systems and site requirements. 4.2 The Owner shall establish and update an overall budget for the Project, including the Construction Cost, the Owner's other costs and reasonable contingencies related to all of these costs. 4.3 If requested by the Architect, the Owner shall furnish evi- dence that financial arrangements have been made to fulfill the Owner's obligations under this Agreement. 4.4 The Owner shall designate a representative authorized to act on the Owner's behalf with respect to the Project. The Owner or such authorized representative shall render decisions in a timely manner pertaining to documents submitted by the Architect in order to avoid unreasonable delay in the orderly and sequential progress of the Architect's services. 4.5 The Owner shall furnish surveys describing physical characteristics, legal limitations and utility locations for the site of the Project, and a written legal description of the site. The surveys and legal information shall include, as applicable, grades and lines of streets, alleys, pavements and adjoining property and structures; adjacent drainage; rights -of -way, restrictions, easements, encroachments, zoning, deed restric- tions, boundaries and contours of the site; locations, dimen- sions and necessary data pertaining to existing buildings, other improvements and trees; and information concerning available utility services and lines, both public and private, above and below grade, including inverts and depths. All the information on the survey shall be referenced to a project benchmark. 4.6 The Owner shall furnish the services of geotechnical engi- neers when such services are requested by the Architect. Such services may include but are not limited to test borings, test pits, determinations of soil bearing values, percolation tests, evaluations of hazardous materials, ground corrosion and resis- tivity tests, including necessary operations for anticipating sub- soil conditions, with reports and appropriate professional recommendations. 4.6.1 The Owner shall furnish the services of other consul- tants when such services are reasonably required by the scope of the Project and are requested by the Architect. 4.7 The Owner shall furnish structural, mechanical, chemical, air and water pollution tests, tests for hazardous materials, and other laboratory and environmental tests, inspections and reports required by law or the Contract Documents. 4.8 The Owner shall furnish all legal, accounting and insurance counseling services as may be necessary at any time for the Project, including auditing services the Owner may require to verify the Contractor's Applications for Payment or to ascertain how or for what purposes the Contractor has used the money paid by or on behalf of the Owner. 4.9 The services, information, surveys and reports required by Paragraphs 4.5 through 4.8 shall be furnished at the Owner's expense, and the Architect shall be entitled to rely upon the accuracy and completeness thereof. 4.10 Prompt written notice shall be given by the Owner to the Architect if the Owner becomes aware of any fault or defect in the Project or nonconformance with the Contract Documents. 4.11 The proposed language of certificates or certifications requested of the Architect or Architect's consultants shall be submitted to the Architect for review and approval at least 14 days prior to execution. The Owner shall not request certifica- tions that would require knowledge or services beyond the scope of this Agreement. AIA DOCUMENT 9141 o OWNER- ARCI11TECT AGREEMENT ® FOURTEENTH EDITION ® AIA® O ©1487 141 °1997 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 ARTICLE 5 CONSTRUCTION COST 5.1 DEFINITION . 5.1.1 The Construction Cost shall be the total cost or esti- mated cost to the Owner of all elements of the Project designed or specified by the Architect: 5.1.2 The Construction Cost shall include the cost at current market rates of labor and materials furnished by the Owner and equipment designed, specified, selected or specially provided for by the Architect, plus a reasonable allowance for the Con- tractor's overhead and profit. In addition, a reasonable allow- ance for contingencies shall be included for market conditions at the time of bidding and for changes in the Work during construction. 5.1.3 Construction Cost does not include the compensation of the Architect and Architect's consultants, the costs of the land, rights -of -way, financing or other costs which are the respon- sibility of the Owner as provided in Article 4. 5.2 RESPONSIBILITY FOR CONSTRUCTION COST 5.2.1 Evaluations of the Owner's Project budget, preliminary estimates of Construction Cost and detailed estimates of Con- struction Cost, if any, prepared by the Architect, represent the Architect's best judgment as a design professional familiar with the construction industry. It is recognized, however, that nei- ther the Architect nor the Owner has control over the cost of labor, materials or equipment, over the Contractor's methods of determining bid prices, or over competitive bidding, market or negotiating conditions. Accordingly, the Architect cannot and does not warrant or represent that bids or negotiated prices will not vary from the Owner's Project budget or from any estimate of Construction Cost or evaluation prepared or agreed to by the Architect. 5.2.2 No fixed limit of Construction Cost shall be established as a condition of this Agreement by the furnishing, proposal or establishment of a Project budget, unless such fixed limit has been agreed upon in writing and signed by the parties hereto. If such a fixed limit has been established, the Architect shall be permitted to include contingencies for design, bidding and price escalation, to determine what materials, equipment, com- ponent systems and types of construction are to be included in the Contract Documents, to make reasonable adjustments in the scope of the Project and to include in the Contract Docu- ments alternate bids to adjust the Construction Cost to the fixed limit. Fixed limits, if any, shalt be increased in the amount of an increase in the Contract Sum occurring after execution of the Contract for Construction. 5.2.3 If the Bidding or Negotiation Phase has not commenced within 90 days after the Architect submits the Construction Documents to the Owner, any Project budget or fixed limit of Construction Cost shall be adjusted to reflect changes in the general level of prices in the construction industry between the date of submission of the Construction Documents to the Owner and the date on which proposals are sought. 5.2.4 If a fixed limit of Construction Cost (adjusted as pro- vided in Subparagraph 5.2.3) is exceeded by the lowest bona fide bid or negotiated proposal, the Owner shall, .3 if the Project is abandoned, terminate in accordance with Paragraph 8.3; or .4 cooperate in revising the Project scope and quality as required to reduce the Construction Cost. 5.2.5 If the Owner chooses to proceed under Clause 5.2.4.4, the Architect, without additional charge, shall modify the Con- tract Documents as necessary to comply with the fixed limit, if established as a condition of this Agreement. The modification of Contract Documents shall be the limit of the Architect's responsibility arising out of the establishment of a fixed limit. The Architect shall be entitled to compensation in accordance with this Agreement for all services performed whether or not the Construction Phase is commenced. ARTICLE 6 USE OF ARCHITECT'S DRAWINGS, 6.1 The Drawings, Specifications and other documents pre- pared by the Architect for this Project are instruments of the Architect's service for use solely with respect to this Project and, unless otherwise provided, the Architect shall be deemed the author of these documents and shall retain all common law, statutory and other reserved rights, including the copyright. The Owner shall be permitted to retain copies, including repro- ducible copies, of the Architect's Drawings, Specifications and other documents for information and reference in connection with the Owner's use and occupancy of the Project. The Archi- tect's Drawings, Specifications or other documents shall not be used by the Owner or others on other projects, for additions to this Project or for completion of this Project by others, unless the Architect is adjudged to be in default under this Agreement, except by agreement in writing and with appropriate compen- sation to the Architect. 6.2 Submission or distribution of documents to meet official regulatory requirements or for similar purposes in connection with the Project is not to be construed as publication in deroga- tion of the Architect's reserved rights. ARTICLE 7 si 7.1 Claims, disputes or other matters in question between the parties to this Agreement arising out of or relating to this Agree- ment or breach thereof shall be subject to and decided by arbi- tration in accordance with the Construction industry Arbitra- tion Rules of the American Arbitration Association currently in effect unless the parties mutually agree otherwise. 7.2 Demand for arbitration shall be filed in writing with the other party to this Agreement and with the American Arbitra- tion Association. A demand for arbitration shall be made within a reasonable time after the claim, dispute or other matter in question has arisen. In no event shall the demand for arbitration be made after the date when institution of legal or equitable proceedings based on such claim, dispute or other matter in question would be barred by the applicable statutes of limitations. 7.3 No arbitration arising out of or relating to this Agreement shall include, by consolidation, joinder or in any other manner, an additional person or entity not a party to this Agreement, .1 give written approval of an Increase in such fixed limit; .2 authorize rebidding or renegotiating of the Project within a reasonable time; AIA DOCUMENT 8141 ® OWNER - ARCHITECT AGREEMENT • FOURTEENTH EDITION • AIA® • ©1987 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 except by written consent containing a specific reference to this Agreement signed by the Owner, Architect, and any other person or entity sought to be joined. Consent to arbitration involving an additional person or entity shall not constitute consent to arbitration of any claim, dispute or other matter in question not described in the written consent or with a person or entity not named or described therein. The foregoing agree- ment to arbitrate and other agreements to arbitrate with an additional person or entity duly consented to by the parties to this Agreement shall be specifically enforceable in accordance with applicable law In any court having jurisdiction thereof. 7.4 The award rendered by the arbitrator or arbitrators shall be final, and judgment may be entered upon it in accordance with applicable law in any court having jurisdiction thereof. TERMINATI ARTICLE 8 t • • •• 8.1 This Agreement may be terminated by either party upon not less than seven days' written notice should the other party fail substantially to perform in accordance with the terms of this Agreement through no fault of the party initiating the termination. 8.2 If the Project is suspended by the Owner for more than Vn consecutive days, the Architect shall be compensated for ser- vices performed prior to notice of such suspension. When the Project is resumed, the Architect's compensation shall be equi- tably adjusted to provide for expenses incurred in the interrup- tion and resumption of the Architect's services. 8.3 This Agreement may be terminated by the Owner upon not less than seven days' written notice to the Architect in the event that the Project is permanently abandoned. If the Project is abandoned by the Owner for more than 90 consecutive days, the Architect may terminate this Agreement by giving written notice. 8.4 Failure of the Owner to make payments to the Architect in accordance with this Agreement shall be considered substantial nonperformance and cause for termination. 8.5 If the Owner fails to make payment when due the Archi- tect for services and expenses, the Architect may, upon seven days' written notice to the Owner, suspend performance of ser- vices under this Agreement. Unless payment in full is received by the Architect within seven days of the date of the notice, the suspension shall take effect without further notice. In the event of a suspension of services, the Architect shall have no liability to the Owner for delay or damage caused the Owner because of such suspension of services. 8.6 In the event of termination not the fault of the Architect, the Architect shall be compensated for services performed prior to termination, together with Reimbursable Expenses then due. r ` Termination Expenses are in addition to compensation for Basic andAdditional Services, and include expenses which are directly attribmable to termination. Termination Expenses shall be computed as a rcentage of the total compensation for Basic Services and Adtlitl n Services earned to the time of ter- mination, as follows: \, .1 Twenty percent of the total ,ensation for Basic and Additional Services earned to aa<lf termination occurs before or during the predesign, sit alysis, or Schematic Design Phases; or Ten percent of the total compensation for Basic and 'onal of earned to date if termination occurs the Design Development Phase; or .3 Five percent of the compensation for Basic and Additional Services e date i arne f termination occurs during any subsequent ph ARTICLE 9 9.1 Unless otherwise provided, this Agreement shall be gov- erned by the law of the principal place of business of the Architect. 9.2 Terms in this Agreement shall have the same meaning as those in AIA Document A201, General Conditions of the Con- tract for Construction, current as of the date of this Agreement. 9.3 Causes of action between the parties 'to this Agreement pertaining to acts or failures to act shall be deemed to have accrued and the applicable statutes of limitations shall com- mence to run not later than either the date of Substantial Com- pletion for acts or failures to act occurring prior to Substantial Completion, or the date of issuance of the final Certificate for Payment for acts or failures to act occurring after Substantial Completion. 9.4 The Owner and Architect waive all rights against each other and against the contractors, consultants, agents and employees of the other for damages, but only to the extent cov- ered by property insurance during construction, except such rights as they may have to the proceeds of such insurance as set forth in the edition of AIA Document A201, General Conditions of the Contract for Construction, current as of the date of this Agreement. The Owner and Architect each shall require similar waivers from their contractors, consultants and agents. 9.5 The Owner and Architect, respectively, bind themselves, their partners, successors, assigns and legal representatives to the other party to this Agreement and to the partners, succes- sors, assigns and legal representatives of such other party with respect to all covenants of this Agreement. Neither Owner nor Architect shall assign this Agreement without the written con- sent of the other. 9.6 This Agreement represents the entire and integrated agree- ment between the Owner and Architect and supersedes all prior negotiations, representations or agreements, either writ- ten or oral. This Agreement may be amended only by written instrument signed by both Owner and Architect. 9.7 Nothing contained in this Agreement shall create a contrac- tual relationship with or a cause of action in favor of a third party against either the Owner or Architect. 9.8 Unless otherwise provided in this Agreement, the Architect and Architect's consultants shall have no responsibility for the discovery, presence, handling, removal or disposal of or expo- sure of persons to hazardous materials in any form at the Project site, including but not limited to asbestos, asbestos products, polychlorinated biphenyl (PCB) or other toxic substances. 9.9 The Architect shall have the right to include representa- tions of the design of the Project, including photographs of the exterior and interior, among the Architect's prornotional and professional materials. The Architect's materials shall not include the Owner's confidential or proprietary information if the Owner has previously advised the Architect in writing of 7 �41�19�7 AIA DOCUMENT 9141 e OWNER- ARCII]TECT AGREEMENT • FOURTEENTH EDITION 6 AIA' ® ©1987 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 OR the specific information considered by the Owner to be confi- dential or proprietary. The Owner shall provide professional credit for the Architect on the construction sign and in the pro- motional materials for the Project. ARTICLE 10 PAYMENTS TO THE ARCHITECT 10.1 DIRECT PERSONNEL EXPENSE 10.1.1 Direct Personnel Expense is defined as the direct salaries of the Architect's personnel engaged on the Project and the portion of the cost of their mandatory and customary con- tributions and benefits related thereto, such as employment taxes and other statutory employee benefits, insurance, sick leave, holidays, vacations, pensions and similar contributions and benefits. 10.2 REIMBURSABLE EXPENSES 10.2.1 Reimbursable Expenses are in addition to compensa- tion for Basic and Additional Services and include expenses incurred by the Architect and Architect's employees and con- sultants in the interest of the Project, as identified in the follow- ing Clauses. 10.2.1.1 Expense of transportation in connection with the Project; expenses in connection with authorized out -of -town travel; long- distance communications; and fees paid for secur- ing approval of authorities having jurisdiction over the Project. 10.2.1.2 Expense of reproductions, postage and handling of Drawings, Specifications and other documents. 10.2.1.3 If authorized in advance by the Owner, expense of overtime work requiring higher than regular rates. 10.2.1.4 Expense of renderings, models and mock -ups requested by the Owner. 10.2.1.5 Expense of additional insurance coverage or limits, including professional liability insurance, requested by the Owner in excess of that normally carried by the Architect and Architect's consultants. 10.2.1.6 Expense of computer -aided design and drafting equipment time when used in connection with the Project. 10.3 PAYMENTS ON ACCOUNT OF BASIC SERVICES 10.3.1 An Initial payment as set forth in Paragraph 11.1 is the minimum payment under this Agreement. 10.3.2 Subsequent payments for Basic Services shall be made monthly and, where applicable, shall be in proportion to ser- vices performed within each phase of service, on the basis set forth in Subparagraph 11.2.2. 10.3.3 If and to the extent that the time initially established in Subparagraph 11.5.1 of this Agreement is exceeded or extended through no fault of the Architect, compensation for any ser- vices rendered during the additional period of time shall be computed in the manner set forth in Subparagraph 11.3.2. 10.3.4 When compensation is based on a percentage of Con- struction Cost and any portions of the Project are deleted or otherwise not constructed, compensation for those portions of the Project shall be payable to the extent services are per- formed on those portions, in accordance with the schedule set forth in Subparagraph 11.2.2, based on (1) the lowest bona fide bid or negotiated proposal, or (2) if no such bid or proposal is received, the most recent preliminary estimate of Construction Cost or detailed estimate of Construction Cost for such por- tions of the Project. 10.4 PAYMENTS ON ACCOUNT OF ADDITIONAL SERVICES 10.4.1 Payments on account of the Architect's Additional Services and for Reimbursable Expenses shall be made monthly upon presentation of the Architect's statement of services ren- dered or expenses incurred. 10.5 PAYMENTS WITHHELD 10.5.1 No deductions shall be made from the Architect's com- pensation on account of penalty, liquidated damages or other sums withheld from payments to contractors, or on account of the cost of changes in the Work other than those for which the Architect has been found to be liable. 10.6 ARCHITECT'S ACCOUNTING RECORDS 10.6.1 Records of Reimbursable Expenses and expenses per- taining to Additional Services and services performed on the basis of a multiple of Direct Personnel Expense shall be avail- able to the Owner or the Owner's authorized representative at mutually convenient times. _ -T.-_il ? f _T+�' � tF�� tl t r r (J � l`�li � I • �7 ►1 The Owner shall compensate the Architect as follows: 11.1 AN INITIAL PAYMENT of Dollars (S shall be made upon execution of this Agreement and credited to the Owner's account at final payment. , 11.2 BASIC COMPENSATION 11.2.1 FOR BASIC SERVICES, as described in Article 2, and any other services included in Article 12 as part of Basic Services, Basic Compensation shall be computed as follows: (Insert basis of compensation, including stipulated sums, multiples or percentages, and identify phases to which particular methods of compensation apply, if necessarp,) Refer to Section 12. AiA DOCUMENT 8141 • OWNER ARCHITECT AGREEMENT • FOURTEENTH EDITION • AIA® e ©1987 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 8141 -1987 8 11.2.2 Where compensation is based on a stipulated sum or percentage of Construction Cost, progress payments for Basic Services in each phase shall total the following percentages of the total Basic Compensation payable: (Insert additional phases as appropriate.) Schematic Design Phase: Not applicable percent( - - %) Design Development Phase: Thirty percent( 30 0 /0 Construction Documents Phase: Sixty-two percent ( 6 2 %) Bidding or Negotiation Phase: Eight percent ( g %) Construction Phase: Not applicab percent ( - - %) Total Basic Compensation: one hundred percent (100 %) 11.3 COMPENSATION FOR ADDITIONAL SERVICES 11.3.1 FOR PRC!IECT REPRESENTATION BEYOND BASIC SERVICES, as described in Paragraph 3.2, compensation shall be com- puted as follows: On an hourly basis at billing rates noted in Appendix "B ", plus reimbursable expenses. 11.3.2 FOR ADDITIONAL SERVICES OF THE ARCHITECT, as described in Articles 3 and 12, other than (1) Additional Project Representation, as described in Paragraph 3,2, and (2) services included in Article 12 as part of Additional Services, but excluding ser- vices of consultants, compensation shall be computed as follows: (Insert basis of compensation, including rates and /or multiples of Direct Personnel i ypense jor Principals and employees, and identify Principals and classify employees, ij required. Identify specific services to which particular methods of compensation apply, j necessary.) On an hourly basis at billing rates noted in Appendix "B ", plus reimbursable expenses. 11.3.3 FOR ADDITIONAL SERVICES OF CONSULTANTS, including additional structural, mechanical and electrical engineering services and those provided under Subparagraph 3.4.19 or identified in Article 12 as part of Additional Services, a multiple of ( 1.1 ) times the amounts billed to the Architect for such services. (Identify specific types of consultants in Article 12, if required.) 11.4 REIMBURSABLE EXPENSES 11.4.1 FOR REIMBURSABLE EXPENSES, as described in Paragraph I0.2, and any other items included in Article 12 as Reimbursable Expenses, a multiple of ( 1.1 ) times the expenses incurred by the Architect, the Architect's employees and consultants in the interest of the Project. 11.5.1 IF THE BASIC SERVICES covered by this Agreement have not been completed within twe 1ve ( 12 ) months of the date hereof, through no fault of the Architect, extension of the Architect's services beyond that time shall be compensated as provided in Subparagraphs 10.3.3 and 11.3.2. 11.5.2 Payments are due and payable thirty ( 30 ) days from the date of the Architect's invoice. Amounts unpaid thirty ( 30 ) days after the invoice date shall bear interest at the rate entered below, or in the absence thereof at the legal rate prevailing from time to time at the principal place of business of the Architect. (Insert rate of interest agreed upon.) 1% per month (Usury faux and requirements under the Federal Truth in Lending Act, similar state and local consumer credit laws and other regulations at the Owner's and Arcbi- tect's principal places of business, the location of the Project and elsewhere may affect the validity of ibis provision. Specific legal advice should be obtained with respect to deletions or modifications, and also regarding requirements such as written disclosures or waivers.) 9 ®141 -1SS� AIA DOCUMENT B141 - OWNFR- ARCHITECT AGREEMENT - FOURTEENTH EDITION - AIA - ©1987 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 11.5.3 The rates and multiples set forth for Additional Services shall be annually adjusted in accordance with normal salary review practices of the Architect. ARTICLE 12 OTHER CONDITIONS OR SERVICES (Insert descriptions of other services, Identify Additional Semices included within Basic compensation and modifications to the payment and compensation terms included in this Agreement,) See page 11. This Agreement entered into as of the day and year first written above. OWNER ; CITY OF NEW HOPE, MN By 6en,7tmvi^ Rd rd J - Eric song Mayor ARCHITECT: BONESTROO, ROSENE, ANDERLIK & ASSOCIATES, INC. (Signature) t5 G 1 ;' Ld ro L `-end By FP+i to Ha+nece+rAi }aniel J. Donahue, Manager (Printed name andt :tte) AIA DMUh1ENT 8141 • OWNER ARCIIITECT AGREEMENT o FOURTEENTH EDITION • AIA® " ©1987 5141 °1987 10 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 Article 12 12.1 Compensation for Basic Services 12.1.1 For Basic Services as described in Paragraphs 2.3 through 2.5 ("Design Services"), Owner shall pay Architect a fee of $39,000, plus reimbursable expenses. This fee reflects a credit of $6,000 for the previous schematic design studies completed for the Owner by the Architect in February, March and July, 1991. 12.1.2 For Basic Services as described in Paragraph 2.6 ("Construction Phase Services"), Owner shall pay Architect on an hourly basis, plus reimbursable expenses. Hourly rates are those currently in effect under Owner/Architect agreement for consulting engineering services, as tabulated in Appendix "B." 12.2 Architect shall perform a physical survey of the site for design purposes, as described in Paragraph 4.5. The survey will not include legal information and will not be considered a "boundary survey" or a "land survey." Owner shall pay Architect for this work on an hourly basis, plus reimbursable expenses. The cost is estimated to range from $800-$1,500. -11- Ap pendix "A" Scope of the Project Project Title: City Hall Front and Rear Remodeling/Addition Projects Project Scope: A. Rear Addition 1. Garage Renovation (based on 3/5/91 Architect Report). Approximately 1,500 sq.ft. of space rehabilitation. Opinion of probable construction cost: $40,000. 2. Upper Floor Addition (based on 3/5/91 Architect Report). Approximately 4,040 sq.ft. of new space on the second level. Opinion of probable construction cost: $250,000. Firing range lead removal is not included in the scope of this project. Cost estimates were current as of January, 1991, and have not been adjusted for inflation. B. Front Addition 1. Elevator and building addition (based on 2/24/91 Architect construction cost estimate). Includes a handicapped- accessible elevator, new colored metal accent roof and skylight, new entry doors. opinion of probable construction cost: $215,000. 2. Sidewalks, stairs, canopy, landscaping (based on 2/24/91 Architect construction cost estimate). Opinion of probable construction cost: $85,000. C. Front Entrance Site Improvements 1. Site sign (based on 7/10/91 Architect Report). Opinion of probable construction cost: $30,000. 2. Fountains (based on 7/10/91 Architect Report). Opinion of probable construction cost: $30,000. Total estimated costs of approximately $650,000 are construction costs only, and do not include design fees, soil borings, site surveys, cost of land, rights-of-way, financing, or costs other than labor, materials, and equipment, including the Contractor's overhead and profit. -12- Appendix "B" 1992 Billing Rate Schedule Labor Classification Senior Principal Principal / Project Manager Registered Engineer/Architect Project Engineer/Architect Graduate Engineer/Architect/Field Supervisor Senior Draftsperson Senior Technician Technician Word Processor Clerical / Printing $77.75 67.50 58.50 52.00 46.50 42.75 39.50 27.50 28.25 21.75 These rates are adjusted annually at the first of the year in accordance with the normal review procedures of Bonestroo, Rosene, Anderlik and Associates, Inc. Hourl Rate -13- 4401 Xylon Avenue North New Hope, Minnesota 55428 Phone: 531 -5100 FAX (612) 531 -51; v March 24, 1992 Mr. Bob Russek Bonestroo, Rosene, 2335 West Hwy. 36 St. Paul, MN 55113 Dear Mr. Russek: Anderlik & Associates Enclosed is a fully executed architectural agreement between Bonestroo and the City of New Hope for city hall remodeling /addition projects. We retained the second copy for our files. The City Council approved the agreement at its meeting of March 23, 1992. We understand the compensation for basic services is as described in Article 12 and would obligate the City to pay Design Service fees of $39,000, plus reimbursable expenses up to the time that the bids are opened. Sincerely, `- rx-L Valerie Leone City Clerk enc. Family Styled City For Family Living 0� ft xx n Our PolypreneTM thermoplastic rubber hinge mat is more environmentally stable than vinyl hinge mats — resisting ozone, heat, mildew, ultraviolet light, and temperature extremes. It remains flexible down to -71' and has been flex- tested up to 3.4 million cycles with absolutely no breakdown. The exclusive hinge design eliminates metal -to -metal noise and the mat configuration causes water and dirt to run oft quickly and easily. This quality - made mat is available with the same frame options as the Model No. 546 mat. 2" --I NO. 557 SPECIFICATION INSERT: Roll -up mat shall be Reese Perfec Cls ABRASIVE TREAD MAT abrasive tread mat. Tread rails shall be serrated aluminum filled 100% silicon carbide or aluminum oxide grit bonded with heat re Top surface to have either exposed silicon carbide or aluminum adhesive or other coating. Color to be black for 100% silicon ca 314' TO SCALE brown, gray, beige, blue, or rose for 100% aluminum oxide grit. r • 2 „ — / --� 3116 rrrr NO. 536 CARPET TREAD MAT SPECIFICATION INSERT: Roll -up mat shall be Reese Perfec Cle, carpet insert mat. Carpet inserts shall be of 100% nylon, fusion d backing for durability, and mechanically secured in tread rails. C -. (Insert carpet color and numerical desigr 314” TO SCALE selection on page 10.) NO. 537 VINYL TREAD MAT SPECIFICATION INSERT: Roll -up mat shall be Reese Perfec Cle durometer vinyl insert mat. Tread surface shall be convex to per and crosshatched to improve slip resistance. Color to be 314" TO SCALE (Insert color: black, brown, gray, beige, blue, or rose.) 2" --I NO. 557 SPECIFICATION INSERT: Roll -up mat shall be Reese Perfec Cls ABRASIVE TREAD MAT abrasive tread mat. Tread rails shall be serrated aluminum filled 100% silicon carbide or aluminum oxide grit bonded with heat re Top surface to have either exposed silicon carbide or aluminum adhesive or other coating. Color to be black for 100% silicon ca 314' TO SCALE brown, gray, beige, blue, or rose for 100% aluminum oxide grit. r • AMERICAN ENGINEERING TESTING, INC, AND DENSITY TESTING PROJECT: CITY HALL ADDITION NEW HOPE, MINNESOTA AET JOB NO.: 92 -1839 DATE: OCTOBER 7, 1992 CONSULTANTS ° GEOTECHNICAL MATERIALS ° ENVIRONMENTAL CITY OF NEW HOPE C/O BONESTROO ROSENE ANDERLIK & ASSOCIATES 2335 WEST HIGHWAY 35 ST. PAUL, MN 55113 ATTN: GARY KRISTOFITZ This report contains the results of soil observations and testing we performed at the referenced site. Our services were done on a part-time intermittent trip basis. The scope of our work was limited to the following: • observing the base of the completed excavation for foundation construction • drilling hand auger borings in the base of the completed excavation • providing a judgment on the suitability of the exposed soils to support anticipated foundation loadings • conducting compaction tests in fill • summarizing the results of the above in a written report Our work on this project was authorized by Mr. Gary Kristofitz on September 14, 1992. "AN AFFIRMATIVE ACTION EMPLOYER" 2102 University Ave. W * St. Paul, MN 55114 a 612 - 659 -9001 a Fax 612 - 659 -1879 4431 West Michigan Street, Suite k4 . Duluth, MN 55807 ° 218- 628 -1518 w Fax 218- 628 -1580 1730 First Avenue ° Mankato, MN 56001 •507 -387 -2222 ° Fax 507- 387 -6999 AET #92 -1839 - Page 2 CONCLUSIONS Based on the results of our observations, hand auger borings and available information, it is our judgment the soils finally exposed in the completed building area excavation were suitable for support of fill and foundation loadings of 3000 psf. In the northern and northeast portion of the construction area, the excavation terminated at about planned foundation grade. Within the remainder of the building area, excavation extended to depths ranging from about 2 1 /2' to 3 /2' below the top of foundations for the existing structure. According to foundation location and elevation information supplied by project personnel, the excavation appeared to extend beyond the limits of the foundations to provide a suitable 1:1 lateral oversize. The results of three soil density tests performed on compacted fill placed to reestablish foundation grade indicated the specified minimum compaction level of 98 % was attained or exceeded at the location elevation of these tests. These conclusions are intended as a summary. Please read the remainder of the report for additional details. Previously, we conducted a subsurface exploration program at the referenced site. The results were included in the report of AET Job No. 92 -792, dated April 10, 1992. Please refer to that report for pertinent building background information, and for our recommendations for structural support. AET #92 -1839 - Page 3 DESIGN INFORMATION We understand that this southern addition will be a two story structure and will include an elevator. We understand the walls of the structure will be of masonry construction and that the addition will be about 22' x 40' in plan. The foundations have been designed based upon an allowable bearing capacity of 3000 psf. We further assume that the proposed building addition: t) will have normal tolerance to settlement; 2) will be of conventional design and construction; and 3) will be constructed in accordance with applicable building code requirements. Deviations from the above design information could necessitate altering our conclusions and recommendations. On September 15, 1992, we observed the excavation for the proposed construction of the southern addition. We were not present at the site on a full -time basis. Our observations consisted of two visits to the site as coordinated with the contractor. In conjunction with observing the base of the completed excavation, we conducted shallow hand auger borings in the base of the excavation. The soils encountered were classified in general accordance with ASTM:D2488. and compared to those described in the report of the preliminary subsurface exploration. Estimates were made of their strength characteristics. At the time of our initial visit, the soils exposed in the southern and southeastern portion of the building area at about planned foundation grade consisted of loose, wet, mixed fill composed of sand with silt, silty sand and clayey sand and some debris. This loose fill was judged to be unsuitable for support of foundation loadings. The fill was underlain by naturally- deposited clayey sand judged to be competent for structural support. We recommended to project personnel that the in- place, loose, uncontrolled fill be removed from the building area to expose the underlying competent naturally- deposited soils. AET #92 -1839 - Page 4 At the time of our second visit to the project site, excavation of the previously - placed uncontrolled fill had been completed throughout the building area. The exposed soils consisted of naturally- deposited clayey sand similar to the soil described in the report of the subsurface exploration. These soils were judged to be suitable for structural support. Along the south and west walls of the existing structure, excavation terminated approximately at planned foundation grade. Within the remainder of the area of the planned addition, excavation terminated at depths f'anging from about 2 1 /2' to about 3 /a' below the elevation of the top of the existing foundations. Therefore, placement of compacted fill was required to reestablish planned foundation elevation. Since some water entered the excavation area, we recommended that the fill used to reestablish foundation grade consist of a clean, free draining sand - gravel. FILL COMPACTION TESTING On September 21, 1992, three soil density tests were performed in compacted fill placed to reestablish foundation grade. The field density tests were then evaluated against the laboratory Standard Proctor density (ASTM:D698) to arrive at a percent compaction level for that test location. The results of these tests are attached. The test results indicate the specified minimum compaction level of 98% has been attained at the location and elevation of these tests. The following sheets are attached and constitute an integral part of this report: Report of Density Testing Earthwork Quality Control Information AET #92 -1839 - Page 5 To protect the client, the public and American Engineering Testing, Inc., this report (and all supporting information) is provided for the addressee's own use. No representations are made to parties other than the addressee. Report Prepared By: Gary C Larson Senior Engineering Assistant Under the Supervision of: / Jeffery K. Voyen, PE MN Reg. #15928 CONSULTANTS GEOTECHNICAL MATERIALS ENVIRONMENTAL PROJECT: CITY HALL ADDITION NEW HOPE, MINNESOTA . ! CITY OF NEW HOPE C/O BONESTROO ROSENE ANDERLIK & ASSOCIATES 2335 WEST HIGHWAY 36 ST. PAUL, MN 55113 ATTN: GARY KRISTOFITZ AET JOB NO: 92 -1834 DATE: OCTOBER 7, 1992 FIELD DENSITY TEST DATA Note: Proctor values adjusted for variable gravel content; and accordingly, values shown on Proctor list are not necessarily the value used in calculating % compaction. Test Test Test Elev. No. Date Location Depth 1 9/21/92 20'E & 2 1 /2S of SW Building 913 pcf % Corner (on Footing Line) No. 2 9/21/92 10'N of SW Building Corner 913 118.5 4.0 (on Footing Line) 1 3 9/21/92 15'N & 10'E of SW Building 913 12 1 Corner 98 Dry Moist. % Dens. Cont. Oversize Proc. Percent Specified pcf % Material No. Compaction Minimum 118.5 4.0 12 1 100 98 117.5 5.1 12 1 99th 98 117.0 4.9 12 1 99 98 Method: Sand Cone (ASTM D1556) _; Nuclear (ASTM D2922) X ; Balloon (ASTM D2167) To protect the addressee, the public, and ourselves, this report (and all supporting information) is provided for the addressee's own use. No representations are made to parties other than the addressee. Reviewed By "AN AFFIRMATIVE ACTION EMPLOYER" 2102 University Ave. IN * St. Paul, MN 55114 o 612 - 659 -9001 0 Fax 612659 -1379 4431 West Michigan Street, Suite #4 - Duluth, MN 55807 ®218- 628 -1.518 -Fax 218 -628 -1580 1730 First Avenue -Mankato, MN 56001 -507- 387 -2222 -Fax 507- 387 -6999 AET #92 -1834 - Page 2 LABORATORY MOISTURE - DENSITY RELATIONS OF SOILS (PROCTOR) No. Soil Description Sand, mostly fine grained, brown (SP) Opt. Moisture Max. Dry Method Content % Density pcf A 15.6 114.4 Procedure & Method: Standard (ASTM D698) X ; Modified (ASTM D1557)