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Imp. Proj. #629RESOLUTION AWARDING CONTRACT FOR CIVIC CENTER PARK IMPROVEMENTS (IMPROVEMENT PROJECT NO. 629) TO NORTH VALLEY INC. -$259,313.93 REQUESTED ACTION Staff and engineers are recommending that the City Council award a contract to North Valley, Inc. for the Civic Center Park Improvements Project #629 (Phase One of the Master Plan) for a total price of $259,313.93. This bid includes the base bid and alternate #1 which includes replacement of existing luminaire with new. Alternate #2 was for providing a new service panel and electrical service from the existing transformer to hand -hole (only needed if the pool concessions area project #601 C is not awarded). Staff is recommending alternate #2 not be accepted as it is recommended that the pool project be awarded tonight, also. POLICY /PAST PRACTICE The City has been rebuilding tennis courts in all its parks on a planned basis since 1991. The courts at Civic Center Park are in bad shape due to New Hope's clay soil and need to be rebuilt. The existing courts were built in the late 1960's and have only been resurfaced in the intervening years. BACKGROUND The City Council accepted a Master Plan for Civic Center Park in May of 1998. The local neighborhood, local tennis and basketball enthusiasts, and the Advisory Commission have all been a part of the development of the Master Plan and have reviewed the plans for these needed improvements included project 629. Phase one of the Master Plan includes the rebuilding of the four existing tennis courts, the building of a new lighted basketball court, a new lighted volleyball court, some new pathways, and realignment of the drive leading from Zealand Avenue to the Fire Station along with the provision of a dozen parking spots. Plans also include landscaping materials to enhance the park as well as provide some screening of the new courts from the Zealand Avenue neighbors. This is the second time that the phase one project #629 has been bid, with the first bid coming in at approximately $317,000 last July which included the base bid and the alternate to replace the luminaries. It was recommended then by the engineers that if the project were to be rebid in the late winter that much better bids may be received which has proven to be true. • s M North Valley, Inc. is a new company, a spin -off of Valley Paving. FUNDING TIF funding is available for this project. The engineer's estimate for the base bid was $308,000. The low bid is 17.5% below this estimate. ATTACHMENTS Bids were opened March 16, 1999 and are attached. The five lowest are summarized below. Contractor Base Bid North Valley, Inc. $254,845.13 Arrigoni Brothers $263,546.70 WB Miller $285,224.10 Barber Construction $307,262.75 Hardrives, Inc. $311,518.35 Alternate #1 Total Base + Alternate #1 $4,468.80 $259,313.93 $4,480.00 $268,026.70 $3,136.00 $288,360.10 $3,220.00 $310,482.75 $4,620.00 $316,138.35 CITY OF NEW HOPE RESOLUTION NO. 99- 53 RESOLUTION AWARDING CONTRACT FOR CIVIC CENTER PARK IMPROVEMENTS (IMPROVEMENT PROJECT NO. 629) TO NORTH VALLEY INC. - $259,313.93 WHEREAS, pursuant to advertisement for bids for Civic Center Park Improvements, bids were received, opened and tabulated according to law, and the following bids were received complying with the advertisement: Contractor Base Bid North Valley, Inc. $254,845.13 Arrigoni Brothers $263,546.70 WB Miller $285,224.10 Barber Construction $307,262.75 Hardrives, Inc. $311,518.35 Alternate #1 Total Base + Alternate #1 $4,468.80 $259,313.93 $4,480.00 $268,026.70 $3,136.00 $288,360.10 $3,220.00 $310,482.75 $4,620.00 $316,138.35 WHEREAS, it appears that North Valley, Inc. is the lowest responsible bidder. NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of New Hope, Minnesota: the Mayor and City Manager are hereby authorized and directed to enter into a contract with North Valley, Inc. in the name of the City of New Hope for Civic Center Park Improvements according to the plans and specifications for a total bid of $259,313.93 therefore approved by the City Council and on file in the office of the City Clerk. 2. The City Clerk is hereby authorized and directed to return forthwith to all bidders the deposits made with their bids, except that the deposits of the successful bidder and the next lowest bidder shall be retained until a contract has been signed. Adopted by the City Council of the City of New Hope, Hennepin County, Minnesota, this 22 day of March, 1999. Attest: 4 �a&j�t4 - ", City Clerk ri i r t tat£ vl � March 17, 1999 Honorable Mayor and City Council City of New Hope 4401 Xylon Ave N New Hope, MN 55428 -4898 Bonestroo, Rosene, Anderlik and Associates, Inc. is an Affirmative Action /Equal Opportunity Employer Principals' Otto G. Bonestroo, RE. • Joseph C. Anderlik, P.E. • Marvin L. Sorvala, PE. Richard E. Turner, P.E. • Glenn R Cook, P.E. • Robert G. Schunicht, P.E. • Jerry A. Bourdon, P.E. Robert W. Rosene, PE. and Susan M. Eberlin, C.P.A., Senior Consultants Associate Principals: Howard A. Sanford, P.E. • Keith A. Gordon, RE. • Robert R. Pfefferle, PE. Richard W. Foster, PE • David O. Loskota, P.E. • Robert C. Russek, A.I.A. • Mark A. Hanson, P.E. Michael T. Rautmann, PE • Ted K.Field, RE. • Kenneth P Anderson, RE. • Mark R. Rolfs, RE, Sidney P Williamson, RE, L.S. • Robert F Kotsmith • Agnes M. Ring • Michael P Rau, RE. Allan Rick Schmidt, RE. Offices: St. Paul, Rochester, Willmar and St. Cloud, MN • Milwaukee, WI Website. www.bonestroo.com Re: City of New Hope Civic Center Park Improvements Client Project No. 629 BRA File No. 34 -98 -224 Honorable Mayor and City Council: Bids were opened for the project stated above on March 16, 1999. Transmitted herewith is a copy of the bid tabulation for your information and file. Copies will also be distributed to each bidder. There were a total of 7 bids. The following summarizes the results of the low 5 bids received. Bid Amount Contractor Low North Valley, Inc. #2 Arrigom Brothers Company #3 W B Miller, Inc. #4 Barber Construction Co., Inc #5 Hardrives, Inc. Bid Amount Alternate No. 1 $254,845.13 $4,468.80 $263,546.70 $4,480.00 $285,224.10 $3,136.00 $307,262.75 $3,220.00 $311,518.35 $4,620.00 Alternate No. 2 $10,381.35 $10,500.00 $7,500.00 $8,000.00 $10,875.00 The low bidder on the project was North Valley, Inc. with a base bid of $254,845.13. This is 17.5% lower than the engineers estimate of $308,000.00. These bids have been reviewed and found in order. North Valley, Inc. started in 1998 as a separate company. Previously they were associated with Valley Paving. We are familiar with their personnel and feel they are capable of completing the Civic Center Park Improvements. Therefore, we recommend that the project be awarded to North Valley, Inc. for the base bid amount of $254,845.13. Alternate No. 1 includes replacement of the existing luminaires on the Tennis Court light poles. We recommend approval of this alternate based on the bid unit price and pat discussions with staff. Alternate No. 2 is not recommended. If Project 601C is not awarded, Alternate No. 2 would be required. Should you have any questions, please feel free to contact me. My direct dial phone number is (651) 604- 4790. Yours very truly, BONESTROO, ROSENE, ANDERLIK & ASSOCIATES, INC. Vincent Vander Top Enclosures VTV:jms 2335 West Highway 36 a St. taut, MN 55113 651- 636 -4600 a Fax: 651-636-1311 Bonestroo Base Bid 1 Rosene Project Name: Civic Center Park Improvements i hereby certify that this is an exact Anderlik & Project No.: 629 File No.: 34 -98 -224 reproduction of bids received. Associates fire station 3 Engineers & Architects Bid Opening: 3/16/99 11:00 AM Owner: _City of New Hope (fire Gall appranaus) 4 Vince Vander Top, P.E. Tree 5 Remove and salvage hydrant Registration No. 25770 6 Bid No. 1 Bid No. 2 Bid No. 3 Bid No. 4 Bid No. 5 Reconstruct sanitary manhole North Valley Inc Arrigoni Brothers W B Miller Inc Barber Construction Co Hardrives Inc Item I Remove and remount time controls EA Num Item Units Qty Unit Price Total Unit Price Total I Unit Price Total I Unit Price Total Unit Price 1.00 $4,350.00 $4,350.00 1.00 $2,000.00 $2,000.00 1.00 $1,000.00 $1,000.00 1.00 $150.00 $150.00 1.00 $903.00 $903.00 2.00 $2,112.60 $4,225.20 4.70 $105.00 $493.50 3.61 $35.70 $128.88 4.00 $157.50 $630.00 3.00 $1,260.00 $3,780.00 1.00 $866.25 $866.25 64.00 $7.50 $480.00 360.00 $3.15 $1,134.00 1.00 $4,650.00 $4,650.00 1.00 $6,500.00 $6,500.00 150.00 $10.00 $1,500.00 1150.00 $12.90 $14,835.00 1320.00 $9.50 $12,540.00 2800.00 $13.50 $37,800.00 $15.75 $10,237.501 $11.60 $7 2800.00 $1.99 $5,572.00 590.00 $1.99 $1,174.10 2.00 $1,680.00 $3,360.00 410.00 $32.48 $13,316.80 $2.90 $8,120.00 $3.00 $1,770.00 $1,200.00 $2,400.00 $34.00 $13,940.00 240.001 $21.91 $5,258.40 4.00 $668.85 $2,675.40 1.00 $1,207.50 $1,207.50 600.00 $7.85 $4,710.00 600.00 $14.50 $8,700.00 120.00 $25.00 $3,000.00 500.00 $9.50 $4,750.00 8700.00 $1.83 $15,921.00 100.00 $13.65 $1,365.00 $7,400.00 $7,400.00 $4,600.00 $4,600.00 $500.00 $500.00 $500.00 $500.00 $1,400.00 $1,400.00 $1,700.00 $3,400.00 $180.00 $846.00 $170.00 $613.70 $160.00 $640.00 $1,300.00 $3,900.00 $900.00 $900.00 $3.00 $192.00 $2.00 $720.00 $1,000.00 $1,000.00 $12,500.00 $12,500.00 $18.00 $2,700.00 $12.50 $14,375.00 $12.50 $16,500.00 $11.60 $32,480.00 $23.00 $5,520.00 $700.00 $2,800.00 $200.00 $200.00 $6.00 $3,600.00 $9.00 $5,400.00 $17.00 $2,040.00 $8.00 $4,000.00 $2.10 $18,270.00 $17.00 $1,700.00 $3,800.00 $3,800.00 $3,700.00 $3,700.00 $365.00 $365.00 $55.00 $55.00 $1,675.00 $1,675.00 $1,950.00 $3,900.00 $380.00 $1,786.00 $160.00 $577.60 $260.00 $1,040.00 $1,200.00 $3,600.00 $600.00 $600.00 $5.25 $336.00 $2.10 $756.00 $1,775.00 $1,775.00 $30,000.00 $30,000.00 $12.50 $1,875.00 $14.35 $16,502.50 $10.25 $13,530.00 $13.25 $37,100.00 $14.25 $2.50 $7,000.00 $2.50 $1,475.00 $1,675.00 $3,350.00 $32.50 $13,325.00 $22.00 $5,280.00 $750.00 $3,000.00 $1,200.00 $1,200.00 $4.20 $2,520.00 $10.50 $6,300.00 $27.00 $3,240.00 $1.05 $525.00 $2.35 $20,445.00 $16.75 $1,675.00 $8,300.00 $8,300.00 $6,550.00 $6,550.00 $5,500.00 $5,500.00 $7,100.00 $7,100.00 $1,500.00 $1,500.00 $850.00 $850.00 $350.00 $350.00 $350.00 $350.00 $900.00 $900.00 $945.00 $945.00 $2,500.00 $5,000.00 $2,215.00 $4,430.00 $150.00 $705.00 $160.00 $752.00 $75.00 $270.75 $85.00 $306.85 $275.00 $1,100.00 $165.00 $660.00 $1,260.00 $3,780.00 $1,320.00 $3,960.00 $600.00 $600.00 $900.00 $900.00 $5.00 $320.00 $3.30 $211.20 $3.00 $1,080.00 $1.70 $612.00 $4,000.00 $4,000.00 $1,500.00 $1,500.00 $6,000.00 $6,000.00 $39,000.00 $39,000.00 $18.00 $2,700.00 $23.00 $3,450.00 $16.00 $18,400.001 $12.60 $14,490.00 $12.50 $16,500.001 $10.70 $14,124.00 $21.00 $58,800.001 $16.05 $44,940.00 $16.00 $10,400.001 $16.75 $10,887.50 $3.00 $8,400.00 $2.42 $6,776.00 $3.00 $1,770.00 $2.42 $1,427.80 $2,500.00 $5,000.00 $1,760.00 $3,520.00 $34.00 $13,940.00 $34.00 $13,940.00 $23.00 $5,520.001 $23.00 $5,520.00 $800.00 $3,200.00 $900.00 $900.00 $7.00 $4,200.00 $8.00 $4,800.00 $13.00 $1,560.00 $11.00 $5,500.00 $2.56 $22,272.00 $18.00 $1,800.00, $770.00 $1,265.00 $4.95 $10.10 $16.85 $12.10 $2.10 $14.30 $3,080.00 $1,265.00 $2,970.00 $6,060.00 $2,022.00 $6,050.00 $18,270.00 $1,430.00 34- 98 -224bt BT -1 Base Bid 1 Demolish & remove ex. paving & LS fencing (four tennis courts) 2 Demolish & remove ex. driveway to LS fire station 3 Remove &salvage poles, wire, etc. LS (fire Gall appranaus) 4 Clear and Grub Tree 5 Remove and salvage hydrant EA 6 Remove /relocate hydrant EA 7 Reconstruct sanitary manhole LF 8 Reconstruct cleanout sta. 1 +60 LF 9 Remove and remount time controls EA 10 Refurbish ex. tennis court light poles EA and time control 11 Extend concrete base for ex. light pole LS 12 Remove concrete curb and gutter LF 13 Silt fence, regular LF 14 Temporary fence during construction LS 15 Site grading/final shaping LS 16 Natural stone retaining wall SF 17 Driveway paving including aggregate SY 18 Trail paving including aggregate SY 19 Tennis court paving including SY aggregate base, granular base and bituminous paving 20 Basketball court, paving including SY aggregate base and bitumnous paving 21 Color coating & tennis court line SY marking 22 Color coating & basketball court line SY marking 23 Furnish & install basketball pole, EA backboard, rim, net 24 Tennis Court chain link fencing (wind LF screen) 25 Tennis Court chain link fencing LF (standard) 26 Tennis post and net EA 27 Volleyball posts, net, nylon rope and LS anchors 28 Subgrade excavation (EV) CY 29 Granular borrow (CV) CY 30 Volleyball sand CY 31 Topsoil borrow (CV) CY 32 Sodding, lawn type SY 33 12" PVC sanitary sewer, SDR 35 LF 1.00 $4,350.00 $4,350.00 1.00 $2,000.00 $2,000.00 1.00 $1,000.00 $1,000.00 1.00 $150.00 $150.00 1.00 $903.00 $903.00 2.00 $2,112.60 $4,225.20 4.70 $105.00 $493.50 3.61 $35.70 $128.88 4.00 $157.50 $630.00 3.00 $1,260.00 $3,780.00 1.00 $866.25 $866.25 64.00 $7.50 $480.00 360.00 $3.15 $1,134.00 1.00 $4,650.00 $4,650.00 1.00 $6,500.00 $6,500.00 150.00 $10.00 $1,500.00 1150.00 $12.90 $14,835.00 1320.00 $9.50 $12,540.00 2800.00 $13.50 $37,800.00 $15.75 $10,237.501 $11.60 $7 2800.00 $1.99 $5,572.00 590.00 $1.99 $1,174.10 2.00 $1,680.00 $3,360.00 410.00 $32.48 $13,316.80 $2.90 $8,120.00 $3.00 $1,770.00 $1,200.00 $2,400.00 $34.00 $13,940.00 240.001 $21.91 $5,258.40 4.00 $668.85 $2,675.40 1.00 $1,207.50 $1,207.50 600.00 $7.85 $4,710.00 600.00 $14.50 $8,700.00 120.00 $25.00 $3,000.00 500.00 $9.50 $4,750.00 8700.00 $1.83 $15,921.00 100.00 $13.65 $1,365.00 $7,400.00 $7,400.00 $4,600.00 $4,600.00 $500.00 $500.00 $500.00 $500.00 $1,400.00 $1,400.00 $1,700.00 $3,400.00 $180.00 $846.00 $170.00 $613.70 $160.00 $640.00 $1,300.00 $3,900.00 $900.00 $900.00 $3.00 $192.00 $2.00 $720.00 $1,000.00 $1,000.00 $12,500.00 $12,500.00 $18.00 $2,700.00 $12.50 $14,375.00 $12.50 $16,500.00 $11.60 $32,480.00 $23.00 $5,520.00 $700.00 $2,800.00 $200.00 $200.00 $6.00 $3,600.00 $9.00 $5,400.00 $17.00 $2,040.00 $8.00 $4,000.00 $2.10 $18,270.00 $17.00 $1,700.00 $3,800.00 $3,800.00 $3,700.00 $3,700.00 $365.00 $365.00 $55.00 $55.00 $1,675.00 $1,675.00 $1,950.00 $3,900.00 $380.00 $1,786.00 $160.00 $577.60 $260.00 $1,040.00 $1,200.00 $3,600.00 $600.00 $600.00 $5.25 $336.00 $2.10 $756.00 $1,775.00 $1,775.00 $30,000.00 $30,000.00 $12.50 $1,875.00 $14.35 $16,502.50 $10.25 $13,530.00 $13.25 $37,100.00 $14.25 $2.50 $7,000.00 $2.50 $1,475.00 $1,675.00 $3,350.00 $32.50 $13,325.00 $22.00 $5,280.00 $750.00 $3,000.00 $1,200.00 $1,200.00 $4.20 $2,520.00 $10.50 $6,300.00 $27.00 $3,240.00 $1.05 $525.00 $2.35 $20,445.00 $16.75 $1,675.00 $8,300.00 $8,300.00 $6,550.00 $6,550.00 $5,500.00 $5,500.00 $7,100.00 $7,100.00 $1,500.00 $1,500.00 $850.00 $850.00 $350.00 $350.00 $350.00 $350.00 $900.00 $900.00 $945.00 $945.00 $2,500.00 $5,000.00 $2,215.00 $4,430.00 $150.00 $705.00 $160.00 $752.00 $75.00 $270.75 $85.00 $306.85 $275.00 $1,100.00 $165.00 $660.00 $1,260.00 $3,780.00 $1,320.00 $3,960.00 $600.00 $600.00 $900.00 $900.00 $5.00 $320.00 $3.30 $211.20 $3.00 $1,080.00 $1.70 $612.00 $4,000.00 $4,000.00 $1,500.00 $1,500.00 $6,000.00 $6,000.00 $39,000.00 $39,000.00 $18.00 $2,700.00 $23.00 $3,450.00 $16.00 $18,400.001 $12.60 $14,490.00 $12.50 $16,500.001 $10.70 $14,124.00 $21.00 $58,800.001 $16.05 $44,940.00 $16.00 $10,400.001 $16.75 $10,887.50 $3.00 $8,400.00 $2.42 $6,776.00 $3.00 $1,770.00 $2.42 $1,427.80 $2,500.00 $5,000.00 $1,760.00 $3,520.00 $34.00 $13,940.00 $34.00 $13,940.00 $23.00 $5,520.001 $23.00 $5,520.00 $800.00 $3,200.00 $900.00 $900.00 $7.00 $4,200.00 $8.00 $4,800.00 $13.00 $1,560.00 $11.00 $5,500.00 $2.56 $22,272.00 $18.00 $1,800.00, $770.00 $1,265.00 $4.95 $10.10 $16.85 $12.10 $2.10 $14.30 $3,080.00 $1,265.00 $2,970.00 $6,060.00 $2,022.00 $6,050.00 $18,270.00 $1,430.00 34- 98 -224bt BT -1 Item Bid No. 1 $13.00 Num Item Units 34 12" PVC, perforated drain pipe LF 35 6" PVC drain tile LF 36 4" PVC drain tile LF 37 4" PVC solid wall drain pipe LF 38 4' diameter storm CBMH EA 39 24 in yard drain w/R1642 type c grate EA 40 Connect to existing manhole EA 41 8618 concrete curb and gutter LF 42 B612 concrete curb and gutter LF 43 Concrete valley gutter SY 44 Parking lot stripping LS 45 30 It pole, concrete base, luminar & LS 2.00 time control (basketball court) $5,460.00 46 Luminaire, 1500W Quartz EA 47 2" PVC Conduit, SCH. 40 LF 48 0 AWG Wire LF 49 #1 AWG Wire LF 50 #10 AWG Wire LF 51 Handhole EA 52 Remove wiring - park shelter building LS 53 Install yard hydrant LS 54 Install fountain LS 55 Remove bituminous pavement SY 56 Remove drain structure LS 57 Remove water main LF 58 Remove water fountain LS 59 Remove volley ball court LS 60 Adjust frame and ring casting, storm EA 1.00 MH -102 $52.50 61 Adjust Valve Box EA 62 4" DIP water main, Class 52 LF 63 4" gate valve EA 64 Lighting control panel EA 65 Picnic table (4 seats) with concrete EA 3.00 pad(400 sf) $2,283.00 66 Bench, litter receptacle with concrete EA 5.00 pad (48 sf) $1,128.75 67 Bench, litter receptacle with concrete EA 3.00 pad (56 so HC accessable $289.80 68 Picnic table (3 seats) w /conc. pad EA 17.00 (300 sf) - HC accessible $499.80 69 Scotch Pine, 6' B &B EA 70 Black Hills Spruce, 6' B &B EA 71 Prairie (Flame) Crabapple, 1" Cal. EA 20.00 container stock $630.00 72 Autumn Purple White Oak, 2 1/2" cal. EA container stock 73 Red Twigged Dogwood, #3 pot EA 74 Littleleaf Linden, 2" Cal. container EA stock 75 Swamp White Oak, 2" Cal. container EA stock 76 Baily Compact Viburnum, #3 pot EA 77 Hahs Viburnum, #3 pot EA Total Base Bid Bid No. 2 Arrigoni Brothers Unit Price Total $17.00 Bid No. 1 $13.00 $3,380.00 North Valley Inc Qty Unit Price Total 200.00 $16.80 $3,360.00 260.00 $11.55 $3,003.00 290.00 $7.35 $2,131.50 50.00 $5.25 $262.50 1.00 $1,387.05 $1,387.05 2.00 $777.00 $1,554.00 1.00 $210.00 $210.00 100.00 $13.23 $1,323.00 650.00 $8.67 $5,635.50 40.00 $44.10 $1,764.00 1.00 $175.00 $175.00 2.00 $2,730.00 $5,460.00 14.00 $162.75 $2,278.50 1000.00 $4.04 $4,040.00 4000.00 $1.73 $6,920.00 1300.00 $1.62 $2,106.00 500.00 $0.12 $60.00 2.00 $640.50 $1,281.00 1.00 $420.00 $420.00 1.00 $1,579.20 $1,579.20 1.00 $2,709.00 $2,709.00 200.00 $3.50 $700.00 1.00 $483.00 $483.00 80.00 $10.50 $840.00 1.00 $241.50 $241.50 1.00 $1,000.00 $1,000.00 1.00 $105.00 $105.00 1.00 $52.50 $52.50 170.00 $21.00 $3,570.00 1.00 $388.50 $388.50 1.00 $4,249.35 $4,249.35 2.00 $1,050.00 $2,100.00 3.00 $371.70 $1,115.10 3.00 $761.00 $2,283.00 1.00 $1,128.75 $1,128.75 5.00 $225.75 $1,128.75 10.00 $225.75 $2,257.50 3.00 $96.60 $289.80 6.00 $322.35 $1,934.10 17.00 $29.40 $499.80 5.00 $225.75 $1,128.75 5.00 $322.35 $1,611.75 8.00 $29.40 $235.20 20.00 $31.50 $630.00 $254,845.13 Bid No. 2 Arrigoni Brothers Unit Price Total $17.00 $3,400.00 $13.00 $3,380.00 $10.00 $2,900.00 $20.00 $1,000.00 $1,200.00 $1,200.00 $1,000.00 $2,000.00 $300.00 $300.00 $13.00 $1,300.00 $9.00 $5,850.00 $50.00 $2,000.00 $200.00 $200.00 $2,900.00 $5,800.00 $160.00 $2,240.00 $4.00 $4,000.00 $1.60 $6,400.00 $1.60 $2,080.00 $0.15 $75.00 $660.00 $1,320.00 $450.00 $450.00 $1,500.00 $1,500.00 $4,000.00 $4,000.00 $2.25 $450.00 $500.00 $500.00 $10.00 $800.00 $200.00 $200.00 $1,700.00 $1,700.00 $200.00 $200.00 $200.00 $200.00 $22.00 $3,740.00 $600.00 $600.00 $4,400.00 $4,400.00 $1,200.00 $2,400.00 $250.00 $750.00 $670.00 $2,010.00 $1,400.00 $1,400.00 $225.00 $1,125.00 $225.00 $2,250.00 $150.00 $450.00 $320.00 $1,920.00 $35.00 $595.00 $275.00 $1,375.00 $300.00 $1,500.00 $40.00 $320.00 $40.00 $800.00 $263,546.70 Bid No. 3 W B Miller Inc Unit Price Total $22.00 $4,400.00 $16.65 $4,329.00 $16.00 $4,640.00 $8.00 $400.00 $1,675.00 $1,675.00 $1,025.00 $2,050.00 $525.00 $525.00 $13.30 $1,330.00 $8.75 $5,687.50 $44.25 $1,770.00 $500.00 $500.00 $2,075.00 $4,150.00 $115.00 $1,610.00 $5.50 $5,500.00 $1.55 $6,200.00 $1.15 $1,495.00 $0.55 $275.00 $615.00 $1,230.00 $275.00 $275.00 $1,050.00 $1,050.00 $2,400.00 $2,400.00 $2.10 $420.00 $1,050.00 $1,050.00 $9.15 $732.00 $750.00 $750.00 $315.00 $315.00 $210.00 $210.00 $185.00 $185.00 $35.50 $6,035.00 $350.00 $350.00 $5,850.00 $5,850.00 $1,050.00 $2,100.00 $375.00 $1,125.00 $775.00 $2,325.00 $1,150.00 $1,150.00 $140.00 $700.00 $185.00 $1,850.00 $105.00 $315.00 $210.00 $1,260.00 $50.00 $850.00 $315.00 $1,575.00 $315.00 $1,575.00 $50.00 $400.00 $52.00 $1,040.00 $285,224.10 Bid No. 4 Barber Construction Co Unit Price Total $22.00 $4,400.00 $15.00 $3,900.00 $10.00 $2,900.00 $10.00 $500.00 $1,500.00 $1,500.00 $750.00 $1,500.00 $300.00 $300.00 $11.20 $1,120.00 $10.30 $6,695.00 $37.00 $1,480.00 $700.00 $700.00 $2,000.00 $4,000.00 $115.00 $1,610.00 $6.00 $6,000.00 $1.59 $6,360.00 $1.22 $1,586.00 $1.00 $500.00 $600.00 $1,200.00 $300.00 $300.00 $1,600.00 $1,600.00 $2,600.00 $2,600.00 $2.00 $400.00 $470.00 $470.00 $11.00 $880.00 $250.00 $250.00 $622.00 $622.00 $150.00 $150.00 $100.00 $100.00 $25.00 $4,250.00 $400.00 $400.00 $6,000.00 $6,000.00 $1,250.00 $2,500.00 $500.00 $1,500.00 $975.00 $2,925.00 $1,500.00 $1,500.00 $240.00 $1,200.00 $240.00 $2,400.00 $180.00 $540.00 $270.00 $1,620.00 $25.00 $425.00 $250.00 $1,250.00 $250.00 $1,250.00 $29.00 $232.00 $29.00 $580.00 $307,262.75 Bid No. 5 Hardrives Inc Unit Price Total $17.50 $3,500.00 $12.00 $3,120.00 $7.70 $2,233.00 $5.50 $275.00 $1,455.00 $1,455.00 $815.00 $1,630.00 $220.00 $220.00 $10.80 $1,080.00 $9.90 $6,435.00 $40.00 $1,600.00 $200.00 $200.00 $2,850.00 $5,700.00 $170.00 $2,380.00 $4.25 $4,250.00 $1.80 $7,200.00 $1.70 $2,210.00 $0.13 $65.00 $670.00 $1,340.00 $440.00 $440.00 $1,655.00 $1,655.00 $2,850.00 $2,850.00 $1.35 $270.00 $500.00 $500.00 $11.00 $880.00 $255.00 $255.00 $10.00 $10.00 $110.00 $110.00 $55.00 $55.00 $22.00 $3,740.00 $410.00 $410.00 $4,450.00 $4,450.00 $1,950.00 $3,900.00 $825.00 $2,475.00 $1,300.00 $3,900.00 $2,100.00 $2,100.00 $220.00 $1,100.00 $220.00 $2,200.00 $132.00 $396.00 $305.00 $1,830.00 $44.00 $748.00 $275.00 $1,375.00 $275.00 $1,375.00 $44.00 $352.00 $45.00 $900.00 $311,518.35 34- 98 -224bt BT -2 Bid No. 1 Bid No. 2 Bid No. 3 Bid No. 4 Bid No. 5 North Valley Inc Arrigoni Brothers W B Miller Inc Barber Construction Co Hardrives Inc Item Num Item Units Q Unit Price Total Unit Price Total Unit Price Total Unit Price Total Unit Price Total Alternate No. 1 78 Replace existing luminaire with new EA 28.00 $159.60 $4,468.80 $160.00 $4,480.00 $112.00 $3,136.00 $115.00 $3,220.00 $165.00 $4,620.00 luminaire Total Alternate No. 1 $4,468.80 $4,480.00 $3,136.00 $3,220.00 $4,620.00 Alternate No. 2 79 Provide new service panel and electric LS $10,381.35 $10,38125 $10,500.00 $10,500.00 $7,500.00 $7,500.00 $8,000.00 $8,000.00 $10,875.00 $10,875.00 service from existing transformer to handhole Total Alternate No. 2 $10,381.35 $10,500.00 $7,500.00 $8,000.00 $10,875.00 Contractor Name and Address: North Valley Inc Arrigoni Brothers Company W B Miller Inc Barber Construction Co Hardrives Inc 4105 85th Ave N Bldg B 817 Vandalia St 6701 Norris Lake Rd NW Inc 14475 Quiram Dr Ste 202 St Paul, MN 55114 Elk River, MN 55330 5400 Rowland Rd Rogers, MN 55374 -9461 Brooklyn Park, MN 55443 Minnetonka, MN 55343 Phone: (612) 425 -2988 (651) 645 -9321 (612) 241 -0397 (612) 938 -9607 (612) 428 -8886 Fax (612) 425 -1356 (651) 645 -9322 (612) 241 -0580 (612) 930 -0532 (612) 428.8868 Signed By: Brad Schmidtbauer Dennis J. Arrigoni Greg Holm James M. Barber Donald R. Hall Title: President President Vice President President Vice President Bid Security: Bid Bond Bid Bond Bid Bond Bid Bond Bid Bond Addenda Acknowledged: One One One One One 34- 98 -224bt BT -3 Attorneys At Law 8525 EDINBROOK CROSSING, STE. 201 BROOKLYN PARK, MINNESOTA 55443 -1999 TELEPHONE (612) 424 -8811 • TELEFAx (612) 493 -5193 GORDON L.JENSEN* WILLIAM G. SWANSON STEVEN A.SONDRALL MARTIN P. MALECHA C. ALDEN PEARSONt DEAN A.TRONGARDt JULIE A. TRILL OF COUNSEL LORENS Q.BRYNESTAD *Real Property Law Specialist Certified By The Minnesota State Bar Association tQualified ADR Neutral April 11, 1999 Valerie Leone City of New Hope 4401 Xylon Avenue North New Hope, MN 55428 RE: Civic Center Park Court Improvements City Project No. 629 Our File No. 99.10,000 Dear Valerie: Enclosed please find five copies of the contract and bonds for the above - referenced project, as well as the certificate of insurance. All are in order from a legal standpoint. Be sure to call me if you have any questions. cc: Daniel J. Donahue, City Manager Kirk McDonald, Director of Community Development Tom Schuster, Contract Manager Mark Hanson, City Engineer Steven A. Sondrall, City Attorney April 20, 1999 4401 Xylon Avenue North New Hope, Minnesota 55428 -4898 North Valley, Inc. 4105 85' Ave. N. Building B, Suite 203 Brooklyn Park, MN 55443 City Hall: 612.531 -5100 Police: 612 -531 -5170 Public Works: 612 -533 -4823 TDD: 612. 531 -5109 SUBJECT: CIVIC CENTER PARK IMPROVEMENTS (IMPROVEMENT PROJECT NO. 629) Enclosed are two fully executed copies of the contract document s Project No. 629. One copy is for your records and the second transmitted to your bonding company. City Hall Fax: 612 - 531 -5136 Police Fax: 612 - 531 -5174 Public Works Fax. 612- 533 -7650 Fire Dept. Fax: 612. 531 -5175 for New Hope copy should be This contract was awarded by the New Hope City Council on March 22, 1999, for $259,313.93. Enclosed is return of your bid bond. Also enclosed is a "Withholding Affidavit for Contractors" (IC -134 form). We cannot make final payment to contractors until this is approved by the Minnesota Department of Revenue and submitted to our office (Minnesota Statute 290.97). The form contains instructions for completion. Sincerely, Valerie Leone City Clerk, CMC enc. cc: Steve Sondrall, City Attorney (file no. 99.10,000) Shari French, Director of Parks & Recreation Tom Schuster, Contract Manager Family Styled City W "q - For Family living 14 � CIVIC CENTER PARK COURT IMPROVEMENTS CITY PROJECT NO. 629 FILE NO. 34224 NEW HOPE, MINNESOTA 1999 Index Advertisement for Bids Information to Bidders Proposal Special Provisions 01310. Project Meetings 01330. Submittals 01400. Quality Control 01570. Erosion and Sediment Control 01600. Product Requirements 02225. Removals 02230. Site Clearing 02280. Adjust Miscellaneous Structures 02315. Excavation and Fill 02318. Finish Grading 02320. Trench Excavation and Backfill 02510. Water Main 02515, Water Services 02630. Storm Drainage 02635. Subdrainage 02720. Aggregate Base Course 02740. Plant Mixed Bituminous Pavements 02760, Pavement Markings 02770. Concrete Curb and Gutter 02775. Concrete Paving 02790. Athletic and Recreational Surfaces 02820. Chain Link Fence 02830. Stone Retaining Wall 02870. Site Furnishings 02880. Play Field Equipment and Structures 02920. Lawns and Grasses 02930. Trees and Shrubs 16110. Raceways 16120. Wires and Cables 16500. Lighting Construction Bar Schedule Form Conditions of the Contract 34224R 2r 1999 Bonestroo, Rosene, Anderlik & Associates, Inc. INDEX I hereby certify that this plan, specification, or report was prepared by me or under my direct supervision and that I am a duly Registered Professional Engineer under the laws of the State of Minnesota. Vincent T. Vander Top, P.E. Date: March 1, 1999 Reg. No. 25770 34224R 1-2 0 1999 Bonestroo, Rosene, Anderlilk & Associates, Inc. INDEX ADVERTISEMENT FOR BIDS Sealed bids will be received by the City of New Hope, Minnesota at the City Hall, at 4401 Xylon Avenue, until 11:00 A.M., C.S.T., on Tuesday, March 16, 1999, at which time they will be publicly opened and read aloud for the furnishing of all labor and materials and all else necessary for the following: � � Demolish and remove existing paving and fencing for four tennis courts. Demolish and remove existing driveway from Zealand Avenue to Fire Station Furnish and install paving and fencing for four tennis courts (salvage existing lighting). Fumish and install new paving and lighting for one basketball court. Furnish and install new sand volleyball court. Furnish and install new driveway to fire station. 350 LF 12" Storm Sewer 550 LF Perforated Drain Pipe 250 LF 4-inch to 6 inch Water Main Miscellaneous site improvements include grading, landscape, site furniture, bituminous trails, and restoration for a 3-acre site. Plans and specifications, proposal forms and contract documents may be seen at the office of the City Clerk, New Hope, Minnesota, and at the office of Bonestroo, Rosene, Anderlik & Associates, Inc., Consulting Engineers, 2335 W. Trunk Highway 36, St. Paul, MN 55113, (612 Each bid shall be accompanied by a bidder's bond naming the City of New Hope as obligee, certified check payable to the Clerk of the City of New Hope or a cash deposit equal to at least five percent (5%) of the amount of the bid, which shall be forfeited to the City in the event that the bidder fails to enter into a contract. The City Council reserves the right to retain the deposits of the three lowest bidders for a period not to exceed 45 days after the date and time set for the opening of bids. No bids may be withdrawn for a period of forty-five (45) days after the date and time set for the opening of bids. Payment for the work will be by cash or check. Contractors desiring a copy of the plans and specifications and proposal forms may obtain theirs from g the office of Bonestroo, Rosene, Anderlik & Associates, Inc., upon payment of a non-refundable fee of $30.00. See "Information to Bidders" for plan/specification fee policy. The City Council reserves the right to reject any and all bids, to waive irregularities and informalities therein and further reserves the right to award the contract to the best interests of the City. Daniel Donahue, City Manager City of New Hope, Minnesota 34-98-224R C 1999 Bonestroo, Rosene, Anderlik & Associates, Inc, ADVERTISEMENT FOR BIDS 1. BID PROPOSAL. Each planholder has been furnished a specification, plan set and one extra proposal. Bids shall be submitted on the separate Proposal Form designated "BID COPY'. Th Proposal containing the bid shall be submitted in a sealed envelope. 1) Plans and specifications shall only be available on a non-refundable, per plan basis, with all contractors and vendors being charged the same. Planholders may obtain more than one set of plans and specifications for the stipulated amount, however, all are non-refundable. 2) The amount for the bid package will be stated in the Advertisement for Bids, 4. BID TABUATION: Planholders submitting a bid will be mailed a Bid Tabulation. Plg�olders not submitting a bid may purchase a copy of the Bid Tabulation for Five Dollars ). 1998 Gemerzinfo 0 1998 Rcn"tmo, Rwsene, An der & AssociaWs, Ync, PROPOSAL CIVIC CENTER PARK COURTIMPROVEMENTS CITY PROJECT NO. 629 FILE NO. 34 -98 -224 NEW HOPE, MINNESOTA 1999 Opening Time: 11:00 A.M., C.S.T. Opening Date: Tuesday, March 16, 1999 Honorable City Council City of New Hope 4401 Xylon Avenue North New Hope, Minnesota 55428 Dear Council Members: The undersigned, being familiar with your local conditions, having made the field inspections and investigations deemed necessary, having studied the plans and specifications for the work including Addenda Nos. I and being familiar with all factors and other conditions affecting the work and cost thereof, hereby proposes to furnish all labor, tools, materials, skills, equipment and all else necessary to completely construct the project in accordance with the plans and specifications on file with you and Bonestroo, Rosene, Anderlik & Associates, Inc., 2335 West Highway 36, St. Paul, MN 55113, as follows: No. Bonestro Unit Qty. Unit Price Rosene Bidder: North Valley, Inc. Total Base Bid 254,845.13 Anderlik & Address: 4105 85th Ave. N. Ste. 203 Telephone No. 612.425.2988 Associate 1 $4,350.00 $4,350.00 fencing (four tennis courts) Engineers & Architects City State, Zip: Brooklyn Park, MN 55443 Fax No. 612.425.1356 _.St. _Paul • i , Demolish & remove ex. driveway to PROPOSAL CIVIC CENTER PARK COURTIMPROVEMENTS CITY PROJECT NO. 629 FILE NO. 34 -98 -224 NEW HOPE, MINNESOTA 1999 Opening Time: 11:00 A.M., C.S.T. Opening Date: Tuesday, March 16, 1999 Honorable City Council City of New Hope 4401 Xylon Avenue North New Hope, Minnesota 55428 Dear Council Members: The undersigned, being familiar with your local conditions, having made the field inspections and investigations deemed necessary, having studied the plans and specifications for the work including Addenda Nos. I and being familiar with all factors and other conditions affecting the work and cost thereof, hereby proposes to furnish all labor, tools, materials, skills, equipment and all else necessary to completely construct the project in accordance with the plans and specifications on file with you and Bonestroo, Rosene, Anderlik & Associates, Inc., 2335 West Highway 36, St. Paul, MN 55113, as follows: No. Item Unit Qty. Unit Price Total Price Base Bid I Demolish & remove ex. paving & LS 1 $4,350.00 $4,350.00 fencing (four tennis courts) 2 Demolish & remove ex. driveway to LS 1 $2,000.00 $2,000.00 fire station 3 Remove &salvage poles, wire, etc. LS 1 $1,000.00 $1,000.00 (fire Gall appranaus) 4 Clear and Grub Tree 1 $150.00 $150.00 5 Remove and salvage hydrant EA 1 $903.00 $903.00 6 Remove /relocate hydrant EA 2 $2,112.60 $4,225.20 7 Reconstruct sanitary manhole LF 4.7 $105.00 $493.50 8 Reconstruct cleanout sta. 1 +60 LF 3.61 $35.70 $128.88 34 -98- 224 \contract.wK P -1 9 Remove and remount time controls EA 4 $157.50 $630.00 10 Refurbish ex. tennis court light poles EA 3 $1,260.00 $3,780.00 and time control 11 Extend concrete base for ex. light LS 1 $866.25 $866.25 pole 12 Remove concrete curb and gutter LF 64 $7.50 $480.00 13 Silt fence, regular LF 360 $3.15 $1,134.00 14 Temporary fence during construction LS 1 $4,650.00 $4,650.00 15 Site grading/final shaping LS 1 $6,500.00 $6,500.00 16 Natural stone retaining wall SF 150 $10.00 $1,500.00 17 Driveway paving including aggregate SY 1150 $12.90 $14,835.00 18 Trail paving including aggregate SY 1320 $9.50 $12,540.00 19 Tennis court paving including SY 2800 $13.50 $37,800.00 aggregate base, granular base and bituminous paving 20 Basketball court, paving including SY 650 $15.75 $10,237.50 aggregate base and bitumnous paving 21 Color coating & tennis court line SY 2800 $1.99 $5,572.00 marking 22 Color coating & basketball court line SY 590 $1.99 $1,174.10 marking 23 Furnish & install basketball pole, EA 2 $1,680.00 $3,360.00 backboard, rim, net 24 Tennis Court chain link fencing LF 410 $32.48 $13,316.80 (wind screen) 25 Tennis Court chain link fencing LF 240 $21.91 $5,258.40 (standard) 26 Tennis post and net EA 4 $668.85 $2,675.40 27 Volleyball posts, net, nylon rope and LS 1 $1,207.50 $1,207.50 anchors 28 Subgrade excavation (EV) CY 600 $7.85 $4,710.00 29 Granular borrow (CV) CY 600 $14.50 $8,700.00 30 Volleyball sand CY 120 $25.00 $3,000.00 31 Topsoil borrow (CV) CY 500 $9.50 $4,750.00 32 Sodding, lawn type SY 8700 $1.83 $15,921.00 33 12" PVC sanitary sewer, SDR 35 LF 100 $13.65 $1,365.00 34 12" PVC, perforated drain pipe LF 200 $16.80 $3,360.00 35 6" PVC drain tile LF 260 $11.55 $3,003.00 36 4" PVC drain tile LF 290 $73 $2,131.50 37 4" PVC solid wall drain pipe LF 50 $5.25 $262.50 34- 98- 224\contract.n b2 P -2 38 4' diameter storm CBMH EA 1 $1,387.05 $1,387.05 39 24 in yard drain w/R1642 type c grate EA 2 $777.00 $1,554.00 40 Connect to existing manhole EA 1 $210.00 $210.00 41 B618 concrete curb and gutter LF 100 $13.23 $1,323.00 42 B612 concrete curb and gutter LF 650 $8.67 $5,635.50 43 Concrete valley gutter SY 40 $44.10 $1,764.00 44 Parking lot stripping LS 1 $175.00 $175.00 45 30 ft pole, concrete base, luminar & LS 2 $2,730.00 $5,460.00 time control (basketball court) 46 Luminaire, 150OW Quartz EA 14 $162.75 $2,278.50 47 2" PVC Conduit, SCH. 40 LF 1000 $4.04 $4,040.00 48 0 AWG Wire LF 4000 $1.73 $6,920.00 49 #1 AWG Wire LF 1300 $1.62 $2,106.00 50 #10 AWG Wire LF 500 $0.12 $60.00 51 Handhole EA 2 $640.50 $1,281.00 52 Remove wiring - park shelter LS 1 $420.00 $420.00 building 53 Install yard hydrant LS 1 $1,579.20 $1,579.20 54 Install fountain LS 1 $2,709.00 $2,709.00 55 Remove bituminous pavement SY 200 $3.50 $700.00 56 Remove drain structure LS 1 $483.00 $483.00 57 Remove water main LF 80 $10.50 $840.00 58 Remove water fountain LS 1 $241.50 $241.50 59 Remove volley ball court LS 1 $1,000.00 $1,000.00 60 Adjust frame and ring casting, storm EA 1 $105.00 $105.00 MH -102 61 Adjust Valve Box EA 1 $52.50 $52.50 62 4" DIP water main, Class 52 LF 170 $21.00 $3,570.00 63 4" gate valve EA 1 $388.50 $388.50 64 Lighting control panel EA 1 $4,249.35 $4,249.35 65 Picnic table (4 seats) with concrete EA 2 $1,050.00 $2,100.00 pad(400 sf) 66 Bench, litter receptacle with concrete EA 3 $371.70 $1,115.10 pad (48 sf) 67 Bench, litter receptacle with concrete EA 3 $761.00 $2,283.00 pad (56 sf) HC accessable 34 -98- 224 \contract.wK P -3 68 Picnic table (3 seats) w /conc. pad EA 1 $1,128.75 $1,128.75 (300 sf) - HC accessible 69 Scotch Pine, 6' B &B EA 5 $225.75 $1,128.75 70 Black Hills Spruce, 6' B &B EA 10 $225.75 $2,257.50 71 Prairie (Flame) Crabapple, 1" Cal. EA 3 $96.60 $289.80 container stock 72 Autumn Purple White Oak, 2 1/2" EA 6 $32235 $1,934.10 cal. container stock 73 Red Twigged Dogwood, #3 pot EA 17 $29.40 $499.80 74 Littleleaf Linden, 2" Cal. container EA 5 $225.75 $1,128.75 stock 75 Swamp White Oak, 2" Cal. container EA 5 $322.35 $1,611.75 stock 76 Baily Compact Viburnum, #3 pot EA 8 $29.40 $235.20 77 Hahs Viburnum, #3 pot EA 20 $31.50 $630.00 Total Base Bid $254,845.13 Alternate No. 1 78 Replace existing luminaire with new EA 28 $159.60 $4,468.80 luminaire Total Alternate No. 1 $4,468.80 Alternate No. 2 79 Provide new service panel and LS $10,381.35 $10,381.35 electric service from existing transformer to handhole Total Alternate No. 2 $10,381.35 34 -98- 224 \contract.wK P4 The final amount of the contract shall be determined by multiplying the final measured quantities of the various items actually constructed and installed by the unit prices therefore, in the manner prescribed in the specifications. However, the low bidder shall be determined by adding the sums resulting from multiplying the quantities stated by the unit prices bid therefore. Accompanying this bid is a bidder's bond certified check, or cash deposit in the amount of five percent (i%) of amount bid , which is at least five percent (5 %) of the amount of my /our bid made payable to the Owner, and the same is subject to forfeiture in the event of default on the part of the undersigned or failure on the part of the undersigned to execute the prescribed contract and bond within fifteen (15) days after its submittal to me /us. In submitting this bid, it is understood that the Owner retains the right to reject any and all bids and to waive irregularities and informalities therein and to award the contract to the best interests of the Owner. In submitting this bid, it is understood that payment will be by cash or check. It is understood that bids may not be withdrawn for a period of 45 days after the date and time set for the opening of bids. It is understood that the Owner reserves the right to retain the certified check or bond of the three lowest bidders as determined by the Owner for a period not to exceed 45 days after the date set for the opening of bids. Respectfully submitted, (A Corporation) North Valley, Inc. (An Individual) Name (A Partnership) Brad Schmidtbauer Signer President Title Brad Schmidtbauer Printed Name of Signer 34 -98- 224 \contract.wK P -5 PROJECT NAME: CIVIC CENTER PARK - COURT IMPROVEMENTS CITY PROJECT No. 629 fflom� (III M, — 7-1�1 1 - 1 Y OT WORK ITEM January f February March April May June July August September Octob�e�rNovember December - 5 5 2E 15 31 3C .5 31 5 3 1 5 3 7 3i 1 5 3C .5 Temporary fencing Erosion control Demolish tennis courts Demolish driveway to fire station Site grading � � l Pave parking — � Pave tennis courts Install volleyboli court Install basketball court Install lighting Install pork furnishings Install trees and shrubs --4 Sodding Punch list Final contract CONTRACTOR SCHEDULE: -- CL Variable Variable Variable 4"x4 Wood Fence Post 4' above grade /Pointed b|ue\ Curb Stop and Box ( to 1" be/ow finish grade) m _ � o � 1 1/7" Corporation Stop Water Service 1 1/2" Type "K" Copper PL Concrete Block Support ./ \-1/2 (�Y—1 1 /2 R(}CK 45~ ' ' / I NOTE: For services larger than 1 o tappi sleeve is required. Rockwell type 730 full circle, with tap threaded for appropriate size copper corporation stop. /(}r nquO|\ Corporation Stop Curb Stop Curb Box Mueller H-15000 Mueller H-15154 Mueller H-10300 Ford 600 Ford B22-444M Ford EM 2-75-57 A.Y. McDonald 4701 A.Y. McDonald 6104 A.Y. McDonald 5615 NOTES 1. Cud} box shall have o stationary rod Curb �. urb box shall extend from 78" to QO''. 3. Service shall be bedded in granular bOrn}vv. Except the last ten feet where aggregate will be required. ___J7 BRA Plate No. 3-06J City Plate No. .STANDARD DETAILS WATER SERVICE CONNECTION UNITED FIRE & CASUALTY COMPANY HOME OFFICE - CEDAR RAPIDS, IOWA Un CERTIFIED COPY OF POWER OF ATTORNEY (Original on file at Home Office of Company — See Certification) NOW ALL MEN BY THESE PRESENTS, That the UNITED FIRE & CASUALTY COMPANY, a corporation duly organized and existing nder the laws of the State of Iowa, and having its Principal office in Cedar Rapids, State of Iowa, does make, constitute and , Point TERRY STARKS, OR DAVID E. SELL, OR OTTO T. BANG, OR ROBERT E. CLEMANTS OR MELISSA M. NORDIN, OR CHRISTINE FIETEK, OR JOAN K. REMICK, ALL INDIVIDUALLY f PO BOX 16527 MINNEAPOLIS MN 55416 s true and lawful Attorney(s) —in —Fact with power and authority hereby conferred to sign, seal and execute in its behalf all wful bonds, undertakings and other obligatory instruments of similar nature as follows: ANY AND ALL BONDS id to bind UNITED FIRE & CASUALTY COMPANY thereby as fully and to the same extent as if such instruments were signed by e duly authorized officers of UNITED FIRE & CASUALTY COMPANY and all the acts of said Attorney, pursuant to the authority =reby given are hereby ratified and confirmed. The Authority hereby granted shall expire JANUARY 25th 2001 unless sooner revoked. This power of Attorney is made and executed pursuant to and by authority of the following By —Law duly adopted by the card of Directors of the Company on April 18, 1973. "Article V — Surety Bonds and Undertakings." Section 2, Appointment of Attorney -in -Fact. "The President or any Vice President, or any other officer of the Company, may, from time to time, appoint by written certificates attorneys -in -fact to act in behalf of the Company in the execution of policies of insurance, bonds, undertakings and other obligatory instruments of like nature. The signature of any officer authorized hereby, and the Corporate seal, may be affixed by facsimile to any powerof attorney or special power of attorney or certification of either authorized hereby; such signature and seal, when so used, being adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed. Such attorneys -in -fact, subject to the limitations set forth in their respective certificates of authority shall have full power to bind the Company by their signature and execution of any such instruments and to attach the seal of the Company thereto. The President or any Vice President, the Board of Directors or any other officer of the Company may at any time revoke all power and authority previously given to any attorney -in -tact. IN WITNESS WHEREOF, the UNITED FIRE & CASUALTY COMPANY has caused these presents M►aron,�+i to be signed by its vice president and its corporate seal to be hereto affixed this �� ► iy� 25th day of JANUARY A.D. 1999 CORPORATE ® > ? $s ►L UNITED FIRE & CAS,_VALTY COMPAY B c �a �rI666r6{ { {{ � Y Y "As ce Pr+ tate of Iowa, County of Linn, ss: n this 25th day of JANUARY 1999, before me Personally came Jeffrey A. Chapin me known, who being by me duly sworn, did depose and say: that he resides in Cedar Rapids, State of Iowa; that he is a 'ce President of the UNITED FIRE & CASUALTY COMPANY, the corporation described in and which executed the above strument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporated seal; that was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto irsuant to like authority, and acknowledges same to be the act and deed of said corporation. S& A rr��va Notary ublic SHERYLA.MCVAY MY COMMISSION EXPIRES My commission expires March 4 , 2000 March a, 2000 CERTIFICATION the undersigned officer of the UNITED FIRE & CASUALTY COMPANY, do hereby certify that I have compared the foregoing >py of the Power of Attorney and affidavit, and the copy of the Section of the By —Laws of said Company as set forth in said >wer of Attorney, with the ORIGINALS ON FILE IN THE HOME OFFICE OF SAID COMPANY, and that the same are correct anscripts thereof, and of the whole of the said originals, and that the said Power of Attorne as not been revoked and is Sw in full force and effect. nrrrroy,� In testimony whereof I have hereunto subcribed my name and of xed a corporate seal f the said Company this 1ST day of APRIL 19 99 COAPOtAtE �.rsa { rr Secretary 'wauwu {{ UND3269b(Rev. 01 -99) UNITED FIRE & CASUALTY COMPANY HOME OFFICE - CEDAR RAPIDS, IOWA Un CERTIFIED COPY OF POWER OF ATTORNEY (Original on file at Home Office of Company - See Certification) NOW ALL MEN BY THESE PRESENTS, That the UNITED FIRE & CASUALTY COMPANY, a corporation duly organized and existing nder the laws of the State of Iowa, and having its principal office in Cedar Rapids, State of Iowa, does make, constitute and point TERRY STARKS, OR DAVID E. SELL, OR OTTO T. BANG, OR ROBERT E. CLEMANTS OR MELISSA M. NORDIN, OR CHRISTINE FIETEK, OR JOAN K. REMICK, ALL INDIVIDUALLY f PO BOX 16527 MINNEAPOLIS MN 55416 s true and lawful Attorney(s)-in -Fact with power and authority hereby conferred to sign, seal and execute in its behalf all wful bonds, undertakings and other obligatory instruments of similar nature as follows: ANY AND ALL BONDS id to bind UNITED FIRE & CASUALTY COMPANY thereby as fully and to the same extent as if such instruments were signed by ie duly authorized officers of UNITED FIRE & CASUALTY COMPANY and all the acts of said Attorney, pursuant to the authority areby given are hereby ratified and confirmed. The Authority hereby granted shall expire JANUARY 25th 2001 unless sooner revoked. This power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the card of Directors of the Company on April 18, 1973. "Article V - Surety Bonds and Undertakings. Section 2, Appointment of Attorney -in -Fact. "The President or any Vice President, or any other officer of the Company, may, from time to time, appoint by written certificates attorneys -in -fact to act in behalf of the Company in the execution of policies of insurance, bonds, undertakings and other obligatory instruments of like nature. The signature of any officer authorized hereby, and the Corporate seal, may be affixed by facsimile to any powerof attorney or special power of attorney or certification of either authorized hereby; such signature and seal, when so used, being adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed. Such attorneys -in -fact, subject to the limitations set forth in their respective certificates of authority shall have full power to bind the Company by their signature and execution of any such instruments and to attach the seat of the Company thereto. The President or any Vice President, the Board of Directors or any other officer of the Company may at any time revoke all power and authority previously given to any attorney -in -tact. IN WITNESS WHEREOF, the UNITED FIRE & CASUALTY COMPANY has caused these presents e�e�ro�,ryi to be signed by its vice president and its corporate seal to be hereto affixed this ` ► 25th day of JANUARY A.D. 1999 C01MI&TE 0— UNITED FIRE & CASPALTY COMPANY SIAL v, bC9CCn!!�� B *AS ! d +ent fate of Iowa, County of Llnn, ss: ce Pr n this 25th day of JANUARY 1999, before me personally came Jeffrey A. Chapin i me known, who being by me duly sworn, did depose and say: that he resides in Cedar Rapids, State of Iowa; that he is a ice President of the UNITED FIRE & CASUALTY COMPANY, the corporation described in and which executed the above strument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporated seal; that was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto irsuant to like authority, and acknowledges same to be the act and deed of said corporation. rnc ,, lic Notary LWA SHE RYL A. MCVAY COMMISSIONEXPIRES My commission expires March 4 2000 March 4, 2000 CERTIFICATION the undersigned officer of the UNITED FIRE & CASUALTY COMPANY, do hereby certify that I have compared the foregoing )py of the Power of Attorney and affidavit, and the copy of the Section of the By -Laws of said Company as set forth in said )wer of Attorney, with the ORIGINALS ON FILE IN THE HOME OFFICE OF SAID COMPANY, and that the same are correct anscripts thereof, and of the whole of the said originals, and that the said Power of Attorne as not been revoked and is )w in full force and effect. a�erny,� In testimony whereof I have hereunto subcribed my name and of xed a corporate seal f the said ` Company this 1ST day of APRIL 19 99 901tOtAYE SIAL �var�d �.o` Secretary "W"O'` UND3269b(Rev. 01 -99) IC L ) CERTIFICATE OF LIABILITY INSURANC &wP LS DATE(MM/DD/YY) - OR NoRT -28 04/05/99 UCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Ahmann Company HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1 City West Parkway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. n Prairie MN 55344 COMPANIES AFFORDING COVERAGE y Pearson COMPANY A Travelers Indemnity Co. of CT No. 612- 941 -9452 Fax No.612- 947 -9793 TED COMPANY B Travelers Indemnity Co. of IL COMPANY North Valley, Inc. C RLI Insurance Co. COMPANY 4105 85th Avenue N. Brooklyn Park MN 55443 D American Compensation Ins Co EE?AGES HIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD VDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS :ERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, D(CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMMO/YY) POLICY EXPIRATION DATE (MM/DWY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE s 2,000, 000 - PRODUCTS - COMP/OPAGG s_ X COMMERCIAL GENERAL LIABILITY CLAIMS MADE ❑X OCCUR OWNER'S & CONTRACTOR'S PROT DT- CO- 912J1081-IND-98 05/01/98 05/01/99 PERSONAL & ADV INJURY S1,000,000 EACH OCCURRENCE $1,000,000 FIRE DAMAGE (Any one fire) $100,000 X Blkt Addl Insured X Per Pro ' ect Agg MED EXP (Anyone person) $5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 X ANY AUTO DT- 810- 912n081- T1L -9s 05/01/98 05/01/99 BODILY INJURY $ ALL OWNED AUTOS (Per fin) SCHEDULED AUTOS BODILY INJURY $ X HIRED AUTOS X NON .OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT $ AGGREGATE S EXCESS LIABILITY EACH OCCURRENCE s2,000,000 AGGREGATE s2,000,000 X UMBRELLA FORM OUL0028390 05/01/98 05/01/99 $ OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND X CRY I O ER EL EACH ACCIDENT S 500 , 000 EMPLOYERS LIABILITY EL DISEASE -POLICY LIMIT s500,00 0 1 $500,000 THE PROPRIETOR/ X INCL AC -WC- 002659 05/01/98 05/01/99 EL DISEASE. EA EMPLOYEE PARTNERS/EXECUTIVE OFFICERS ARE: EXCL OTHER Property Section DT- CO- 912J1081 IND - 98 05/01/98 05/01/99' :RIPTION OF OPERATIONSILOCATIONS(VEHICLES /SPECIAL ITEMS )77ect• Civic Center Park Improvements, BRA File No. 34 -98 -224. North L3ey Job No. 511 -9. *MC ,TIFICATE HOLDER CANCELLATION BONES 0 5 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of New Hope EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL Xp1.X7 kA X( MAIL c/o Bonestroo , Rosene 30 DAYS WRITTEN NOTE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Anderlik & Associates 2335 West Highway 36 St. Paul MN 55113 AUTHO NT E )RD25- 5(1195) !f 'Aofzr' o►Ial:lure ` : i COUNCIL 1:RFA\P&R\Parks\fina1 629.doe REQUEST FOR ACTION 0 Q trr Originating Department Approved for Agenda Agenda Section Parks & Recreation November 13, 2000 Consent Item No. By: Shari French By: 6.15 MOTION TO ACCEPT IMPROVEMENT PROJECT NO. 629 (CIVIC CENTER PARK IMPROVEMENTS) TO NORTH VALLEY INC. AND APPROVE FINAL PAY REQUEST TO NORTH VALLEY INC. IN THE AMOUNT $14,668.92 REQUESTED ACTION Staff is recommending that the Council accept Improvement Project 629 and approve final payment to North Valley, Inc. in the amount of $14,668.92. The City has received all appropriate paperwork in order to close out this project. BACKGROUND This project involved work at Civic Center Park including the replacement of the four existing tennis courts, the addition of a new lighted basketball court and a new lighted sand volleyball court, the realignment of the drive off Zealand Avenue leading to the fire station, the addition of a dozen parking spaces along that same drive, new trails between the courts, and the addition of new landscaping. FUNDING The cost of this project totals $256,244.77. The original contract amount was $259,314.93. (See the engineer's letter for a full explanation of the final amount to be paid.) Funding is to come from Parks CIP. ATTACHMENTS The Engineer's letter recommending final payment is attached. MOTION SECOND BY BY TO: A 1:RFA\P&R\Parks\fina1 629.doe Bonestroo, Rosene, Anderlik and Associates, Inc. is an Affirmative Action /Equal Opportunity Employer and Employee Owned Principals: Otto G. Bonestroo, P.E. • Marvin L. Sorvala, P.E. • Glenn R. Cook, P.E. Robert G. Schunicht, PE. • Jerry A. Bourdon, PE. Senior Consultants: Robert W. Rosene, P.E. • Joseph C. Anderlik, P.E. • Richard E. Turner, P.E. Susan M. Eberlin, C.P.A. Associate Principals: Howard A. Sanford, P.E. • Keith A. Gordon, P.E. • Robert R. Pfefferle, P.E. Richard W. Foster, P.E. • David O. Loskota, P.E. • Robert C. Russek, A.I.A. • Mark A. Hanson, P.E. Michael T. Rautmann, P.E. • Ted K.Field, P.E. • Kenneth P Anderson, P.E. • Mark R. Rolfs, PE. David A. Bonestroo, M.B.A. • Sidney R Williamson, P.E., L.S. • Agnes M. Ring, M.B.A. • Allan Rick Schmidt, PE. Offices: St. Paul, St. Cloud, Rochester and Willmar, MN • Milwaukee, WI Website: www.bonestroo.com November 6, 2000 Ms. Shari French City of New Hope 4401 Xylon Avenue North New Hope, MN 55428 Re: Civic Center Park Improvements BRA File No. 34 -98 -224 Dear Shari, All project requirements have been completed. Attached find signed pay requests and IC -134 forms from North Valley and their subcontractors. The original contract amount was $259,313.93. Change Order #1 was previously approved for work on the emergency siren controls. This raised the contract amount to $260,693.33. Several changes were made during construction including the installation of "heavy duty" fencing around the entire tennis court and additional drain the under the tennis court. The final value of the work completed including the additions is $263,844.77 or 1.2% over the revised contract amount. It should also be noted that the City retained $7,600.00 in liquidated damages. This reduces the actual amount paid to the contractor to $256,244.77. We recommend that the final payment in the amount of $14,668.92. Should you have any questions, please feel free to call. My direct number is (651) 604 -4790. Respectfully, BONESTROO, ROSENE, ANDERLIK & ASSOCIATES, INC. Vincent T. Vander Top, P.E. 2335 West Highway 36 - St. Paul, MN 55113 a 651- 636 -4600 - Fax: 651 -636 -1311 /A � �A Y , A Z I Tai Bonestroo Rosene Anderlik & Associates Engineers & Architects Dwner: City of New Hope, 4401 Xylon Ave. N., New Hope, MN 55428 Date: October 13, 2000 =or Period: 7!28!2000 to 10!13!2000 Request No: 7 AND FINAL Dontractor: North Valley Inc., 4105 85th Ave. N., Brooklyn Park, MN 55443 REQUEST FOR PAYMENT CIVIC CENTER PARK IMPROVEMENTS BRA FILE NO. 34 -98 -224 CLIENT PROJECT NO. 629 SUMMARY 1 Original Contract Amount 2 Change Order - Addition 3 Change Order - Deduction 4 Revised Contract Amount 5 Value Completed to Date 6 Material on Hand 7 Amount Earned 8 Less Retainage 0% 9 Subtotal 10 Less Amount Paid Previously 11 Liquidated damages - 12 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. 7 AND FINAL Recommended for Approval by: BONESTROO, ROSENE, ANDERLIK & ASSOCIATES, INC. Brad Schmidtbauer Specified Contract Completion Date: June 25, 1999 $ 259,313.93 $ 1,379.40 $ 0.00 $ 260,693.33 $ 263,844.77 $ 0.00 $ 263,844.77 $ 0.00 $ 263,844.77 $ 241,575.85 $ 7,600.00 $ 14 668.92 t 4 �� Approv by Owner: CITYj0F,NEW HOPE Date: requestMnal No. 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 M 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 request7Final Contract Unit Quantity Amount Item Unit Quantity Price to Date to Date Base Bid Demolish & remove ex. paving & fencing (four tennis courts) LS 1 4350.00 1 $4,350.00 Demolish & remove ex. driveway to fire station LS 1 2000.00 1 $2,000.00 Remove &salvage poles, wire, etc. (fire Gall appranaus) LS 1 1000.00 1.2 $1,200.00 Clear and Grub Tree 1 150.00 3 $450.00 Remove and salvage hydrant EA 1 903.00 1 $903.00 Remove /relocate hydrant EA 2 2112.60 2 $4,225.20 Reconstruct sanitary manhole LF 4.7 105.00 4.7 $493.50 Reconstruct cleanout sta. 1 +60 LF 3.61 35.70 $0.00 Remove and remount time controls EA 4 157.50 4 $630.00 Refurbish ex. tennis court light poles and time control EA 3 1260.00 3 $3,780.00 Extend concrete base for ex. light pole LS. 1 866.25 1 $866.25 Remove concrete curb and gutter LF 64 7.50 127 $952.50 Silt fence, regular LF 360 3.15 $0.00 Temporary fence during construction LS 1 4650.00 1 $4,650.00 Site grading /final shaping LS 1 6500.00 1 $6,500.00 Natural stone retaining wall SF 150 10.00 150 $1,500.00 Driveway paving including aggregate SY 1150 12.90 1200 $15,480.00 Trail paving including aggregate SY 1320 9.50 1320 $12,540.00 Tennis court paving including aggregate base, granular base and bituminous paving SY 2800 13.50 2800 $37,800.00 Basketball court, paving including aggregate base and bitumnous paving SY 650 15.75 650 $10,237.50 Color coating & tennis court line marking SY 2800 1.99 2800 $5,572.00 Color coating & basketball court line marking SY 590 1.99 590 $1,174.10 Furnish & install basketball pole, backboard, rim, net EA 2 1680.00 2 $3,360.00 Tennis Court chain link fencing (wind screen) LF 410 32.48 650 $21,112.00 Tennis Court chain link fencing (standard) LF 240 21.91 $0.00 Tennis post and net EA 4 668.85 4 $2,675.40 Volleyball posts, net, nylon rope and anchors LS 1 1207.50 1 $1,207.50 Subgrade excavation (EV) CY 600 7.85 600 $4,710.00 Granular borrow (CV) CY 600 14.50 600 $8,700.00 Volleyball sand CY 120 25.00 120 $3,000.00 Topsoil borrow (CV) CY 500 9.50 514 $4,883.00 Sodding, lawn type SY 8700 1.83 8000 $14,640.00 12" PVC sanitary sewer, SDR 35 LF 100 13.65 100 $1,365.00 12" PVC, perforated drain pipe LF 200 16.80 200 $3,360.00 6" PVC drain tile LF 260 11.55 260 $3,003.00 4" PVC drain tile LF 290 7.35 599 $4,402.65 4" PVC solid wall drainpipe LF 50 5.25 40 $210.00 4' diameter storm CBMH EA 1 1387.05 1.29 $1,789.29 24" yard drain w/R1642 type c grate EA 2 777.00 2 $1,554.00 Connect to existing manhole EA 1 210.00 1 $210.00 B618 concrete curb and gutter LF 100 13.23 122 $1,614.06 8612 concrete curb and gutter LF 650 8.67 650 $5,635.50 Concrete valley gutter SY 40 44.10 47 $2,072.70 Parking lot stripping LS 1 175.00 1 $175.00 30 ft pole, concrete base, luminar & time control (basketball court) LS 2 2730.00 2 $5,460.00 Luminaire, 150OW Quartz EA 14 162.75 14 $2,278.50 2" PVC Conduit, SCH. 40 LF 1000 4.04 1000 $4,040.00 0 AWG Wire LF 4000 1.73 4000 $6,920.00 #1 AWG Wire LF 1300 1.62 1300 $2,106.00 #10 AWG Wire LF 500 0.12 500 $60.00 Handhole EA 2 640.50 2 $1,281.00 Remove wiring - park shelter building LS 1 420.00 $0.00 Install yard hydrant LS 1 1579.20 1 $1,579.20 Install fountain LS 1 2709.00 1 $2,709.00 Remove bituminous pavement SY 200 150 220 $770.00 Remove drain structure LS 1 483.00 1 $483.00 Remove water main LF 80 10.50 20 $210.00 Remove water fountain LS 1 241.50 1 $241.50 Remove volley ball court LS 1 1000.00 1 $1,000.00 request7Final Change Order Number 1 1 Conduit and wiring for emergency siren electrical service. LS 1 1379.40 1 $1,379.40 Total Change Order No. 1 $1,379.40 Total Base Bid $257,996.57 Total Alternate No. 1 $4,468.80 Total Change Order No. 1 $1,379.40 Total Work Completed To Date $263,844.77 request7Final Contract Unit Quantity Amount No. Item Unit Quantity Price to Date to Date 60 Adjust frame and ring casting, storm MH -102 EA 1 105.00 2 $210.00 61 Adjust Valve Box EA 1 52.50 1 $52.50 62 4" DIP water main, Class 52 LF 170 21.00 240 $5,040.00 63 4" gate valve EA 1 388.50 2 $777.00 64 Lighting control panel EA 1 4249.35 1 $4,249.35 65 Picnic table (4 seats) with concrete pad(400 sf) EA 2 1050.00 1.63 $1,711.50 66 Bench, litter receptacle with concrete pad (48 so EA 3 371.70 1.05 $390.29 67 Bench, litter receptacle with concrete pad (56 so HC accessable EA 3 761.00 0.64 $487.04 68 Picnic table (3 seats) w /cone. pad (300 sf) - HC accessible EA 1 1128.75 0.97 $1,094.89 69 Scotch Pine, 6' B &B EA 5 225.75 5 $1,128.75 70 Black Hills Spruce, 6' B &B EA 10 225.75 10 $2,257.50 71 Prairie (Flame) Crabapple, 1" Cal. container stock EA 3 96.60 3 $289.80 72 Autumn Purple White Oak, 2 1/2" cal. container stock EA 6 322.35 6 $1,934.10 73 Red Twigged Dogwood, #3 pot EA 17 29.40 22 $646.80 74 Littleleaf Linden, 2" Cal. container stock EA 5 225.75 5 $1,128.75 75 Swamp White Oak, 2" Cal. container stock EA 5 322.35 5 $1,611.75 76 Baily Compact Viburnum, #3 pot EA 8 29.40 8 $235.20 77 Hahs Viburnum, #3 pot EA 20 31.50 20 $630.00 Total Base Bid $257,996.57 Alternate No. 1 78 Replace existing luminaire with new luminaire EA 28 159.60 28 $4,468.80 Total Alternate No. 1 $4,468.80 Change Order Number 1 1 Conduit and wiring for emergency siren electrical service. LS 1 1379.40 1 $1,379.40 Total Change Order No. 1 $1,379.40 Total Base Bid $257,996.57 Total Alternate No. 1 $4,468.80 Total Change Order No. 1 $1,379.40 Total Work Completed To Date $263,844.77 request7Final PROJECT PAYMENT STATUS OWNER CITY OF NEW HOPE CLIENT PROJECT NO. 629 BRA FILE NO. 34 -98 -224 CONTRACTOR NORTH VALLEY INC CHANGE ORDERS No_ Data Descrintion Amount 1 7/27/2000 Change order to complete emergency siren hook up to new concession building. $1,379.40 3,951.69 79,033.89 2 06/02/99 07/07/99 76,034.48 7,953.51 159,070.19 Total Change Orders i $1,379.40 PAYMENT SUMMARY No. From To Pavment Retainaae Completed 1 05/01/99 06/01/99 75,082.20 3,951.69 79,033.89 2 06/02/99 07/07/99 76,034.48 7,953.51 159,070.19 3 07/08/99 08/30/99 37,171.79 9,909.92 198,198.39 4 08/31/99 10/14/99 10,961.17 10,486.82 209,736.46 5 10/15/99 01/24/00 21,546.68 12,020.86 232,817.18 6 01/25/2000 07/27/00 20,779.53 13,114.52 254,690.37 7 AND FINAL 07/28/2000 10/13/00 14,668.92 263,844.77 Material on Hand Total Payment to Date $256,244.77 Original Contract $259,313.93 Retains a Pay No. 7 AND FINAL Change Orders $1,379.40 Total Amount Earned $256,244.77 Revised Contract $260,693.33 requesUFinal :!MINNESOTA 2 0 s3 Depart of Reven 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. IC -134 Minnesota withholding tax ID number 3744649 Month /year work began W Project number Project location 629 Civic Center Park Court Imps —New Hope Project owner Address city State Zip code City of Neiv Hope 4401 Xylon Ave N Neu Hope TMN 55428 Did you have employees work on this project? XX Yes ❑ No If no, who did the work? Check the box that describes your involvement in the project and fill in all information requested. ❑ Sole contractor ❑ Subcontractor Name of contractor who 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 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 Electrical Installation & Maint. 1480 Cty Rd 90 Mapl Plain MN 55359 Marty O'Connor Greenworks, Inc. 8940 Greenfield Rd, Loretto, MN 55357 Janine Hebner Penn Contracting, Inc. 13025 Central Ave NE— Blaine, M 55434 Dean Luxemburg American Surfaces Corp. of MN 5885 N 165th St., Hugo, MN 55038 Chris B ring Designing Nature, Inc. 3312 Red F Hamel, MN 55340 Gwen Leuer Century Fence C ompany PO Box 277 Forest Lake, MN 55025 Jane Lewis 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. Contrac o 's sigrpture Title Date Mail to: MN Dept. of Revenue, Withholding Division, Mail Station 6610, St. Paul, MN 551 -6610 Certificate of Compliance 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. Del rt ent of Revenue ova Date }^ Stock No. 5000134 IRev. 11 /95) printed on recycled paper with 10% post - consumer waste using soy -based ink. Instructions for Form IC- 134 Who must file? If you are a prime contractor, a contractor or a subcontractor who did work on a project for the state of Minnesota or any of its local government subdivisions — such as a county, city or school district — you must file Form IC -134 with the Minnesota Department of Revenue. This affidavit must be certified and returned before the state or any of its subdivisions can make final payment for your work. When to file The IC -134 cannot be processed until you finish the work. If you send it in for certification before the project is completed, it will be returned to you unprocessed. If you are a subcontractor or sole contractor, send in the form when you have completed your part of the project. Are you a prime contractor and a subcontractor on the same project? If you were hired as a subcontractor to do work on a project, and you subcontracted all or a part of your portion of the project to another contractor, you are a prime contractor as well. Fill out both the subcontractor and prime contractor areas on a single form. Where to file Mail to: MN Dept. of Revenue Withholding Tax Division Mail Station 6610 St. Paul, MN 55146 -6610 Minnesota tax ID number You must fill in your Minnesota withholding tax ID number on the form. You must have a Minnesota tax ID number if you have employees who work in Minnesota. If you are a prime contractor, send in the form when the entire project is completed and you have received certified affidavits from all of your subcontractors. How to file If you have fulfilled the requirements of Minnesota withholding tax laws, the Department of Revenue will sign your affidavit and return it to you. If any withholding payments are due to the state, Minnesota law requires that payment be made by money order, cashiers check, certified check or cash (M.S. 290.97). Submit the certified affidavit to your prime contractor or to the government unit for which the work was done in order to receive your final payment. If you do not have a Minnesota ID number, you must apply for one. Call (612) 282 -5225 or 1- 800 -657- 3605. Or write to the following address to request an application (Form ABR). Minnesota Tax Forms Mail Station 1421 St. Paul, MN 55146 -1421 If you have no employees and did all the work yourself, you do not need a Minnesota tax ID number. If this is the case, fill in your Social Security number in the space for Minnesota tax ID number and explain who did the work. Use of information The Department of Revenue needs all the information, except your phone number, to determine if you have met all state income tax withholding requirements. If all required information is not provided, the IC -134 will be returned to you for completion. All information on this affidavit is private by state law. It cannot be given to others without your permission, except to the Internal Revenue Service, other states that guarantee the same privacy and certain government agencies as provided by law. Information and assistance If you need help or additional information to fill out this form, call (612) 282 -9999 or 1- 800 -657 -3594. Hearing, speech or visually impaired? TDD users may contact the department through the Minnesota Relay Service. Call (612) 297 -5353 or 1 -800- 627 -3529; ask for (612) 282 -9999. If you need information in an alternative format, such as Braille, large print or audio tape, we will provide it. To get more IC -134 forms If you need more IC -134 forms, call (612) 296 -4444 or 1- 800 - 657 -FORM. Or write to: Minnesota Tax Forms Mail Station 1421 St. Paul, MN 55146 -1421 Business Name Address Owner/Officer North Country Concrete, Inc. 7040 143 Ave NW Ramsey MN 55303 Amy Gangl MINNESOTA Department of Revenue "it 61cling Afficlavilt for Contractors IC-134 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. Please type or prin clearly. This will be your mailing label for returning the completed form. "C Company name Da phone Electrical Installation & Maintenance (763)479-3744 I Minnesota withholdin tax ID number 4120631 Address T o tal contract arnown! Month/ be 1480 County Road 90 $ 3 4 Cit State Amo u nt - s t i T11 k e Z) t Month/ work ended Maple Plain, MN 55359 $ i 0 61 0, �9�3 _-) ---- ---- 101 ------- ___ - Project number I Project location C l I----------- ____ tea x Project owner Address city State Zip code 0V Y 1 - 4 A AJ M�f Hof�Q -_ __T____ - - is Did you have J on th proje work XYes ❑ No If no, who did the work? Check the box that describes your involvement in the project and fill in all information requested. F Sole contractor Subcontractor Name of contractor who hired y ou A-1 Address 'q Cc V_ F Prime contractor—If you subcontracted out any work on this project, a!! of your subcontractors must file their own IC -1 34 affidavits and have them certified by the Department of Revenue before you can file your affidavit. For each subcontractor you had, fill in the information below and attach a copy of each Subcontractor's certified IC -1 34. If you need more space, attach a separate sheet. Business name Address Owner/Cirfi . .... . / 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. � C T t tor's signature < Tittle e Dat I Z 1 1(76 MN Dept. of Revenue, Withholding Division, Mail Station 6610, St. Paul, VN 55 1 46 -66 1 0 Certificate of Compliance 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. Department of Revenue approval Date Sr-P Stock No . 5000134 (Rev- 11/96) Printed on recycled paper with 10% post-consumer waste uimq soy-based ink. MINNESOTA Department of Revenue W ithhold ing 1 Contra IC -134 OW SEP 252 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. Please type or print clearly. This will be your mailing label for returning the completed form. CD ` - ' �- ----------- - - - - -� �, ;t t� a k' ( Company name Daytime phone Minnesota withholding tax ID number c.� GREENWORKS, INC. ( 763 498 - 7696 Address Total contract amount 8940 Greenfield Road $21,893.00 _ City St to Zip Code I Amount still due (o r t— - - - - -- J $ 2,994.65 Project number I Project location I Civic Center Park Court, New Ho MN Project owner Address City State Zip code City of New Hope, Minnesota Did you have employees work on this project? [I Yes ❑ No If no, who did the work? Check the box that describes your involvement in the project and fill in all information requested. ❑ Sole contractor ® Subcontractor Name of contractor who hired you N ORTH VALLEY INC. Address 4105 85th Avenue North, Brooklyn Park, MN 55443 ❑ 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 information below and attach a copy of each subcontractor's certified IC -134. If you need more space, attach a separate sheet. name Address I declare that all information t have filled in on this form is true and complete to the best of my knowledge and belief. t 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. .eb'�ractor's s / J Title Date Office Manager 9 - 21 - 00 to: MN Dept. of kevenue, Withholding Division, Mail Station 6610, St. Paul, MN 55146-6610 Certificate of Compliance 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. Department of Revenue approval Date EP 2 4522225 ionth /year work began 7/99 10/ Stock No. 5000134 (Rev. 11/95) Printed on recycled paper with 10% post-consumer waste using soy -based ink. MINNESOTA Department of Revenue ? 8 , 1 a, Withholding Aff 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. t ' : I �� 1 i aiwy, , Please type or print clearly. This will be your mailing label for returning the completed form. C ompany name — — , T T � Daytime phone Penn Contracting, Inc. 1763)767 2 141 Address ' Total contract amount 13025 Central Ave NE I $ 32 U b City Blaine �i Sta Zip Code ( Amount still due � — T — — n. ^ — 5543 - $ ',>- ��CO0 00 Minnesota withholding tax ID number 2808643 Month /year work began "M(kX, [°t `'A Month /year work ended Project number Project location /r y (� f /n y p ' i 1 t t. ( I L e v i t,.- L L- � X� � t x 1 � D r� � P U Project owner Address . City ' State Zip code Did you have employees work on this project? Yes ❑ No If no, who did %e work? Check the box that describes your involvement in the project and fill in all information requested. ' ❑ Sole contractor Subcontractor Name of contractor who hired you Address 5 r `l ❑ 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 fill in the information below and attach a copy of each subcontractor's certified I0134. If you need more space, attach a separate sheet. Business name Address Owner /Officer r i declare that all information f 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 su ,*ntractors if f am a coptractor, and to the contracting agency. Mail to: MN Dept._of Revenue, Withholding Divisi Mail Station 6610, St. Paul, MN 55146.6610 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. Department of Revenue approval Dote 't VL�1� 0 S q� 5 i-k stock No. 5000134 (Rev. 11/95) Printed on recycled paper with 10% post-consumer waste using soy -based ink. Please type or print clearly. This will be your mailing /abet for returning the completed form. � � ­­ Address 1 Daytime phone r� .. •• No 6 . a Hu go , t t l Project number I Project location (651) 426 -8883 Minnesota withholding tax ID number 1157297 Total contract amount Month /year work began $ 8805.50 7/99 Amount still due Month /year work ended It 498.34 9/99 CIVIC CENTER PARK NEW HOPE MN 55427 Project owner Address City State Zip code CITY Ol~ NEW HOPE, 113 Did you have employees work on this project? X Yes ❑ No If no, who did the work? Check the box that describes your involvement in the project and fill in all information requested. ❑ Sole contractor 1 Subcontractor NORTH VALLEY, INC. Name of contractor who hired you 4105 85th Avenue N . Brooklyn park, —M 55443 Address Prime contractor — 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 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 as me co) actor, and to the contracting agency. i Contractor's signature President 9/22/00 Mail to: MN Dept. of Reve�iue, Vvr Division, Mail Station 6610, St. Paul, MN 55146-6610 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. Deportmynkof Revenue approval Date t r OCT Stock No. 5000134 (Rev. 11/95) Printed on recycled paper with 10% post- consumer waste using soy -based ink. • • • Who must file? If you are a prime contractor, a contractor or a subcontractor who did work on a project for the state of Minnesota or any of its local government subdivisions — such as a county, city or school district — you must file Form IC -134 with the Minnesota Department of Revenue. This affidavit must be certified and returned before the state or any of its subdivisions can make final payment for your work. When to file The IC -134 cannot be processed until you finish the work. If you send it in for certification before the project is completed, it will be returned to you unprocessed. If you are a subcontractor or sole contractor, send in the form when you have completed your part of the project. If you are a prime contractor, send in the form when the entire project is completed and you have received certified affidavits from all of your subcontractors. How to ile If you have fulfilled the requirements of Minnesota withholding tax laws, the Department of Revenue will sign your affidavit and return it to you. If any withholding payments are due to the state, Minnesota law requires that payment be made by money order, cashiers check, certified check or cash (M.S. 290.97). Submit the certified affidavit to your prime contractor or to the government unit for which the work was done in order to receive your final payment. Where to file Mail to: MN Dept. of Revenue Withholding Tax Division Mail Station 6610 St. Paul, MN 55146 -6610 Minnesota x ID number You must fill in your Minnesota withholding tax ID number on the form. You must have a Minnesota tax ID number if you have employees who work in Minnesota. If you do not have a Minnesota ID number, you must apply for one. Call (612) 282 -5225 or 1- 800 -657- 3605. Or write to the following address to request an application (Form ABR). Minnesota Tax Forms Mail Station 1421 St. Paul, MN 55146 -1421 If you have no employees and did all the work yourself, you do not need a Minnesota tax ID number. If this is the case, fill in your Social Security number in the space for Minnesota tax ID number and explain who did the work. The Department of Revenue needs all the information, except your phone number, to determine if you have met all state income tax withholding requirements. If all required information is not provided, the IC -134 will be returned to you for completion. All information on this affidavit is private by state law. It cannot be given to others without your permission, except to the Internal Revenue Service, other states that guarantee the same privacy and certain government agencies as provided by law. assistance If you need help or additional information to fill out this form, call (612) 282 -9999 or 1- 800 - 657 -3594. Hearing, speech or visually impaired? TDD users may contact the department through the Minnesota Relay Service. Call (612) 297 -5353 or 1- 800 - 627 -3529; ask for (612) 282 -9999. If you need information in an alternative format, such as Braille, large print or audio tape, we will provide it. • • • - kielo it M-NNESOTA Department of Revenue Withholding Affildaylt for Contractors IC- 1 34 this affidavit must be approved by the Minnesota Department of Reverue before the state of Minnesota or any of its subdivisions can rnak6 final payment to contractors, Plowcp.5pe or print clearly, This will { e your mailing label for returning ,the completed term. �N4 — — — — — — — ny nqrn; Daytime phone Minnesota withholding toy. ID nvmbe, IDesigning Nature Inc 1 (612478-9583 2901604 ri I Address Tctat contract amount Monfh /yevr work bN=m Q, 13312 RED FOXDRIVE $ 1,950.00 July 1999 City 5tote Zip Cc de Amount still due Month /your work t-nded I Hamel, MN 55340 $ 1,950.00 1 July 1999 Project number I Project localion Civic Center Park Court New Hope MN Project owner Address City state Zip code '_ city of New Hope Did YOU have employees Work on 1h1& Project? Yes ❑ No if no, who did the work, Check the box that describes your involvement in the project and fill in all information requested. 7 L Sole contractor n;'Q`1 qp 10 Subcontractor Nrmr. of contractor who hired yov 0 1, N orth I I n c AtWeqss 4105 85th Ave North, Brooklyn park, MN 55443 i s 0 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 befor you can File your aff idavit, For each subcontractor you had, fil:t in the information below and attach a copy of each subcontractor's certified IC -1 34. If you need more space, attach a separate sheet. Business norrie Address Owner/Officer 4 U., I dNfaFe- thot all inFormah'on I have filled in on htris Form it frue and complete to the best of m knowledge and 6elie f, I outharize the Oeport meat of Y Revenue to d' lose porHnnt information relating to this project, inclueierg sending copies a iM form, to the prime confroctor if am c 5ubconh-actor, to n contractors if I orn a r e contractor, and to the controcfing or..ncy, and Con htictq/Xsignatvre 6nue, ithb g Division, Moil tli� MN Dept. of. goldinz Acil Storion 6 Certificate of Compliance 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 f rom wages paid to employees relating to contract services with the state of Minnesota and/or its subdivisions. 0*porhrt of Revenue approval Oot• J —01 Stock N.. 5000 1 34 (Re,. 11/96) PrWnd on -ecycled paper w;th 10% p­tcvnumcr waslo uS;n� 5Qy-1;+V*? d ink � , IC -134 Please type or print clearly. This will be your mailing label for returning the completed form. Company name ; Daytime phone Century Fence Company (651) 464 -7373 P.O. Box 277 ty State Zip Code Forest Lake, MN 55025 Project number Project location Civic Center Park - New Minnesota withholding tax ID number 8678834 Total contract amount Month /year work began $27,980.00 Apr -99 Amount still due Month /year work ended $1,200.45 Sep -99 Project owner Address City State Zip code City of New Hope Did you have employees work on this project? (X) Yes () No If no, who did the work? Check the box that describes your involvement in the project and fill in all information requested. ( ) Sole contractor (X) Subcontractor Name of contractor who hired you North Valley, Inc. Address 4105 85th Ave. N., Building B, Suite 203, Brooklyn Park, MN 55443 () 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 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 prine 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 L&t Office Manager 9/21/00 MN Dept. of Revenue, Withholding Division, Mail Station 6610, St. Paul, MN 55146 -6610 • • • 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. Department of Revenue approval Date COD MINI ESOTA Department of Revenue Withholding Affidavit for Contractors IC- 1 34 This affidavit must be approved by the Minnesota Department of Revenue before the state of SEP a, Minnesota or any of its subdivisions can make final payment to contractors. CZ r ... Please type or print clearly. This will be your mailing label for returning the completed form. ++ &.' _ Company name _ Daytime phone A roo Minnesota withholding tax ID number 10 7 i� Address Total contract amount y y r $ Month /year work began f f tl l 1 if l/ Cl _ / g / State Zip (j Zip ✓pC CCo y de � Amount still) d 1t M t /year work ended q q Project (num✓b}er i Project location t. A. Project owner Address /j {. � � C $tote lip code Did you have employees work on this project? ❑ Yes ❑ No If no, who did the work? Check the box that describes your involvement in the project and fill in all information requested. ❑❑ ole contractor Ll� Subcontractor Name of contractor who hired you „ ` K i ,I_ } \J 1J �'( Ot e (LA � � G Address �[ C75 �s A-Vt nl,. Le- A/ F_ " 5 L (f Id in C, 5�l f I Ntlyc.I R-4 n1 ❑ 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 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 l 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. 9 6ntt'actor's signature� o ? tle Date Mail to: MN Dept. of Rev6 /nue, WhHholding Division, Mail Station 6610, St. Paul, MN 55146-66 10 Certificate of Compliance 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. Department of Revenue approval Date �'� s a i., Stock No. 5000134 (Rev. 11/96) Printed on recycled paper with 10% post - consumer waste using soy -based ink. Who must file? If you are a prime contractor, a contractor or a subcontractor who did work on a project for the state of Minnesota or any of its local government subdivisions — such as a county, city or school district — you must file Form IC -134 with the Minnesota Department of Revenue. This affidavit must be certified and returned before the state or any of its subdivisions can make final payment for your work. When to file The IC -134 cannot be processed until you finish the work. If you send it in for certification before the project is completed, it will be returned to you unprocessed. If you are a subcontractor or sole contractor, send in the form when you have completed your part of the project. If you are a prime contractor, send in the form when the entire project is completed and you have received certified affidavits from all of your subcontractors. If you have fulfilled the requirements of Minnesota withholding tax laws, the Department of Revenue will sign y cur a .... t �._ to you. If any withholding payments are due to the state, Minnesota law requires that payment be made by money order, cashiers check, certified check or cash (M.S. 290.97). Submit the certified affidavit to your prime contractor or to the government unit for which the work was done in order to receive your final payment. Are you a prime contractor and a subcontractor on the same project? If you were hired as a subcontractor to do work on a project, and you subcontracted all or a part of your portion of the project to another contractor, you are a prime contractor as well. Fill out both the subcontractor and prime contractor areas on a single form. Where to file MN Dept. of Revenue Withholding Tax Division Mail Station 6610 St. Paul, MN 55146 -6610 Minnesota tax ID number You must fill in your Minnesota withholding tax ID number on the form. You must have a Minnesota tax ID number if you have employees who work in Minnesota. If you do not have a Minnesota ID number, you must apply for one. Call (612) 282 -5225 or 1- 800 -657- 3605. Or write to the following address to request an application (Form ABR). Minnesota Tax Forms Mail Station 1421 St. Paul, MN 55146 -1421 If you have no employees and did all the work vrnirsalf ymi clo not need a Minnesota tax ID number. If this is the case, fill in your Social Sc -_:ry number in the space for Minnesota tax ID number and explain who did the work. The Department of Revenue needs all the information, except your phone number, to determine if you have met all state income tax withholding requirements. If all required information is not provided, the IC -134 will be returned to you for completion. All information on this affidavit is private by state law. It cannot be given to others without your permission, except to the Internal Revenue Service, other stales Ll tat guarantee the same privacy and certain government agencies as provided by law. assistance If you need help or additional information to fill out this form, call (612) 282 -9999 or 1 -800- 657 -3594. Hearing, speech or visually impaired? TDD /TTY users may contact the department through the Minnesota Relay Service. Call 1 -800- 627 -3529. If you need information in an alternative format, such as Braille, large print or audio tape, we will provide it. To get more IC -134 forms If you need more IC -134 forms, call (612) 296 -4444 or 1- 8uu- o5 /- F0R - VI. Or write to: ' ",nnesota Tax Forms Mail Station 1421 St. Paul, MN 55146 -1421