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Contract 54750-FP1
AC Coded 08.24.23 Vendor Name: Winston Electric Inc CSC No. 54750-FP1 Invoice No.: 54750 - FP1 Invoice Date: 08/22/23 Release Retainage CITY OF FORT WORTH 56019-0O2648 FID 56019-206000-0O2648-CRETAN NOTICE OF PROJECT COMPLETION CS 54750 $437,639.35 Regarding City Secretary Contract 54750 for the Village Creek Water Reclamation Facility (VCWRF) Phase II Electrical Improvements, (City Proiect No. CO2648) which was requested by the Water Department and approved by City Council on September 09, 2020 through M&C 20-0699, the Director of the Water Department, upon the recommendation and approval of the Citv Proiect Manager, has accepted the project as complete. Final Payment (Pav Application # 28 - Final) will be issued in accordance with Administrative Regulation C-6. Original Contract Price: $ 8,647,846.00 Amount of Approved Change Orders: $ 104,941.00 Number: 03 Revised Contract Amount: $ 8,752,787.00 Less Liquidated Damages: $ 0.00 Total Value of Work to Date: $ 8,752,787.00 Less Previous Payments: $ 8,315,147.65 Final Payment Due: $ 437,639.35 July 11, 2023 Approved, Farida Goderya Date Sr. Project Manager, Water Department (oO � Sn� � 8 22 2� Recommended, Tony Sholola Date Assistant Director, Water Department Christopher Hafder (Aug 24, 2023 14:21 CDT) Accepted, Chris Harder Date Director, Water Department 'Darla &Wao ff Dana Burgh doff (Aug , 202313:54 CDT) Assistant City Manager, Dana Burghdoff Date OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Date of Final Completion Date of Warranty Start May 05.2023 Mav 05.2023 5000 Martin St ACME ELECTRIC Ft Worth, TX 76119 Company June 27, 2023 Farida Goderya, PhD, PE CITY OF FORT WORTH 200 Texas Street Fort Worth TX 76102 Re: Project Number CO2648-II Village Creek WRF Phase II Electrical 4500 Wilma Lane, Arlington, TX 76012 Dear Ms. Goderya: This letter shall serve as Acme Electric Company's Completion Notice for the above -referenced project. The project was completed May 5, 2023. The Final Statement of Contract Time is 1086 calendar days. Sincerely, Todd Bozeman Project Manager 817-654-1618 APPLICATION AND CERTIFICATE FOR PAYMENT Received 7/7/23 INVOICE Page 1 To(OWNER): City of Fort Worth Texas 200 Texas Street Fort Worth, TX 76102 From: Acme Electric Company 5000 Martin Street Fort Worth, Texas 76119 Project: Village Creek WRF Phase 2 4500 Wilma Lane Arlington, TX 76012 Via(Architect): OK to pay, 7/11/23 Farida Goderya CONTRACTOR'S APPLICATION FOR PAYMENT Application No: Invoice No: Period To: 29 FINAL 2675-29 6/30/2023 Project No: CO2648-II Invoice Date: 6/27/2023 Contract Date: 10/5/2020 Application is made for Payment, as shown below, in connection with the Contract. Continuation Sheet is attached. 1. ORIGINAL CONTRACT SUM .................................. $ 8,647,846.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS 2. Net change by Change Orders .............................. $ 104,941.00 3. CONTRACT SUM TO DATE(Line 1 +/- 2)................ $ 8,752,787.00 Approved previous months 104,941.00 0.00 4. TOTAL COMPLETED & STORED TO DATE .............. $ 8,752,787.00 Approved this month 0.00 0.00 5. RETAINAGE......................................................... $ 0.00 6. TOTAL EARNED LESS RETAINAGE ......................... $ 8,752,787.00 TOTALS 104,941.00 0.00 (Line 4 less Line 5) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT..... $ 8,315,147.65 Net change by change orders 104,941.00 (Line 6 from prior Certificate) The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTrK Company By: Date: 027/2423 / / ARCHITECTS CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on -she observations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architects knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. 18. CURRENT PAYMENT DUE ..................................... $ 437,639.35 9. BALANCE TO FINISH, PLUS RETAINAGE................ $ 0.00 (Line 3 less Line 6) State of: TOW',S County of: dwo / Subscribed and sworn to before me this 27 day of hoc, 20,�3 Notary Public A�j� �� .���un'', RHONDA CASON ��,rµV PUB 'i My Commission expires: :z°:�{ Notary Public, state of Texas ;�.� �. Y: Comm. Expires 10-26-2025 Notary ID 1007901-4 AMOUNT CERTIFIED ............................................ $ (Attach explanation if amount certified differs from the amount applied for.) ARCHITECT: By Date This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract, Page 2 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) B1 RPS #2 Elect. Equipment 001 Procure RPS #2 Elect. Building 257,498.00 257,498.00 0.00 0.00 257,498.00 100 0.00 0.00 002 Procure Gen. Quick Disconnect 24,251.00 24,251.00 0.00 0.00 24,251.00 100 0.00 0.00 003 Procure 100 AMP Disconnect 8,903.00 8,903.00 0.00 0.00 8,903.00 100 0.00 0.00 004 Procure 60 AMP Disconnect 4,801.00 4,801.00 0.00 0.00 4,801.00 100 0.00 0.00 005 Procure 30 AMP Disconnect 7,294.00 7,294.00 0.00 0.00 7,294.00 100 0.00 0.00 006 Procure TX-1-2 & Panel L2 6,355.00 6,355.00 0.00 0.00 6,355.00 100 0.00 0.00 007 Procure DPRS2A Breakers 6,512.00 6,512.00 0.00 0.00 6,512.00 100 0.00 0.00 008 Procure DPRS3 Breaker 6,512.00 6,512.00 0.00 0.00 6,512.00 100 0.00 0.00 009 Procure Panel HBP 6,688.00 6,688.00 0.00 0.00 6,688.00 100 0.00 0.00 010 Procure TX-LBP & Panel LBP 8,188.00 8,188.00 0.00 0.00 8,188.00 100 0.00 0.00 Oil Procure Fixtures 20,363.00 20,363.00 0.00 0.00 20,363.00 100 0.00 0.00 B2 RPS #2 ELECTRICAL WORK 012 Install RS21,22,23,24 Equip. 12,679.00 12,679.00 0.00 0.00 12,679.00 100 0.00 0.00 Rack 013 Install RS21,22,23,24 PWR & 13,377.00 13,377.00 0.00 0.00 13,377.00 100 0.00 0.00 CNTRL Conduit 014 Install WAS-23 Equipment Rack 13,297.00 13,297.00 0.00 0.00 13,297.00 100 0.00 0.00 015 Install WAS-23 PWR & CNTRL 13,297.00 13,297.00 0.00 0.00 13,297.00 100 0.00 0.00 Conduit 016 Install Box R Valve Equipment 4,065.00 4,065.00 0.00 0.00 4,065.00 100 0.00 0.00 Rack 017 Install Box R Valve PWR Conduit 2,293.00 2,293.00 0.00 0.00 2,293.00 100 0.00 0.00 018 Install RS2 Sump Pump Equip. 6,956.00 6,956.00 0.00 0.00 6,956.00 100 0.00 0.00 Rack 019 Install RS2 Sump Pump Pwr 6,956.00 6,956.00 0.00 0.00 6,956.00 100 0.00 0.00 Conduit 020 Install Scum PMP #8 Equip. 4,402.00 4,402.00 0.00 0.00 4,402.00 100 0.00 0.00 Rack 021 Install Scum PMP #8 PWR & 4,402.00 4,402.00 0.00 0.00 4,402.00 100 0.00 0.00 CNTRL Conduit Page 3 CONTINUATION SHEET Application Number: 29 A ITEM NO. 022 023 024 025 026 027 028 029 030 D31 032 033 034 035 D36 D37 D38 039 D40 041 B DESCRIPTION OF WORK B2 RPS #2 ELECTRICAL WORK C SCHEDULED VALUE C III WORK BILLED FROM PREV. APPLICATION THIS PERIOD (D+E+F) Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 F G H I MATERIALS TOTAL % BALANCE TO REfAINAGE STORED THIS COMPLETED G/C FINISH (C-G) PERIOD AND STORED TO DATE (D+E+F) Install Conduit for WA-23 4,065.00 4,065.00 0.00 0.00 4,065.00 100 0.00 0.00 (Future) Install FC-4,5,6 Gate Equip. 4,402.00 4,402.00 0.00 0.00 4,402.00 100 0.00 0.00 Rack Install FC-4,5,6 Gate PWR & 4,402.00 4,402.00 0.00 0.00 4,402.00 100 0.00 0.00 CNTRL Conduit Install JP-201,202, 203 9,161.00 9,161.00 0.00 0.00 9,161.00 100 0.00 0.00 Install JC-201 & 202 9,161.00 9,161.00 0.00 0.00 9,161.00 100 0.00 0.00 Install RSPS #2 Fixtures 4,442.00 4,442.00 0.00 0.00 4,442.00 100 0.00 0.00 Install RSPS #2 Lighting & 4,442.00 4,442.00 0.00 0.00 4,442.00 100 0.00 0.00 Branch Conduit Install JP-46, 4,5,6 8,479.00 8,479.00 0.00 0.00 8,479.00 100 0.00 0.00 Install JC-46, 4,5,6 8,479.00 8,479.00 0.00 0.00 8,479.00 100 0.00 0.00 Install FC-4,5 & 6 PWR & CNTRL 8,479.00 8,479.00 0.00 0.00 8,479.00 100 0.00 0.00 Conduit Install FC-4,5,6 Fixtures 7,420.00 7,420.00 0.00 0.00 7,420.00 100 0.00 0.00 Install FC-4,5,6 Lighting & 7,420.00 7,420.00 0.00 0.00 7,420.00 100 0.00 0.00 Branch Conduit Install FC Flow MV JP Box 8,479.00 8,479.00 0.00 0.00 8,479.00 100 0.00 0.00 Install FC Flow MV PWR & 8,479.00 8,479.00 0.00 0.00 8,479.00 100 0.00 0.00 INSTR. Conduit Install CI Inject. Vault JP Box 8,479.00 8,479.00 0.00 0.00 8,479.00 100 0.00 0.00 Install CI Inject. Vault PWR 8,479.00 8,479.00 0.00 0.00 8,479.00 100 0.00 0.00 Condit Install INFLU MV-3&4 SUMP 10,215.00 10,215.00 0.00 0.00 10,215.00 100 0.00 0.00 PMP Equip. Rack Install INFLU. MV-3&4 SUMP 5,108.00 5,108.00 0.00 0.00 5,108.00 100 0.00 0.00 PMP PWR Conduit Install Tx-1-2 & Panel L2 5,706.00 5,706.00 0.00 0.00 5,706.00 100 0.00 0.00 Install TX-2 & Panel L2 Feeder 5,706.00 5,706.00 0.00 0.00 5,706.00 100 0.00 0.00 Conduit Page 4 CONTINUATION SHEET A B ITEM DESCRIPTION OF WORK NO. B2 RPS #2 ELECTRICAL WORK 042 Install AB-3(4) Disconnects 043 Install AB-4 (4) Disconnects 044 Install AB-3&4 PWR & INSTR. Conduit PRIMARY INFLU FLOW BYPASS MV 1 045 Install JP-120, JI-11 & JI 046 Install PWR, CNTRL, & INSTR. Conduit RETURN SLUDGE MV RS-2 047 Install PWR & INSTR. Conduit PRIMARY EFFLU.FLOW BYPASS MV 1 D48 Install Panels HBP & LBP 049 Install Tx-LBP D50 Install HBP,LBP & TX-LBP Feeder Conduit AB-3&4 AIR VALVE 351 Install JP-3,4 & JI-3,4 052 Install PWR & INSTR. Conduit 353 Lightning Protection B3 RPS #2 YARD ELECTRICAL )54 Procure 3 EMH & 1 IHH )55 Install 3 EMH & IHH )56 Install RSPS #2 Elect. Building Grounding )57 Install Duct Bank 4 )58 Install Duct Bank 5 Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 C D E F G H I SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREV. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) 12,658.00 12,658.00 - -0.00 0.00 12,658.00 190 0.00 0.00 12,334.00 12,334.00 0.00 0.00 12,334.00 100 0.00 0.00 38,369.00 38,369.00 0.00 0.00 38,369.00 100 0.00 0.00 5,108.00 5,108.00 0.00 0.00 5,108.00 100 0.00 0.00 4,483.00 4,483.00 0.00 0.00 4,483.00 100 0.00 0.00 5,749.00 5,749.00 0.00 0.00 5,749.00 100 0.00 0.00 5,108.00 5,108.00 0.00 0.00 5,108.00 100 0.00 0.00 4,060.00 4,060.00 0.00 0.00 4,060.00 100 0.00 0.00 3,162.00 3,162.00 0.00 0.00 3,162.00 100 0.00 0.00 10,227.00 10,227.00 0.00 0.00 10,227.00 100 0.00 0.00 10,227.00 10,227.00 0.00 0.00 10,227.00 100 0.00 0.00 6,788.00 6,788.00 0.00 0.00 6,788.00 100 0.00 0.00 47,224.00 47,224.00 0.00 0.00 47,224.00 100 0.00 0.00 27,744.00 27,744.00 0.00 0.00 27,744.00 100 0.00 0.00 8,528.00 8,528.00 0.00 0.00 8,528.00 100 0.00 0.00 18,413.00 18,413.00 0.00 0.00 18,413.00 100 0.00 0.00 18,413.00 18,413.00 0.00 0.00 18,413.00 100 0.00 0.00 Page S CONTINUATION SHEET Application Number: 29 A ITEM NO. 059 060 061 062 063 064 065 066 067 068 069 D70 071 072 073 074 D75 D76 D77 1yW D79 D80 D81 082 083 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 B C D E F G H I DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREV. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) B3 RPS #2 YARD ELECTRICAL Install Duct Bank 6 18,413.00 1-8,413.00 0.00 0.00 18,413.00 100 0.00 0.00 Install Duct Bank 7 18,413.00 18,413.00 0.00 0.00 18,413.00 100 0.00 0.00 Install Duct Bank 9 35,400.00 35,400.00 0.00 0.00 35,400.00 100 0.00 0.00 Install Duct Bank 10 35,400.00 35,400.00 0.00 0.00 35,400.00 100 0.00 0.00 Install Duct Bank 12 50,500.00 50,500.00 0.00 0.00 50,500.00 100 0.00 0.00 Install Duct Bank 13 27,850.00 27,850.00 0.00 0.00 27,850.00 100 0.00 0.00 Install Duct Bank 14 27,850.00 27,850.00 0.00 0.00 27,850.00 100 0.00 0.00 Install Duct Bank 20 51,340.00 51,340.00 0.00 0.00 51,340.00 100 0.00 0.00 Install Duct Bank 1 17,365.00 17,365.00 0.00 0.00 17,365.00 100 0.00 0.00 Install Duct Bank 2 17,365.00 17,365.00 0.00 0.00 17,365.00 100 0.00 0.00 Install Duct Bank 3 17,365.00 17,365.00 0.00 0.00 17,365.00 100 0.00 0.00 Install Duct Bank 11 17,365.00 17,365.00 0.00 0.00 17,365.00 100 0.00 0.00 Install Duct Bank 16 17,365.00 17,365.00 0.00 0.00 17,365.00 100 0.00 0.00 Install Duct Bank 17 17,365.00 17,365.00 0.00 0.00 17,365.00 100 0.00 0.00 Install Duct Bank 18 17,365.00 17,365.00 0.00 0.00 17,365.00 100 0.00 0.00 Install Duct Bank 19 16,610.00 16,610.00 0.00 0.00 16,610.00 100 0.00 0.00 Install Duct Bank 8 27,850.00 27,850.00 0.00 0.00 27,850.00 100 0.00 0.00 Install RSPS #2 Elect. Building 19,420.00 19,420.00 0.00 0.00 19,420.00 100 0.00 0.00 Pull RSPS #2 Elect. Building 23,085.00 23,085.00 0.00 0.00 23,085.00 100 0.00 0.00 Feeder Cable Test RSPS #2 Elect. Building 4,430.00 4,430.00 0.00 0.00 4,430.00 100 0.00 0.00 Feeder Cable Terminate RSPS #2 Elect. 4,430.00 4,430.00 0.00 0.00 4,430.00 100 0.00 0.00 Building Feeder Cables Install Gen. Quick Connect 16,190.00 16,190.00 0.00 0.00 16,190.00 100 0.00 0.00 Cabinet Pull Gen. Quick Connect Cable 17,205.00 17,205.00 0.00 0.00 17,205.00 100 0.00 0.00 Pull RS21,22,23,24 PWR & 25,695.00 25,695.00 0.00 0.00 25,695.00 100 0.00 0.00 CNTRL Cable Terminate RS21,22,23,24 PWR 4,430.00 4,430.00 0.00 0.00 4,430.00 100 0.00 0.00 & CNTRL Cable Page 6 CONTINUATION SHEET Application Number: 29 A B ITEM DESCRIPTION OF WORK N0, C SCHEDULED VALUE I E WORK BILLED FROM PREV. APPLICATION THIS PERIOD (D+E+F) B3 RPS #2 YARD ELECTRICAL 084 Pull FC#4,#5 PWR & CNTRL 22,650.00 22,650.00 Cable 085 Terminate FC #4 #5 & #6 PWR 11,840.00 11,840.00 & CNTRL Cable 086 Pull WAS-23 PWR & CNTRL 5,155.00 5,155.00 Cable 087 Terminate WAS-23 PWR & 4,430.00 4,430.00 CNTRL Cable 088 Pull Box R Valve PWR Cable 5,155.00 5,155.00 089 Terminate Box R PWR Cable 2,940.00 2,940.00 090 Pull RS2 SUMP PMP PWR Cable 5,155.00 5,155.00 091 Terminate RS2 SUMP PMP PWR 2,940.00 2,940.00 Cable 092 Pull Scum PMP #8 PWR & 3,665.00 3,665.00 CNTRL CCable 093 Terminate Scum PMP #8 PWR & 2,940.00 2,940.00 CNTRL Cable 094 Pull WAS PMP Valve #21 PWR 3,665.00 3,665.00 Cable 095 Terminate WAS PMP Valve #21 2,940.00 2,940.00 PWR Cable 096 Pull DPRS2 Feeder Cable 5,880.00 5,880.00 097 Termonate DPRS2 Feeder Cable 2,940.00 2,940.00 098 Pull FC-4,5,6 Gate PWR & 5,880.00 5,880.00 CNTRL Cable 099 Terminate FC-4,5,6 gate PWR & 2,940.00 2,940.00 CNTRL Cable 100 Pull FC-4,5,6 Lighting & Branch 3,238.00 3,238.00 Cable 101 Terminate FC-4,5,6 Lighting & 2,642.00 2,642.00 Branch Cable Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 F G H I MATERIALS TOTAL % BALANCE TO RETAINAGE STORED THIS COMPLETED G/C FINISH (C-G) PERIOD AND STORED TO DATE (D+E+F) 0.00 0.00 22,650.00 100 0.00 0.00 0.00 0.00 11,840.00 100 0.00 0.00 0.00 0.00 5,155.00 100 0.00 0.00 0.00 0.00 4,430.00 100 0.00 0.00 0.00 0.00 5,155.00 100 0.00 0.00 0.00 0.00 2,940.00 100 0.00 0.00 0.00 0.00 5,155.00 100 0.00 0.00 0.00 0.00 2,940.00 100 0.00 0.00 0.00 0.00 3,665.00 100 0.00 0.00 0.00 0.00 2,940.00 100 0.00 0.00 0.00 0.00 3,665.00 100 0.00 0.00 0.00 0.00 2,940.00 100 0.00 0.00 0.00 0.00 5,880.00 100 0.00 0.00 0.00 0.00 2,940.00 100 0.00 0.00 0.00 0.00 5,880.00 100 0.00 0.00 0.00 0.00 2,940.00 100 0.00 0.00 0.00 0.00 3,238.00 100 0.00 0.00 0.00 0.00 2,642.00 100 0.00 0.00 Page 7 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) B3 RPS #2 YARD ELECTRICAL 102 Pull FC Flow MV PWR & INSTR. 4,688.00 4,688.00 0.00 0.00 4,688.00 100 0.00 0.00 Cable 103 Terminate FC FLow MV PWR & 2,642.00 2,642.00 0.00 0.00 2,642.00 100 0.00 0.00 INSTR. Cable 104 Pull CI Inject. Vault PWR Cable 3,367.00 3,367.00 0.00 0.00 3,367.00 100 0.00 0.00 105 Terminate CI Inject. Vault Cable 2,046.00 2,046.00 0.00 0.00 2,046.00 100 0.00 0.00 106 Pull Influ. MV-3&4 SUMP PMP 4,688.00 4,688.00 0.00 0.00 4,688.00 100 0.00 0.00 PWR Cable 107 Terminate Influ. MV-3&4 SUMP 2,642.00 2,642.00 0.00 0.00 2,642.00 100 0.00 0.00 PMP Cable 108 Pull TX-2 & Panel L2 Feeder 8,313.00 8,313.00 0.00 0.00 8,313.00 100 0.00 0.00 Cable 109 Terminate TX-2 & Panel L2 2,642.00 2,642.00 0.00 0.00 2,642.00 100 0.00 0.00 Feeder Cable 110 Pull AB-3&4 PWR & INSTR. 11,760.00 11,760.00 0.00 0.00 11,760.00 100 0.00 0.00 Cable 111 Terminate AB-3&4 PWR & 7,410.00 7,410.00 0.00 0.00 7,410.00 100 0.00 0.00 IBSTR. Cable PRI. EFFLU. FLOW & RSMV #4 112 Pull PWR, CNTRL & INSTR. 5,880.00 5,880.00 0.00 0.00 5,880.00 100 0.00 0.00 Cable 113 Terminate PWR, CNTRL & 3,238.00 3,238.00 0.00 0.00 3,238.00 100 0.00 0.00 INSTR. Cable PRI. EFFLU. FLOW & RSMV #3 114 Pull PWR, CNTRL & INSTR Cable 5,880.00 5,880.00 0.00 0.00 5,880.00 100 0.00 0.00 115 Terminate PWR, CNTRL & 3,238.00 3,238.00 0.00 0.00 3,238.00 100 0.00 0.00 INSTR. Cable RETURN SLUDGE MV RS-2 Page 8 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) RETURN SLUDGE MV RS-2 116 Pull PWR & INSTR Cable 5,880.00 5,880.00 0.00 0.00 5,880.00 100 0.00 0.00 117 Terminate PWR & CNTRL Cable 3,240.00 3,240.00 0.00 0.00 3,240.00 100 0.00 0.00 PRIMARY EFFLU FLOW BYPASS MV 1 118 Pull HBP,LBP & TX-LBP Feeder 19,815.00 19,815.00 0.00 0.00 19,815.00 100 0.00 0.00 Cable 119 Test HBP,LBP & TX-LBP Feeder 4,430.00 4,430.00 0.00 0.00 4,430.00 100 0.00 0.00 Cable 120 Terminate HBP,LBP & TX-LBP 4,430.00 4,430.00 0.00 0.00 4,430.00 100 0.00 0.00 Feeder Cable 121 Pull PWR & INSTR. Cable 5,880.00 5,880.00 0.00 0.00 5,880.00 100 0.00 0.00 122 Terminate PWR & INSTR. Cable 3,238.00 3,238.00 0.00 0.00 3,238.00 100 0.00 0.00 AB-3&4 AIR VALVES 123 Pull PWR & INSTR. Cable 8,860.00 8,860.00 0.00 0.00 8,860.00 100 0.00 0.00 124 Terminate AB-3&4 PWR & 7,410.00 7,410.00 0.00 0.00 7,410.00 100 0.00 0.00 INSTR. Cable B4 RPS #2 INSTRUMENT. & CNTRL 125 Pre -Engineering CP Design 16,800.00 16,800.00 0.00 0.00 16,800.00 100 0.00 0.00 126 Procure FC-4 Control Panel 20,400.00 20,400.00 0.00 0.00 20,400.00 100 0.00 0.00 127 Procure FC-5 Control Panel 20,400.00 20,400.00 0.00 0.00 20,400.00 100 0.00 0.00 128 Procure FC-6 Control Panel 20,400.00 20,400.00 0.00 0.00 20,400.00 100 0.00 0.00 129 Procure Scum Pump #8 CP 25,200.00 25,200.00 0.00 0.00 25,200.00 100 0.00 0.00 130 Procure Scum Pump #8 Level 1,462,00 1,462.00 0.00 0.00 1,462.00 100 0.00 0.00 Control 131 Weighted Float Level Switch 1,620.00 1,620.00 0.00 0.00 1,620.00 100 0.00 0.00 132 Field Terminations 19,800.00 19,800.00 0.00 0.00 19,800.00 100 0.00 0.00 133 ORT 5,726,00 5,726.00 0.00 0.00 5,726.00 100 0.00 0.00 134 FDT 1,999.00 1,999.00 0.00 0.00 1,999.00 100 0.00 0.00 135 Install FC-4 Torque Switches 18,240.00 18,240.00 0.00 0.00 18,240.00 100 0.00 0.00 Page 9 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) B4 RPS #2 INSTRUMENT. & CNTRL 136 Test FC-4 Torque Switches 960.00 960.00 0.00 0.00 960.00 100 0.00 0.00 137 Install FC-5 Torque Switches 18,240.00 18,240.00 0.00 0.00 18,240.00 100 0.00 0.00 138 Test FC-5 Tourque Switches 960.00 960.00 0.00 0.00 960.00 100 0.00 0.00 139 Install FC-6 Torque Switches 18,240.00 18,240.00 0.00 0.00 18,240.00 100 0.00 0.00 140 Test FC-6 Torque Switches 960.00 960.00 0.00 0.00 960.00 100 0.00 0.00 141 Furnish Spare Instruments 2,856.00 2,856.00 0.00 0.00 2,856.00 100 0.00 0.00 142 Instrument Stands & Brackets 2,700.00 2,700.00 0.00 0.00 2,700.00 100 0.00 0.00 B5 RPS #2 STRUCTURAL 143 Excavate PS-2 Electrical Building 27,350.00 27,350.00 0.00 0.00 27,350.00 100 0.00 0.00 144 Place PS-2 Elect. Bid. Grade 17,188.00 17,188.00 0.00 0.00 17,188.00 100 0.00 0.00 Beams 145 Place PS-2 Elect. Bid. Slab 17,188.00 17,188.00 0.00 0.00 17,188.00 100 0.00 0.00 146 Place (2) Pads On 03E07 782.00 782.00 0.00 0.00 782.00 100 0.00 0.00 147 Place (2) Pads On 03E10 782.00 782.00 0.00 0.00 782.00 100 0.00 0.00 148 Place (1) Pad On 03E11 780.00 780.00 0.00 0.00 780.00 100 0.00 0.00 149 Place (1) Pad On 03E12 780.00 780.00 0.00 0.00 780.00 100 0.00 0.00 150 Place (1) Pad On 03E13 780.00 780.00 0.00 0.00 780.00 100 0.00 0.00 151 Place (2) Pads On 03E22 1,560.00 1,560.00 0.00 0.00 1,560.00 100 0.00 0.00 152 Place (3) Pads On 03E23 1,560.00 1,560.00 0.00 0.00 1,560.00 100 0.00 0.00 B6 RPS #2 CIVIL 153 Survey 9,000.00 9,000.00 0.00 0.00 9,000.00 100 0.00 0.00 154 Layout 10,000.00 10,000.00 0.00 0.00 10,000.00 100 0.00 0.00 155 Electrical Building Back Fill 33,384.00 33,384.00 0.00 0.00 33,384.00 100 0.00 0.00 156 Electrical Building Flexbase Back 11,424.00 11,424.00 0.00 0.00 11,424.00 100 0.00 0.00 Fill 157 Fine Grade Electrical Slab 18,000.00 18,000.00 0.00 0.00 18,000.00 100 0.00 0.00 158 Fine Grade Side Walks 18,000.00 18,000.00 0.00 0.00 18,000.00 100 0.00 0.00 159 Haul Off Spoils 10,000.00 10,000.00 0.00 0.00 10,000.00 100 0.00 0.00 160 Vapor Barrier 12,000.00 12,000.00 0.00 0.00 12,000.00 100 0.00 0.00 Page 10 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREV. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) B6 RPS #2 CIVIL 161 Sidewalks Around Electrical 9,000.00 9,000.00 0.00 0.00 9,000.00 100 0.00 0.00 Building 162 Asphalt Road Repair 25,542.00 25,542.00 0.00 0.00 25,542.00 100 0.00 0.00 163 Sidewalk Repair For Duct Bank 12,400.00 12,400.00 0.00 0.00 12,400.00 100 0.00 0.00 Crossing B7 RPS #1 Elect. Equipment 164 Procure RPS #1 Elect. Building 282,000.00 282,000.00 0.00 0.00 282,000.00 100 0.00 0.00 165 Procure Gen. Quick Disconnect 10,592.00 10,592.00 0.00 0.00 10,592.00 100 0.00 0.00 166 Procure 100 AMP Disconnect 5,744.00 5,744.00 0.00 0.00 5,744.00 100 0.00 0.00 167 Procure 60 AMP Disconnect 5,744.00 5,744.00 0.00 0.00 5,744.00 100 0.00 0.00 168 Procure 30 AMP Disconnect 5,744.00 5,744.00 0.00 0.00 5,744.00 100 0.00 0.00 169 Procure Nema 4X E-Stop Control 5,744.00 5,744.00 0.00 0.00 5,744,00 100 0.00 0.00 Stations 170 Procure TX-L1 & Pannel L1 6,704.00 6,704.00 0.00 0.00 6,704.00 100 0.00 0.00 171 Procure DPRSIA Breakers 5,744.00 5,744.00 0.00 0.00 5,744.00 100 0.00 0.00 172 Procure Eddy CNTRL 6,388.00 6,388.00 0.00 0.00 6,388.00 100 0.00 0.00 173 Start Up 10,512.00 10,512.00 0.00 0.00 10,512.00 100 0.00 0.00 B8 RPS #1 ELECTRICAL WORK 174 Install 3P-101,102, JC-101 & 12,885.00 12,885.00 0.00 0.00 12,885.00 100 0.00 0.00 JI-102 175 Install RSP-RS11,12,13&14 12,885.00 12,885.00 0.00 0.00 12,885.00 100 0.00 0.00 Power Conduit 176 Install RSP-11,12,13 & 14 12,885.00 12,885.00 0.00 0.00 12,885.00 100 0.00 0.00 CNTRL Conduit 177 Install Sump Pump CP 12,885.00 12,885.00 0.00 0.00 12,885.00 100 0.00 0.00 Equipment Rack 178 Install Sump Power Conduit 12,885.00 12,885.00 0.00 0.00 12,885.00 100 0.00 0.00 179 Install Fixtures 2,956.00 2,956.00 0.00 0.00 2,956.00 100 0.00 0.00 Page 11 CONTINUATION SHEET A ITEM NO. I :1, 181 182 183 184 185 iE:f: i:i i:: is 1'1 191 192 193 194 195 196 197 198 199 200 04111 B DESCRIPTION OF WORK B8 RPS #1 ELECTRICAL WORK C SCHEDULED VALUE IC E F WORK BILLED FROM PREV. APPLICATION THIS PERIOD (D+E+F) MATERIALS STORED THIS PERIOD Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 G H I TOTAL % BALANCE TO RETAINAGE COMPLETED G/C FINISH (C-G) AND STORED TO DATE (D+E+F) Install Branch Power & Lighting 5,856.00 5,856.00 0.00 0.00 5,856.00 100 0.00 0.00 Conduit Install Devices 1,668.00 1,668.00 0.00 0.00 1,668.00 100 0.00 0.00 Install WS-11 Equipment Rack 5,522.00 5,522.00 0.00 0.00 5,522.00 100 0.00 0.00 Install WS-11 Power Conduit 5,522.00 5,522.00 0.00 0.00 5,522.00 100 0.00 0.00 Install WS-11 CNTRL Conduit 5,522.00 5,522.00 0.00 0.00 5,522.00 100 0.00 0.00 Install Unit Heater Power 5,522.00 5,522.00 0.00 0.00 5,522.00 100 0.00 0.00 Conduit Install FC Dist. Box Pull Box 5,619.00 5,619.00 0.00 0.00 5,619.00 100 0.00 0.00 Rack Install FC Dist. Box PWR & 5,619.00 5,619.00 0.00 0.00 5,619.00 100 0.00 0.00 CNTRL Conduit Install SP Vault Pull Box Rack 5,619.00 5,619,00 0.00 0.00 5,619.00 100 0.00 0.00 Install Scum Pump CP 5,619.00 5,619.00 0.00 0.00 5,619.00 100 0.00 0.00 Install SC PWR & CNTRL 5,619.00 5,619.00 0.00 0.00 5,619.00 100 0.00 0.00 Conduit Install 3P-13 & 3C-13 9,293.00 9,293.00 0.00 0.00 9,293.00 100 0.00 0.00 Install JP-1 & 3C-1 9,293.00 9,293.00 0.00 0.00 9,293.00 100 0.00 0.00 Install FC #1 CNTRL Panel 9,293.00 9,293.00 0.00 0.00 9,293.00 100 0.00 0.00 Install FC #1 PWR & CNTRL 9,293.00 9,293.00 0.00 0.00 9,293.00 100 0.00 0.00 Conduit Install 3P-3 & IC-3 9,293.00 9,293.00 0.00 0.00 9,293.00 100 0.00 0.00 Install FC #3 CNTRL Panel 9,293.00 9,293.00 0.00 0.00 9,293.00 100 0.00 0.00 Install FC #3 PWR & CNTRL 9,293.00 9,293.00 0.00 0.00 9,293.00 100 0.00 0.00 Conduit Install 3P-2 & JC-2 9,293.00 9,293.00 0.00 0.00 9,293.00 100 0.00 0.00 Install FC #2 CNTRL Panel 9,293.00 9,293.00 0.00 0.00 9,293.00 100 0.00 0.00 Install FC #2 PWR & CNTRL 9,293.00 9,293.00 0.00 0.00 9,293.00 100 0.00 0.00 Conduit Install FC Flow Meter Vault 4,961.00 4,961.00 0.00 0.00 4,961.00 100 0.00 0.00 Equip. Rack Page 12 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) 68 RPS #1 ELECTRICAL WORK 202 Install FC FMV PWR & CNTRL 4,961.00 4,961.00 0.00 0.00 4,961.00 100 0.00 0.00 Conduit 203 Install AB #1&2 PWR & INSTR. 46,898.00 46,898.00 0.00 0.00 46,898.00 100 0.00 0.00 Conduit 204 Install New Disconnects on AB 46,898.00 46,898.00 0.00 0.00 46,898.00 100 0.00 0.00 18c2 205 Install AB #1&2 Air Header PWR 46,898.00 46,898.00 0.00 0.00 46,898.00 100 0.00 0.00 & INSTR. Conduit 206 Install DPRS1 Breakers 3,155.00 3,155.00 0.00 0.00 3,155.00 100 0.00 0.00 207 Install DPRSl Feeders 5,733.00 5,733.00 0.00 0.00 5,733.00 100 0.00 0.00 208 Install TX-Ll & PNL Ll 5,836.00 5,836.00 0.00 0.00 5,836.00 100 0.00 0.00 209 Install TX-L1 & PNL Ll PWR 5,836.00 5,836.00 0.00 0.00 5,836.00 100 0.00 0.00 Conduit 210 Install Infuent Vault #1 Equip. 5,836.00 5,836.00 0.00 0.00 5,836.00 100 0.00 0.00 Rack 211 Install Influent Vault #1 PWR 5,836.00 5,836.00 0.00 0.00 5,836.00 100 0.00 0.00 Conduit 212 Install Influ. Vault #1 CNTRL & 5,836.00 5,836.00 0.00 0.00 5,836.00 100 0.00 0.00 INSTR Conduit 213 Install Influent Vault #2 Equip. 5,836.00 5,836.00 0.00 0.00 5,836.00 100 0.00 0.00 Rack 214 Install Influent Vault #2 PWR 5,836.00 5,836.00 0.00 0.00 5,836.00 100 0.00 0.00 Conduit 215 Install Influ. Vault #2 CNTRL & 5,836.00 5,836.00 0.00 0.00 5,836.00 100 0.00 0.00 INSTR. Conduit 216 Lightning Protection 6,790.00 6,790.00 0.00 0.00 6,790.00 100 0.00 0.00 B9 RPS #1 YARD ELECTRICAL 217 Procure 4 EMH 53,374.00 53,374.00 0.00 0.00 53,374.00 100 0.00 0.00 218 Install 4 EMH 32,240.00 32,240.00 0.00 0.00 32,240.00 100 0.00 0.00 Page 13 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREV. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) B9 RPS #1 YARD ELECTRICAL 219 Install RPS #1 Elect. Building 10,169.00 10,169.00 0.00 0.00 10,169.00 100 0.00 0.00 Grounding 220 Install Duct Bank 1 51,000.00 51,000.00 0.00 0.00 51,000.00 100 0.00 0.00 221 Install Duct Bank 2 34,305.00 34,305.00 0.00 0.00 34,305.00 100 0.00 0.00 222 Install Duct Bank 3 34,305.00 34,305.00 0.00 0.00 34,305.00 100 0.00 0.00 223 Install Duct Bank 4 21,637.00 21,637.00 0.00 0.00 21,637.00 100 0.00 0.00 224 Install Duct Bank 5 21,637.00 21,637.00 0.00 0.00 21,637.00 100 0.00 0.00 225 Install Duct Bank 6 21,637.00 21,637.00 0.00 0.00 21,637.00 100 0.00 0.00 226 Install Duct Bank 7 29,555.00 29,555.00 0.00 0.00 29,555.00 100 0.00 0.00 227 Install Duct Bank 8 29,555.00 29,555.00 0.00 0.00 29,555.00 100 0.00 0.00 228 Install Duct Bank 9 24,805.00 24,805.00 0.00 0.00 24,805.00 100 0.00 0.00 229 Install Duct Bank 10 24,805.00 24,805,00 0.00 0.00 24,805.00 100 0.00 0.00 230 Install Duct Bank 11 18,470.00 18,470.00 0.00 0.00 18,470.00 100 0.00 0.00 231 Install Duct Bank 12 34,305.00 34,305.00 0.00 0.00 34,305.00 100 0.00 0.00 232 Install Duct Bank 12A 34,305.00 34,305.00 0.00 0.00 34,305.00 100 0.00 0.00 233 Install Duct Bank 12B 34,305.00 34,305.00 0.00 0.00 34,305.00 100 0.00 0.00 234 Install Duct Bank 13 29,555.00 29,555.00 0.00 0.00 29,555.00 100 0.00 0.00 235 Install Duct Bank 13A 29,555.00 29,555.00 0.00 0.00 29,555.00 100 0.00 0.00 236 Install Duct Bank 14 29,555.00 29,555.00 0.00 0.00 29,555.00 100 0.00 0.00 237 Install Duct Bank 15 18,470.00 18,470.00 0.00 0.00 18,470.00 100 0.00 0.00 238 Install Duct Bank 16 18,470.00 18,470.00 0.00 0.00 18,470.00 100 0.00 0.00 239 Pull RPS #1 Elect. Building 17,195.00 17,195.00 0.00 0.00 17,195,00 100 0.00 0.00 Feeders 240 Pull Gen. Quick Connect Feeders 13,445.00 13,445.00 0.00 0.00 13,445.00 100 0.00 0.00 241 Terminate Gen. Quick 3,735.00 3,735.00 0.00 0.00 3,735.00 100 0.00 0.00 Disconnect Feeders 242 Pull RSP-RS11,12,13,&14 Feeder 15,541.00 15,541.00 0.00 0.00 15,541.00 100 0.00 0.00 Cable 243 Terminate RSP-RS11,12,13,&14 3,735.00 3,735.00 0.00 0.00 3,735.00 100 0.00 0.00 Feeder Cable Page 14 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY, PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) B9 RPS #1 YARD ELECTRICAL 244 Pull RSP-RS11,12,13 &14 CNTRL 11,945.00 11,945.00 0.00 0.00 11,945.00 100 0.00 0.00 Cable 245 Terminate RSP-RS11,12,13 & 14 3,735.00 3,735.00 0.00 0.00 3,735.00 100 0.00 0.00 CNTRL Cable 246 Pull Sump Pump Feeders 4,639.00 4,639.00 0.00 0.00 4,639.00 100 0.00 0.00 247 Terminate Sump Pump Feeders 1,793.00 1,793.00 0.00 0.00 1,793.00 100 0.00 0.00 248 Pull Branch Power & Lighting 5,235.00 5,235.00 0.00 0,00 5,235.00 100 0.00 0.00 Cable 249 Pull WS-11 Power Cable 5,235.00 5,235.00 0.00 0.00 5,235.00 100 0.00 0.00 250 Pull WS-11 CNTRL Cable 4,639.00 4,639.00 0.00 0.00 4,639.00 100 0.00 0.00 251 Terminate WS-11 Power & 2,543.00 2,543.00 0.00 0.00 2,543.00 100 0.00 0.00 CNTRL Cable 252 Pull & Terminate Inut Heater 3,735.00 3,735.00 0.00 0.00 3,735.00 100 0.00 0.00 253 Pull FC DIST. Box PWR & CNTRL 2,543.00 2,543.00 0.00 0.00 2,543.00 100 0.00 0.00 Cables 254 Terminate FC DIST. Box PWR & 1,947.00 1,947.00 0.00 0.00 1,947.00 100 0.00 0.00 CNTRL Cables 255 Pull SC PWR & CNTRL Cables 5,235.00 5,235.00 0.00 0.00 5,235.00 100 0.00 0.00 256 Terminate SC PWR & CNTRL 1,197.00 1,197.00 0.00 0.00 1,197.00 100 0.00 0.00 Cables 257 Pull FC #1 PWR & CNTRL Cables 4,043.00 4,043.00 0.00 0.00 4,043.00 100 0.00 0.00 258 Terminate FC #1 PWR & CNTRL 1,197.00 1,197.00 0.00 0.00 1,197.00 100 0.00 0.00 Cables 259 Pull FC #3 PWR & CNTRL Cables 4,043.00 4,043.00 0.00 0.00 4,043.00 100 0.00 0.00 260 Terminate FC #3 PWR & CNTRL 1,197.00 1,197.00 0.00 0.00 1,197.00 100 0.00 0.00 Cables 261 Pull FC #2 PWR & CNTRL Cables 4,043.00 4,043.00 0.00 0.00 4,043.00 100 0.00 0.00 262 Terminate FC #2 PWR & CNTRL 1,197.00 1,197.00 0.00 0.00 1,197.00 100 0.00 0.00 Cables 263 Pull FC FMV PWR & CNTRL 4,043.00 4,043.00 0.00 0.00 4,043.00 100 0.00 0.00 Cable Page 1S CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREV. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) B9 RPS #1 YARD ELECTRICAL 264 Terminate FC FMV PWR & 1,197.00 1,197.00 0.00 0.00 1,197.00 100 0.00 0.00 CNTRL Cable 265 Pull Vault PWR Cable 4,043.00 4,043.00 0.00 0.00 4,043.00 100 0.00 0.00 266 Terminate CI Vault PWr Cable 1,197.00 1,197.00 0.00 0.00 1,197.00 100 0.00 0.00 267 Pull AB 1&2 PWR & INSTR. 8,230.00 8,230.00 0.00 0.00 8,230.00 100 0.00 0.00 Cables 268 Terminate AB 1&2 PWR & 1,793.00 1,793.00 0.00 0.00 1,793.00 100 0.00 0.00 INSTR. Cables 269 Terminate DPRSl Feeders 1,942.00 1,942.00 0.00 0.00 1,942.00 100 0.00 0.00 270 Pull TX-L1 & PNL Ll PWR Cables 3,442.00 3,442.00 0.00 0.00 3,442.00 100 0.00 0.00 271 Terminate TX-L1 & PNL Ll PWR 1,346.00 1,346.00 0.00 0.00 1,346.00 100 0.00 0.00 Cables 272 Pull Influent Vault #1 PWR 3,442.00 3,442.00 0.00 0.00 3,442.00 100 0.00 0.00 Cable 273 Terminate Influent Vault #1 Pwr 1,346.00 1,346.00 0.00 0.00 1,346.00 100 0.00 0.00 Cable 274 Pull Influ. Vault #1 CNTRL & 3,442.00 3,442.00 0.00 0.00 3,442.00 100 0.00 0.00 INSTR. Cable 275 Terminate Influ. Vault #1 1,346.00 1,346.00 0.00 0.00 1,346.00 100 0.00 0.00 CNTRL & INSTR. 276 Pull Influent vault #2 PWR 3,442.00 3,442.00 0.00 0.00 3,442.00 100 0.00 0.00 Cable 277 Terminate Influent Vault #2 1,346.00 1,346.00 0.00 0.00 1,346.00 100 0.00 0.00 PWR Cable 278 Pull Influ. Vault #2 CNTRL & 3,442.00 3,442,00 0.00 0.00 3,442.00 100 0.00 0.00 INSTR. Cable 279 Terminate Influ. Vault #2 1,340.00 1,340.00 0.00 0.00 1,340.00 100 0.00 0.00 CNTRL & INSTR 280 Pull Fuel Area Transformer 1,815.00 1,815.00 0.00 0.00 1,815.00 100 0.00 0.00 Feeder Page 16 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) B10 RPS #1 Instrument. & CNTRL 281 Pre -Engineering CP Design 14,000.00 14,000.00 0.00 0.00 14,000.00 100 0.00 0.00 282 Procure FC-1 Control Panel 17,120.00 17,120.00 0.00 0.00 17,120.00 100 0.00 0.00 283 Procure FC-2 Control Panel 17,120.00 17,120.00 0.00 0.00 17,120.00 100 0.00 0.00 284 Procure FC-3 Control Panel 17,120.00 17,120.00 0.00 0.00 17,120.00 100 0.00 0.00 285 Procure Scum Pump #7 CP 21,000.00 21,000.00 0.00 0.00 21,000.00 100 0.00 0.00 286 Procure RS1 Sump Pump CP 17,734.00 17,734.00 0.00 0.00 17,734.00 100 0.00 0.00 287 Procure Scum Pump #7 Level 1,218.00 1,218.00 0.00 0.00 1,218.00 100 0.00 0.00 Control 288 Weighted Float Level Switch 2,038.00 2,038.00 0.00 0.00 2,038.00 100 0.00 0.00 289 Field Termiantions 16,500.00 16,500.00 0.00 0.00 16,500.00 100 0.00 0.00 290 ORT 5,000.00 5,000.00 0.00 0.00 5,000.00 100 0.00 0.00 291 FDT 1,666.00 1,666.00 0.00 0.00 1,666.00 100 0.00 0.00 292 Install FC-4 Torque Switches 15,200.00 15,200.00 0.00 0.00 15,200.00 100 0.00 0.00 293 Test FC-4 Torque Switches 800.00 800.00 0.00 0.00 800.00 100 0.00 0.00 294 Install FC-5 Torque Switches 15,200.00 15,200.00 0.00 0.00 15,200.00 100 0.00 0.00 295 Test FC-5 Torque Switches 800.00 800.00 0.00 0.00 800.00 100 0.00 0.00 296 Install FC-6 Torque Switches 15,200.00 15,200.00 0.00 0.00 15,200.00 100 0.00 0.00 297 Test FC-6 Torque SWitches 800.00 800.00 0.00 0.00 800.00 100 0.00 0.00 298 Furnish Spare Instruments 2,380.00 2,380.00 0.00 0.00 2,380.00 100 0.00 0.00 299 Instrument Stands & Brackets 2,250.00 2,250.00 0.00 0.00 2,250.00 100 0.00 0.00 B11 RPS #1 Structural 300 Excavate PS-1 Electrical Building 28,098.00 28,098.00 0.00 0.00 28,098.00 100 0.00 0.00 301 Place PS-1 Elect. Building Grade 19,571.00 19,571.00 0.00 0.00 19,571.00 100 0.00 0.00 Beams 302 Place PS-1 Elect. Building Slab 19,571.00 19,571.00 0.00 0.00 19,571.00 100 0.00 0.00 303 Place Gen. Connection Pad 1,720.00 1,720.00 0.00 0.00 1,720.00 100 0.00 0.00 304 Place (3) Pads On 04E07 1,726.00 1,726.00 0.00 0.00 1,726.00 100 0.00 0.00 305 Place (2) Pads On 04E10 863.00 863.00 0.00 0.00 863.00 100 0.00 0.00 306 Place (1) Pad On 04E11 863.00 863.00 0.00 0.00 863.00 100 0.00 0.00 307 Place (1) Pad On 04E13 863.00 863.00 0.00 0.00 863.00 100 0.00 0.00 Page 17 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) B11 RPS #1 Structural 308 Place (3) Pads On 04E22 1,725.00 1,725.00 0.00 0.00 1,725.00 100 0.00 0.00 B12 RPS #1 CIVIL 309 Survey 10,175.00 10,175.00 0.00 0.00 10,175.00 100 0.00 0.00 310 Layout 11,100.00 11,100.00 0.00 0.00 11,100.00 100 0.00 0,00 311 Saw Cutting 10,175.00 10,175.00 0.00 0.00 10,175.00 100 0.00 0.00 312 Electrical Building Backfill 35,304.00 35,304.00 0.00 0.00 35,304.00 100 0.00 0.00 313 Electrical Building Flexbse Back 12,417.00 12,417.00 0.00 0.00 12,417.00 100 0.00 0.00 Fill 314 Fine Grade Electrical Slab 18,500.00 18,500.00 0.00 0.00 18,500.00 100 0.00 0.00 315 Fine Grade Side Walks 18,500.00 18,500.00 0.00 0.00 18,500.00 100 0.00 0.00 316 Haul Off Spoils 4,947.00 4,947.00 0.00 0.00 4,947.00 100 0.00 0.00 317 Vapor Barrier 12,950.00 12,950.00 0.00 0.00 12,950.00 100 0.00 0.00 318 Sidewalks Around Electrical 7,622.00 7,622.00 0,00 0.00 7,622.00 100 0.00 0.00 Building 319 Asphalt Road Repair 27,796.00 27,796.00 0.00 0.00 27,796.00 100 0.00 0.00 320 Sidewalk Repair For Duck Bank 4,264.00 4,264.00 0.00 0.00 4,264.00 100 0.00 0.00 Crossing B13 SWPS #2 ELECTRICAL EQUIP. 321 Procure 750KVA Padmounte 59,059.00 59,059.00 0.00 0.00 59,059.00 100 0,00 0.00 Transformer 322 Procure Panelboard PP-SWP2 8,350.00 8,350.00 0.00 0.00 8,350.00 100 0.00 0.00 323 Procure 7.5KVA Transformer 2,570.00 2,570.00 0.00 0.00 2,570.00 100 0.00 0.00 324 Procure Panelboard SWF 8,351.00 8,351.00 0.00 0.00 8,351.00 100 0.00 0.00 325 Start Up 8,572.00 8,572.00 0.00 0.00 8,572.00 100 0.00 0.00 B14 SWPS #2 ELECTRICAL WORK 326 Install 750KVA Transformer 7,822.00 7,822.00 0.00 0.00 7,822.00 100 0.00 0.00 327 Pull 750KVA Transformer 14,073.00 14,073.00 0.00 0.00 14,073.00 100 0.00 0.00 Feeders Page 18 CONTINUATION SHEET A B ITEM DESCRIPTION OF WORK NO. B14 SWPS #2 ELECTRICAL WORK 328 Test 750KVA Transformer Feeders 329 Terminate 750KVA Transformer Feeders 330 Install Panelboard PP-SWG2 331 Install 7.5 KVA Transformer 332 Install Panelboard SWF 333 Pull 7.5 KVA & Panelboard SWF Feeders 334 Termoinate 7.5 KVA & Panel SWF Feeders B15 SWPS#2 ELECT. YARD WORK 335 Tie Into Existing Ground Loop 336 Install 750 KVA Transformer Grounding 337 Install PP-SWG2 Grounding B16 SWPS #2 INSTRU. & CONTROL 338 Install Cats From PQM To PLC 339 Test Cats to SCADA B17 SWPS #2 STRUCTURAL 340 Install Panel Rack With Sunshield B18 CHLORINE AREA ELECT. EOUIP 341 Procure Chlrine Area Elect. Building 342 Procure Gen. Quick Connect Cabinet Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 C D E F G H I SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) 2,608.00 2,608.00 0.00 0.00 2,608.00 100 0.00 0.00 5,215.00 5,215.00 0.00 0.00 5,215.00 100 0.00 0.00 6,358.00 6,358.00 0.00 0.00 6,358.00 100 0.00 0.00 6,358.00 6,358.00 0.00 0.00 6,358.00 100 0.00 0.00 6,358.00 6,358.00 0.00 0.00 6,358.00 100 0.00 0.00 8,858.00 8,858.00 0.00 0.00 8,858.00 100 0.00 0.00 3,350.00 3,350.00 0.00 0.00 3,350.00 100 0.00 0.00 11,667.00 11,667.00 0.00 0.00 11,667.00 100 0.00 0.00 11,667.00 11,667.00 0.00 0.00 11,667.00 100 0.00 0.00 11,666,00 11,666.00 0.00 0.00 11,666.00 100 0.00 0.00 3,125.00 3,125.00 0.00 0.00 3,125.00 100 0.00 0.00 2,625.00 2,625.00 0.00 0.00 2,625.00 100 0.00 0.00 7,500.00 7,500.00 0.00 0.00 7,500.00 100 0.00 0.00 333,240.00 333,240.00 0.00 0.00 333,240.00 100 0.00 0.00 17,384.00 17,384.00 0.00 0.00 17,384.00 100 0.00 0.00 Page 19 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO REfAINAGE NO, VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREV, PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) B18 CHLORINE AREA ELECT. EOUIP 343 Procure 100 AMP Disconnect 19,000.00 19,000.00 0.00 0.00 19,000.00 100 0.00 0.00 344 Procure 400 AMP Disconnect 19,000.00 19,000.00 0.00 0.00 19,000.00 100 0.00 0.00 345 Procure PFA-2B 19,000.00 19,000.00 0.00 0.00 19,000.00 100 0.00 0.00 346 Procure Panelboard LFA-2A 7,078.00 7,078.00 0.00 0.00 7,078.00 100 0.00 0.00 347 Procure Misc. Control Stations 5,938.00 5,938.00 0.00 0.00 5,938.00 100 0.00 0.00 348 Power System Study 4,830.00 4,830.00 0.00 0.00 4,830.00 100 0.00 0.00 349 Equipment Start Up 11,780.00 11,780.00 0.00 0.00 11,780.00 100 0.00 0.00 B19 CHLOR. ELECT. WORK BW PS 3 350 Install WP-31,32,33,34 6,325.00 6,325.00 0.00 0.00 6,325.00 100 0,00 0.00 Disconnect Racks 351 Install WP-31,32,33,34 Power 6,325.00 6,325.00 0.00 0.00 6,325.00 100 0.00 0.00 Conduit 352 Install WP-31,32,33,34 Control 6,325.00 6,325.00 0.00 0.00 6,325.00 100 0.00 0.00 Conduit 353 Install JP-601 At BWPS #3 6,325.00 6,325.00 0.00 0.00 6,325.00 100 0.00 0.00 354 Install backwash Relay Panel 6,325.00 6,325.00 0.00 0.00 6,325.00 100 0.00 0.00 355 Install Backwash Relay PNL 6,325.00 6,325.00 0.00 0.00 6,325.00 100 0.00 0.00 CNTRL Conduit CI SERVICE WATER PS #3 356 Install JP-602 & IC-602 At SWPS 12,381.00 12,381.00 0.00 0.00 12,381.00 100 0.00 0.00 357 Install SW-31,32,33,34 Equip. 12,381.00 12,381.00 0.00 0.00 12,381.00 100 0.00 0.00 Rack 358 Install SW-31,32,33,34 Power 12,381.00 12,381.00 0.00 0.00 12,381.00 100 0.00 0.00 Conduit 359 Install SW-31,32,33,34 CNTRL 12,381.00 12,381.00 0.00 0.00 12,381.00 100 0.00 0.00 Conduit 84" METER VAULT 360 Install JP-603 2,386.00 2,386.00 0.00 0.00 2,386.00 100 0.00 0.00 Page 20 CONTINUATION SHEET A B ITEM DESCRIPTION OF WORK NO. 84" METER VAULT 361 Install 84" MV Power Conduit 362 Install 84" MV CNTRL Conduit FLTR. #21 TO #32 363 Install PFA-26 364 Install PFA-2C Future Conduit 365 Install Effluent Filter #21-32 PWR Conduit SERVICE WATER MV SW-31 366 Install JP-608 & 1I-608 CHLORINE INJECTION VAULT 367 Install JP-609 368 Install SWPS #3 PWR Conduit J-BOX S 369 Install JP-605 370 Install JB-S Branch & lighting Conduit 371 Install CI Induction Unit 1 & 2 Equip. Rack 372 Install CI Induction Unit 1 & 2 PWR Conduit 373 Install CI Induction Unit 1 & 2 CNTRL Conduit 374 Install CI Induction Hoist Equip. Rack J-BOX R 375 Install JP-606 & JI-606 Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 C D E F G H I SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY, PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) 2,386.00 2,386.00 0.00 0.00 2,386.00 100 0.00 0.00 2,386.00 2,386.00 0.00 0.00 2,386.00 100 0.00 0.00 13,449.00 13,449.00 0.00 0.00 13,449.00 100 0.00 0.00 13,449.00 13,449.00 0.00 0.00 13,449.00 100 0.00 0.00 40,376.00 40,376,00 0.00 0.00 40,376.00 100 0.00 0.00 7,339.00 7,339.00 0.00 0.00 7,339.00 100 0.00 0.00 7,339.00 7,339.00 0.00 0.00 7,339.00 100 0.00 0.00 7,339.00 7,339.00 0.00 0.00 7,339.00 100 0.00 0.00 6,058.00 6,058.00 0.00 0.00 6,058.00 100 0.00 0.00 6,058.00 6,058.00 0.00 0.00 6,058.00 100 0.00 0.00 6,058.00 6,058.00 0.00 0.00 6,058.00 100 0.00 0.00 6,058.00 6,058.00 0.00 0.00 6,058.00 100 0.00 0.00 6,058.00 6,058.00 0.00 0.00 6,058.00 100 0.00 0.00 6,058.00 6,058.00 0.00 0.00 6,058.00 100 0.00 0.00 1,949.00 1,949.00 0.00 0.00 1,949.00 100 0.00 0.00 Page 21 CONTINUATION SHEET A B ITEM DESCRIPTION OF WORK NO. J-BOX R 376 Install JB-R Power & CNTRL Conduit SERVICE WATER MV SW-32 377 Install JP-610 & JI-610 378 Install SWMV 32 PWR & CNTRL Conduit METER VAULT T 379 Install JP-611 & JI-611 380 Install MV-T PWR & CNTRL Conduit 381 Install CI Drain PMP 31,32 Equipment Rack 382 Install CI Drain PMP 31,32 Power Conduit 383 Install CI Drain PMP CNTRL Conduit 384 Install Diversion WMO Power Conduit 385 Lightning Protection B20 CHLORINE AREA YARD ELECT. 386 Install Chlorine Area Elect. Building 387 Pull Chlorine Elect. Building Feeders 388 Terminate Chlorine Building Feeders 389 Install Gen. Quick Connect Cabinet Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 C D E F G H I SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREV. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) 1,949.00 1,949.00 0.00 0.00 1,949.00 100 0.00 0.00 4,968.00 4,968.00 0.00 0.00 4,968.00 100 0.00 0.00 4,968.00 4,968.00 0.00 0.00 4,968.00 100 0.00 0.00 4,968.00 4,968.00 0.00 0.00 4,968.00 100 0.00 0.00 4,968.00 4,968.00 0.00 0.00 4,968.00 100 0.00 0.00 6,699.00 6,699.00 0.00 0.00 6,699.00 100 0.00 0.00 4,824.00 4,824.00 0.00 0.00 4,824.00 100 0.00 0.00 4,824.00 4,824.00 0.00 0.00 4,824.00 100 0.00 0.00 4,824.00 4,824.00 0.00 0.00 4,824.00 100 0.00 0.00 6,788.00 6,788.00 0.00 0.00 6,788.00 100 0.00 0.00 19,660.00 19,660.00 0.00 0.00 19,660.00 100 0.00 0.00 18,396.00 18,396.00 0.00 0.00 18,396.00 100 0.00 0.00 5,441.00 5,441.00 0.00 0.00 5,441.00 100 0.00 0.00 10,668.00 10,668.00 0.00 0.00 10,668.00 100 0.00 0.00 Page 22 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RET"AINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREV. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) B20 CHLORINE AREA YARD ELECT. 390 Pull Gen. Quick Connect Feeders 15,531.00 15,531.00 0.00 0.00 15,531.00 100 0.00 0.00 391 Terminate Gen. Quick Connect 5,441.00 5,441.00 0.00 0.00 5,441.00 100 0.00 0.00 Feeders 392 Procure EMH-603 & 604 15,000.00 15,000.00 0.00 0.00 15,000.00 100 0.00 0.00 393 Procure CMH-601 & 602 94,448.00 94,448.00 0.00 0.00 94,448.00 100 0.00 0.00 394 Install EMH-603 & 604 4,941.00 4,941.00 0.00 0.00 4,941.00 100 0.00 0.00 395 Install CMH-601 & 602 4,941.00 4,941.00 0.00 0.00 4,941.00 100 0.00 0.00 396 Install Duck Bank 1 22,500.00 22,500.00 0.00 0.00 22,500.00 100 0.00 0.00 397 Install Duck Bank 2 22,500.00 22,500.00 0.00 0.00 22,500.00 100 0.00 0.00 398 Install Duck Bank 3 13,500.00 13,500.00 0.00 0.00 13,500.00 100 0.00 0.00 399 Install Duck Bank 4 13,500.00 13,500.00 0.00 0.00 13,500.00 100 0.00 0.00 400 Install Duck Bank 5 30,000.00 30,000.00 0.00 0.00 30,000.00 100 0.00 0.00 401 Install Duck Bank 6 15,000.00 15,000.00 0.00 0.00 15,000.00 100 0.00 0.00 402 Install Duck Bank 7 15,000.00 15,000.00 0.00 0.00 15,000,00 100 0.00 0.00 403 Install Duck Bank 8 22,500.00 22,500.00 0.00 0.00 22,500.00 100 0.00 0.00 404 Install Duck Bank 9 15,000.00 15,000.00 0.00 0.00 15,000.00 100 0.00 0.00 405 Install Duck Bank 10 15,000.00 15,000.00 0.00 0.00 15,000.00 100 0.00 0.00 406 Install Duck Bank 11 13,500.00 13,500.00 0.00 0.00 13,500.00 100 0.00 0.00 407 Install Duck Bank 12 5,625.00 5,625.00 0.00 0.00 5,625.00 100 0.00 0.00 408 Install Duck Bank 13 5,625.00 5,625.00 0.00 0.00 5,625.00 100 0.00 0.00 409 Install Duck Bank 14 5,625.00 5,625.00 0.00 0.00 5,625.00 100 0.00 0.00 410 Install Duck Bank 15 12,501.00 12,501.00 0.00 0.00 12,501.00 100 0.00 0.00 411 Install Duck Bank 16 9,000.00 9,000.00 0.00 0.00 9,000.00 100 0.00 0.00 412 Install Duck Bank 17 11,250.00 11,250.00 0.00 0.00 11,250.00 100 0.00 0.00 413 Install Duck Bank 18 5,625.00 5,625.00 0.00 0.00 5,625.00 100 0.00 0.00 414 Install Duck Bank 19 5,625.00 5,625.00 0.00 0.00 5,625.00 100 0.00 0.00 415 Install Duck Bank 20 11,250.00 11,250.00 0.00 0.00 11,250.00 100 0.00 0.00 416 Install Duck Bank 21 11,250.00 11,250.00 0.00 0.00 11,250.00 100 0.00 0.00 417 Install Duck Bank 22 5,625.00 5,625.00 0.00 0.00 5,625.00 100 0.00 0.00 418 Install Duck Bank 23 12,501.00 12,501.00 0.00 0.00 12,501.00 100 0.00 0.00 419 Install Duck Bank 24 5,625.00 5,625.00 0.00 0.00 5,625.00 100 0.00 0.00 Page 23 CONTINUATION SHEET Application Number: 29 A ITEM NO. 420 421 422 423 424 425 426 427 428 429 430 431 I:IrIr►a 433 434 435 H911 437 438 439 440 441 B DESCRIPTION OF WORK B20 CHLORINE AREA YARD ELECT. C SCHEDULED VALUE X E WORK BILLED FROM PREY. APPLICATION THIS PERIOD (D+E+F) Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 F G H I MATERIALS TOTAL % BALANCE TO RETAINAGE STORED THIS COMPLETED G/C FINISH (C-G) PERIOD AND STORED TO DATE (D+E+F) Install Duck Bank 25 12,501.00 12,501.00 0.00 0.00 12,501.00 100 Install Duck Bank 26 7,500.00 7,500.00 0.00 0.00 7,500.00 100 Install Duck Bank 27 7,500.00 7,500.00 0.00 0.00 7,500.00 100 Install Duck Bank 28 7,500.00 7,500.00 0.00 0.00 7,500.00 100 Install Duck Bank 29 13,500.00 13,500,00 0.00 0.00 13,500.00 100 Install Duck Bank 30 11,250.00 11,250.00 0.00 0.00 11,250.00 100 Install Duck Bank 31 5,625.00 5,625.00 0.00 0.00 5,625.00 100 Install Duck Bank 32 37,500.00 37,500.00 0.00 0.00 37,500.00 100 Install Duck Bank 33 13,500.00 13,500.00 0.00 0.00 13,500.00 100 Install Duck Bank 34 7,500.00 7,500.00 0.00 0.00 7,500.00 100 Install Duck Bank 35 7,500.00 7,500.00 0.00 0.00 7,500.00 100 Pull Backwash Relay PNL CNTRL 13,808.00 13,808.00 0.00 0.00 13,808.00 100 Cable Terminate Bck Wash Relay PNL 5,441.00 5,441.00 0.00 0.00 5,441.00 100 CNRTL Pull WP-31,32,33,34 Power 13,793.00 13,793.00 0.00 0.00 13,793.00 100 Cable Pull WP-31,32,33,34 Control 11,293.00 11,293.00 0.00 0.00 11,293.00 100 Cable Terminate WP-31,32,33,34 PWR 5,441.00 5,441.00 0.00 0.00 5,441.00 100 & CNTRL Cable Pull SW-31,32,33,34 Power 13,793.00 13,793.00 0.00 0.00 13,793.00 100 Cable Pull SW-31,32,33,34 CNTRL 11,293.00 11,293.00 0.00 0.00 11,293.00 100 Cable Terminate SW-31,32,33,34 PWR 5,441.00 5,441.00 0.00 0.00 5,441.00 100 & CNTRL Pull 84" MV Power Cable 11,293.00 11,293.00 0.00 0.00 11,293.00 100 Pull 84" MV CNTRL Cable 11,293.00 11,293.00 0.00 0.00 11,293.00 100 Terminate 84" MV PWR & 5,441.00 5,441.00 0.00 0.00 5,441.00 100 CNTRL Cable 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 109] �]��Is] Will] 1/ ll Well] oil 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Page 24 CONTINUATION SHEET Application Number: 29 A B ITEM DESCRIPTION OF WORK NO. C SCHEDULED VALUE D E WORK BILLED FROM PREV. APPLICATION THIS PERIOD (D+E+F) B20 CHLORINE AREA YARD ELECT. 442 Pull PFA-2B Feeders 17,146.00 17,146.00 443 Terminate PFA-2B Feeeders 5,441.00 5,441.00 444 Pull Effluent Filter #21-32 PWR 31,166.00 31,166.00 Cable 445 Terminate Effluent Filter #21-32 5,441.00 5,441.00 PWR Cable 446 Pull SWMV SW-31 PWR & 14,646.00 14,646.00 CNTRL 447 Terminate SWMV SW-31 PWR & 5,441.00 5,441.00 CNTRL 448 Pull SWPS #3 PWR Cables 11,293.00 11,293.00 449 Terminate SWPS #3 PWR Cable 5,441.00 5,441,00 450 Pull JB-S Branch & Lighting 11,293.00 11,293.00 Cable 451 Terminate JB-S Branch & 5,441.00 5,441.00 Lighting 452 Pull CI Induction Unit 1 & 2 11,918.00 11,918.00 PWR Cable 453 Pull CI Induction Unit 1 & 2 11,293.00 11,293.00 CNTRL Cable 454 Terminate CI Induction Unit 1&2 5,441.00 5,441.00 PWR & CNTRL 455 Pull CI Induction Hoist PWR 10,668.00 10,668.00 Cables 456 Terminate CI Hoist PWR Cables 5,441.00 5,441.00 457 Pull JB-R Power & CNTRL Cable 11,918.00 11,918.00 458 Terminate JB-R Power & CNTRL 5,441.00 5,441.00 Cable 459 Pull SWMV 32 PWR & CNTRL 11,918.00 11,918.00 Cable Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 F G H I MATERIALS TOTAL % BALANCE TO RETAINAGE STORED THIS COMPLETED G/C FINISH (C-G) PERIOD AND STORED TO DATE (D+E+F) 0.00 0.00 17,146.00 100 0.00 0.00 0.00 0.00 5,441.00 100 0.00 0.00 0.00 0.00 31,166.00 100 0.00 0.00 0.00 0.00 5,441.00 100 0.00 0.00 0.00 0.00 14,646.00 100 0.00 0.00 0.00 0.00 5,441.00 100 0.00 0.00 0.00 0.00 11,293.00 100 0.00 0.00 0.00 0.00 5,441.00 100 0.00 0.00 0.00 0.00 11,293.00 100 0.00 0.00 0.00 0.00 5,441.00 100 0.00 0.00 0.00 0.00 11,918.00 100 0.00 0.00 0.00 0.00 11,293.00 100 0.00 0.00 0.00 0.00 5,441.00 100 0.00 0.00 0.00 0.00 10,668.00 100 0.00 0.00 0.00 0.00 5,441.00 100 0.00 0.00 0.00 0.00 11,918.00 100 0.00 0.00 0.00 0.00 5,441.00 100 0.00 0.00 0.00 0.00 11,918.00 100 0.00 0.00 Page 25 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREV. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) B20 CHLORINE AREA YARD ELECT. 460 Terminate SWMV 32 PWR & 5,441.00 5,441.00 0.00 0.00 5,441.00 100 0.00 0.00 CNTRL 461 Pull MV-T PWR & CNTRL Cable 11,918.00 11,918.00 0.00 0.00 11,918.00 100 0.00 0.00 462 Terminate MV-T PWR & CNTRL 5,441.00 5,441.00 0.00 0.00 5,441.00 100 0.00 0.00 Cable 463 Pull CI Drain PMP 31,32 Power 11,918.00 11,918.00 0.00 0.00 11,918.00 100 0.00 0.00 Cable 464 Pull CI Drain 31,32 CNTRL Cable 10,668.00 10,668.00 0.00 0.00 10,668.00 100 0.00 0.00 465 Terminate CI Drain PMP 31,32 5,441.00 5,441.00 0.00 0.00 5,441.00 100 0.00 0.00 pWR & CNTRL 466 Pull Diversion WMO Power Cable 10,661.00 10,661.00 0.00 0.00 10,661.00 100 0.00 0.00 467 Terminate WMO Power Cable 5,425.00 5,425.00 0.00 0.00 5,425.00 100 0.00 0.00 B21 CHLORINE INSTR. & CONTROL 468 Procure Low Level Lock Panel 7,250.00 7,250.00 0.00 0.00 7,250.00 100 0.00 0.00 469 Procure Back Wash Waste Relay 7,250.00 7,250.00 0.00 0.00 7,250.00 100 0.00 0.00 Panel 470 Procure Weighted Float Level 844.00 844.00 0.00 0.00 844.00 100 0.00 0.00 Switch 471 Procure Mini CAS CP 6,250.00 6,250.00 0.00 0.00 6,250.00 100 0.00 0.00 472 RTU-32 Modifications 2,992.00 2,992.00 0.00 0.00 2,992.00 100 0.00 0.00 473 Field Terminations 10,625.00 10,625.00 0.00 0.00 10,625.00 100 0.00 0.00 B22 CHLORINE AREA STRUCTURAL 474 Excavate PS-1 Electrical Building 35,240.00 35,240.00 0.00 0.00 35,240.00 100 0.00 0.00 475 Place PS-1 Elect. Building Grade 16,129.00 16,129.00 0.00 0.00 16,129.00 100 0.00 0.00 Beams 476 Place PS-1 Elect. Building Slab 14,905.00 14,905.00 0.00 0.00 14,905.00 100 0.00 0.00 477 Place (2) Pads on 07E12 1,250.00 1,250.00 0.00 0.00 1,250.00 100 0.00 0.00 478 Place (1) Pad on 07E13 625.00 625.00 0.00 0.00 625.00 100 0.00 0.00 479 Place (2) Pads on 07E16 625.00 625.00 0.00 0.00 625.00 100 0.00 0.00 Page 2.6 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) B22 CHLORINE AREA STRUCTURAL 480 Place (1) Pad on 07E17 1,250.00 1,250.00 0.00 0.00 1,250.00 100 0.00 0.00 481 Place (1) Pad on 07E18 625.00 625.00 0.00 0.00 625.00 100 0.00 0.00 482 Place (1) Pad on 07E20 625.00 625.00 0.00 0.00 625.00 100 0.00 0.00 483 Place (3) Pads on 06E07 1,860.00 1,860.00 0.00 0.00 1,860.00 100 0.00 0.00 484 Place (1) Pad on 06E13 616.00 616.00 0.00 0.00 616.00 100 0.00 0.00 B23 CHLORINE AREA CIVIL 485 Survey 12,825.00 12,825.00 0.00 0.00 12,825.00 100 0.00 0.00 486 Layout 15,675.00 15,675.00 0.00 0.00 15,675.00 100 0.00 0.00 487 Backfill Around chlorine Elect. 35,448.00 35,448.00 0.00 0.00 35,448.00 100 0.00 0.00 Building 488 Fine Grade Electrical Building 11,400.00 11,400.00 0.00 0.00 11,400.00 100 0.00 0.00 Slab 489 Haul Off Spoils 4,941.00 4,941.00 0.00 0.00 4,941.00 100 0.00 0.00 490 07C01 Sidewalks 11,947.00 11,947.00 0.00 0.00 11,947.00 100 0.00 0.00 491 Generator Pad Sidewalks 5,700.00 5,700.00 0.00 0.00 5,700.00 100 0.00 0.00 492 Fine Grade Sidewalks 5,700.00 5,700.00 0.00 0.00 5,700.00 100 0.00 0.00 493 Fine Grade Generator 5,985.00 5,985.00 0.00 0.00 5,985.00 100 0.00 0.00 494 Asphalt Road Repair For DB 74,129.00 74,129.00 0.00 0.00 74,129.00 100 0.00 0.00 Crossings B24 MISC. ELECT. & INSTR ITEMS 495 Mobilization 259,435.00 259,435.00 0.00 0.00 259,435.00 100 0.00 0.00 496 Bond 94,314.00 94,314.00 0.00 0.00 94,314.00 100 0.00 0.00 497 Submittals 60,000.00 60,000.00 0.00 0.00 60,000.00 100 0.00 0.00 498 0&M Manuals 40,000.00 40,000.00 0.00 0.00 40,000.00 100 0.00 0.00 499 Power System Study 18,750.00 18,750.00 0.00 0.00 18,750.00 100 0.00 0.00 500 Training 18,750.00 18,750.00 0.00 0.00 18,750.00 100 0.00 0.00 RPS #2 DEMO Page 27 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) RPS #2 DEMO 501 Demo Return Sludge Pumps & 3,910.00 3,910.00 0.00 0.00 3,910.00 100 0.00 0.00 Eddy Clutch 502 Demo Final Clarifiers #4 #5 & 13,410.00 13,410.00 0.00 0.00 13,410.00 100 0.00 0.00 #6 503 Demo RSPS #2 Lower Level 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 504 Demo RS MV Final Clarifiers #4 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 505 Demo Scum PS #SP6 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 506 Demo Influent MV #3  4,470.00 4,470.00 0.00 0.00 4,470.00 100 0.00 0.00 507 Demo AB #3 Lateral Valve 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 508 Demo MCC & RTU 6,705.00 6,705.00 0.00 0.00 6,705.00 100 0.00 0.00 RPS #1 DEMO 509 Demp Retun Sludge Pumps & 4,470.00 4,470.00 0.00 0.00 4,470.00 100 0.00 0.00 Eddy Clutch 510 Demo Final Clarifiers #1,2,& 3 4,470.00 4,470,00 0.00 0.00 4,470.00 100 0.00 0.00 511 Demo RSPS #2 Lower Level 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 512 Demo MCC-RS1 4,470.00 4,470.00 0.00 0.00 4,470.00 100 0.00 0.00 513 Demo R.S. Meter Vault 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 514 Demo AB #1 Lateral Valve 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 515 Demo RTU 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 516 Demo Scum Pump Vault 2,235.00 2,235,00 0.00 0.00 2,235.00 100 0.00 0.00 517 Demo AB #1 & 2 4,470.00 4,470.00 0.00 0.00 4,470.00 100 0.00 0.00 518 Demo Fuel Area Trasformer 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 Feeder 519 Demo Influent Vault #1 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 520 Demo Influent Vault #2 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 SWPS #2 DEMO 521 Demo Transformer PA-38 5,029.00 5,029.00 0.00 0.00 5,029.00 100 0.00 0.00 522 Demo MCC-SWP 2 5,029.00 5,029.00 0.00 0.00 5,029.00 100 0.00 0.00 523 Demo Branch Circuits 5,029.00 5,029.00 0.00 0.00 5,029.00 100 0.00 0.00 Page 28 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) SWPS #2 DEMO 524 Demo Control 5,029.00 5,029.00 0.00 0.00 5,029.00 100 0.00 0.00 CHLORINE DEMO 525 Demo MCC-FA2 2,855.00 2,855.00 0.00 0.00 2,855.00 100 0.00 0.00 526 Demo Back Wash Waste PS #3 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 527 Demo Filter CP 21-32 Conduit & 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 Wire 528 Demo Service PS #3 Conduit & 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 Wire 529 Demo 84" MV Conduit & Wire 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 530 Demo MV-T Conduit & Wire 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 531 Demo SW-31 MV Conduit & wire 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 532 Demo SW-32 MV Conduit & 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 Wire 533 Demo CI Injection Unit Conduit 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 & Wire 534 Demp JB-S Conduit & Wire 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 535 Demo JB-R Conduit & Wire 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 536 Demo CI Basin Drain PS #31 & 2,235.00 2,235.00 0.00 0.00 2,235.00 100 0.00 0.00 # 32 BA1.1 RPS-7 ELECT. EQUIPMENT 537 Procure RPS-7 ELECT. Building 250,850.00 250,850.00 0.00 0.00 250,850.00 100 0.00 0.00 538 Gen Quick Connect Cabinet 13,999.00 13,999.00 0.00 0.00 13,999.00 100 0.00 0.00 539 Procure Mini Load Center 14,443.00 14,443.00 0.00 0.00 14,443.00 100 0.00 0.00 M LC-21 540 Procure Mini Load Center 14,443.00 14,443.00 0.00 0.00 14,443.00 100 0.00 0.00 M LC-23 541 Procure Eddy Clutch Cabinet 7,734.00 7,734.00 0.00 0.00 7,734.00 100 0.00 0.00 542 Procure Disconnects & CNTRL 12,000.00 12,000.00 0.00 0.00 12,000.00 100 0.00 0.00 Stations Page 29 CONTINUATION SHEET Application Number: 29 A B ITEM DESCRIPTION OF WORK NO. BA1.2 RPS-7 ELECT. WORK 543 Install RS-71,72,73 Equip. Racks 544 Install RS-71,72,73 PWR & CNTRL Conduit 545 Install WS-71,72 Equip. Racks 546 Install WS-71,72 PWR & CNTRL Conduit 547 Install RS71 Sump PMP Equip. Racks 548 Install RS71 Sump PMP PWR & CNTRL Conduit 549 Install FC-21,23 Equip. Racks 550 Ibstall FC-21,23 PWR & CNTRL Conduit 551 Install SP10,11,12 Equip. Racks 552 Install Sp10,11,12 PWR & CNTRL Conduit 553 Install Dive. Gate Box 0 PWR & CNTRL Conduit 554 Install MLC-21,23 Equip. Racks 555 Install MLC-21,23 Feeder Conduit 556 Install RSPS-7 Lighting & Branch Conduit 557 Pull RSP-7 Lighting & Branch Cable 558 Procure Fictures 559 Install Fictures & Devices 560 Install JP-701,702 JC-701 & 1I-701 561 Install JC-702 & JI-702 562 Lightning Protection C SCHEDULED VALUE D E WORK BILLED FROM PREY, APPLICATION THIS PERIOD (D+E+F) Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 F G H I MATERIALS TOTAL % BALANCE TO RETAINAGE STORED THIS COMPLETED G/C FINISH (C-G) PERIOD AND STORED TO DATE (D+E+F) 17,699.00 17,699.00 0.00 0.00 17,699.00 100 0.00 0.00 17,764.00 17,764.00 0.00 0.00 17,764.00 100 0.00 0.00 17,197.00 17,197.00 0.00 0.00 17,197.00 100 0.00 0.00 17,764.00 17,764.00 0.00 0.00 17,764.00 100 0.00 0.00 17,113.00 17,113.00 0.00 0.00 17,113.00 100 0.00 0.00 17,113.00 17,113.00 0.00 0.00 17,113.00 100 0.00 0.00 8,031.00 8,031.00 0.00 0.00 8,031.00 100 0.00 0.00 8,031.00 8,031.00 0.00 0.00 8,031.00 100 0.00 0.00 10,575.00 10,575.00 0.00 0.00 10,575.00 100 0.00 0.00 10,575.00 10,575.00 0.00 0.00 10,575.00 100 0.00 0.00 7,836.00 7,836.00 0.00 0.00 7,836.00 100 0.00 0.00 7,770.00 7,770.00 0.00 0.00 7,770.00 100 0.00 0.00 7,770.00 7,770.00 0.00 0.00 7,770.00 100 0.00 0.00 4,131.00 4,131.00 0.00 0.00 4,131.00 100 0.00 0.00 3,406.00 3,406.00 0.00 0.00 3,406.00 100 0.00 0.00 21,250.00 21,250.00 0.00 0.00 21,250.00 100 0.00 0.00 4,861.00 4,861.00 0.00 0.00 4,861.00 100 0.00 0.00 15,662.00 15,662.00 0.00 0.00 15,662.00 100 0.00 0.00 15,662.00 15,662.00 0.00 0.00 15,662.00 100 0.00 0.00 6,790.00 6,790.00 0.00 0.00 6,790.00 100 0.00 0.00 Page 30 CONTINUATION SHEET Application Number: 29 A B ITEM DESCRIPTION OF WORK NO. Bal.3 RPS-7 YARD ELECTRICAL 563 RPS-7 Electrical Building Grounding 564 Demo MCC-RS7 565 Demo RS-71,72 Conduit & Wire 566 Demo RPS-7 Lower Level 567 Demo SP-9,10,11 Conduit & Wire 568 Demo Effluent Box Gate Conduit & Wire 569 Procure EMH-701,702 703 & CMH-701 570 Install EMH-701,702,703 & CMH-701 571 Install Duct Bank 1 572 Install Duct Bank 2 573 Install Duct Bank 3 574 Install Duct Bank 4 575 Install Duct Bank 5 576 Install Duct Bank 6 577 Install Duct Bank 7 578 Install Duct Bank 8 579 Install Duct Bank 9 580 Install Duct Bank 10 581 Install Duct Bank 11 582 Install Duct Bank 12 583 Install RPS-7 Electrical Building 584 Pull RPS-7 Elect. Building Feeders 585 Terminate RPS-7 Elct. Building Feeders C SCHEDULED VALUE E WORK BILLED FROM PREV. APPLICATION THIS PERIOD (D+E+F) Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 F G H I MATERIALS TOTAL % BALANCE TO RETAINAGE STORED THIS COMPLETED G/C FINISH (C-G) PERIOD AND STORED TO DATE (D+E+F) 4,511.00 4,511.00 0.00 0.00 4,511.00 100 0.00 0.00 9,126.00 9,126.00 0.00 0.00 9,126.00 100 0.00 0.00 9,126.00 9,126.00 0.00 0.00 9,126.00 100 0.00 0.00 9,126.00 9,126.00 0.00 0.00 9,126.00 100 0.00 0.00 9,126.00 9,126.00 0.00 0.00 9,126.00 100 0.00 0.00 9,126.00 9,126.00 0.00 0.00 9,126.00 100 0.00 0.00 78,706.00 78,706.00 0.00 0.00 78,706.00 100 0.00 0.00 21,657.00 21,657.00 0.00 0.00 21,657.00 100 0.00 0.00 9,250.00 9,250.00 0.00 0.00 9,250.00 100 0.00 0.00 9,250.00 9,250.00 0.00 0.00 9,250.00 100 0.00 0.00 9,250.00 9,250.00 0.00 0.00 9,250.00 100 0.00 0.00 26,250.00 26,250.00 0.00 0.00 26,250.00 100 0.00 0.00 26,250.00 26,250.00 0.00 0.00 26,250.00 100 0.00 0.00 26,250.00 26,250.00 0.00 0.00 26,250.00 100 0.00 0.00 9,250,00 9,250.00 0.00 0.00 9,250.00 100 0.00 0.00 13,313.00 13,313.00 0.00 0.00 13,313.00 100 0.00 0.00 12,500.00 12,500.00 0.00 0.00 12,500.00 100 0.00 0.00 8,000.00 8,000.00 0.00 0.00 8,000.00 100 0.00 0.00 8,000.00 8,000.00 0.00 0.00 8,000.00 100 0.00 0.00 8,000.00 8,000.00 0.00 0.00 8,000.00 100 0.00 0.00 13,259.00 13,259.00 0.00 0.00 13,259.00 100 0.00 0.00 10,019.00 10,019.00 0.00 0.00 10,019.00 100 0.00 0.00 3,466.00 3,466.00 0.00 0.00 3,466.00 100 0.00 0.00 Page 31 CONTINUATION SHEET Application Number: 29 A ITEM NO. 586 587 588 589 590 591 592 593 594 595 596 597 598 599 600 601 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 B C D E F G H I DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) Ba1.3 RPS-7 YARD ELECTRICAL Install Gen. Quick Connect 8,466.00 8,466.00 0.00 0.00 8,466.00 100 0.00 0.00 Cabinet Pull Gen. Quick Connect Feeders 9,379.00 9,379.00 0.00 0.00 9,379.00 100 0.00 0.00 Terminate Gen. Quick Connect 3,466.00 3,466.00 0.00 0.00 3,466.00 100 0.00 0.00 Feeders Pull RS-71,72,73 PWR & CNTRL 9,585.00 9,585.00 0.00 0.00 9,585.00 100 0.00 0.00 Cable Terminate RS-71,72,73 PWR & 9,585.00 9,585.00 0.00 0.00 9,585.00 100 0.00 0.00 CNTRL Cable Pull WS-71,72 PWR & CNTRL 9,585.00 9,585.00 0.00 0.00 9,585.00 100 0.00 0.00 Cable Terminate WS-71,72 PWR & 9,585.00 9,585.00 0.00 0.00 9,585.00 100 0.00 0.00 CNTRL Cable Pull RS71 Sump PMP PWR & 8,607.00 8,607.00 0.00 0.00 8,607.00 100 0.00 0.00 CNTRL Cable Terminate RS-71 Sump PMP 8,607.00 8,607.00 0.00 0.00 8,607.00 100 0.00 0.00 PWR & CNTRL Cable Pull FC-21,23 PWR & CNTRL 3,043.00 3,043.00 0.00 0.00 3,043.00 100 0.00 0.00 Cable Terminate FC-21,23 PWR & 3,043.00 3,043.00 0.00 0.00 3,043.00 100 0.00 0.00 CNTRL Cable Pull SP10,11,12 PWR & CNTRL 3,685.00 3,685.00 0.00 0.00 3,685.00 100 0.00 0.00 Cable Terminate SP10,11,12 PWR & 3,685.00 3,685.00 0.00 0.00 3,685.00 100 0.00 0.00 CNTRL Cable Pull Dive. Gate BOX 0 PWR & 2,717.00 2,717.00 0.00 0.00 2,717.00 100 0.00 0.00 CNTRL Cable Terminate Dive. Gate BOX 0 2,717.00 2,717.00 0.00 0.00 2,717.00 100 0.00 0.00 PWR & CNTRL Cable Pull MLC-21,23 Feeder Cable 2,717.00 2,717.00 0.00 0.00 2,717.00 100 0.00 0.00 Page 32 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) Bal.3 RPS-7 YARD ELECTRICAL 602 Terminate MLC-21,23 Feeder 2,717.00 2,717.00 0.00 0.00 2,717.00 100 0.00 0.00 Cable BA1.4 RPS-7 INSTRUMEN. & CNTRL 603 Procure FC-21 Control Panel 9,350.00 9,350.00 0.00 0.00 9,350.00 100 0.00 0.00 604 Procure FC-23 Control Panel 9,350.00 9,350.00 0.00 0.00 9,350.00 100 0.00 0.00 605 Procure SP-10 Control Panel 11,550.00 11,550.00 0.00 0.00 11,550.00 100 0.00 0.00 606 Procure SP-11 Control Panel 11,550.00 11,550.00 0.00 0.00 11,550.00 100 0.00 0.00 607 Procure SP-12 Control Panel 11,550.00 11,550.00 0.00 0.00 11,550.00 100 0.00 0.00 608 Procure Sump Pump Control 9,754.00 9,754.00 0.00 0.00 9,754.00 100 0.00 0.00 Panek 609 Procure (3) Scum Pump Floats 2,228.00 2,228.00 0.00 0.00 2,228.00 100 0.00 0.00 610 Procure (3) Scum Pump Levl 2,830.00 2,830.00 0.00 0.00 2,830.00 100 0.00 0.00 Transmitters 611 Procure (3) Scum Pump Level 3,350.00 3,350.00 0.00 0.00 3,350.00 100 0.00 0.00 Displays 612 Instrument Stands & Brackets 2,750.00 2,750.00 0.00 0.00 2,750.00 100 0.00 0.00 613 RTU 15 Modifications 4,169.00 4,169.00 0.00 0.00 4,169.00 100 0.00 0.00 614 Fireld Terminations 34,100.00 34,100.00 0.00 0.00 34,100.00 100 0.00 0.00 615 Install Torque Switches On 7,292.00 7,292.00 0.00 0.00 7,292.00 100 0.00 0.00 FC-21 616 Torque Test FC-21 440.00 440.00 0.00 0.00 440.00 100 0.00 0.00 617 Install Torque Switches On 7,292.00 7,292.00 0.00 0.00 7,292.00 100 0.00 0.00 FC-23 618 Torque Test FC-23 440.00 440.00 0.00 0.00 440.00 100 0.00 0.00 BA1.5 RPS-7 STRUCTURAL 619 Excavate RPS-7 ELectrical 9,488.00 9,488.00 0.00 0.00 9,488.00 100 0.00 0.00 Building 620 Backfill Dirt RPS-7 ELect. 14,733.00 14,733.00 0.00 0.00 14,733.00 100 0.00 0.00 Building Page 33 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) BA1.5 RPS-7 STRUCTURAL 621 Backfill Flexbase Elect. Building 3,329.00 3,329.00 0.00 0.00 3,329.00 100 0.00 0.00 622 Haul Off Spoils 1,067.00 1,067.00 0.00 0.00 1,067.00 100 0.00 0.00 623 Vapor Barrier Elect. Building 4,155.00 4,155.00 0.00 0.00 4,155.00 100 0.00 0.00 624 Place Grde Beams Elect. 8,646.00 8,646.00 0.00 0.00 8,646.00 100 0.00 0.00 Building 625 Place Slab Elect. Building 6,780.00 6,780.00 0.00 0.00 6,780.00 100 0.00 0.00 626 Place (1) Pad On 02E06 452.00 452.00 0.00 0.00 452.00 100 0.00 0.00 627 Place (1) Pad On 02E10 450.00 450.00 0.00 0.00 450.00 100 0.00 0.00 628 Place (1) Pad On 02E11 450.00 450.00 0.00 0.00 450.00 100 0.00 0.00 629 Place (2) Pads On 02EII 450.00 450.00 0.00 0.00 450.00 100 0.00 0.00 BA1.6 RPS-7 CIVIL 630 Survey 13,275.00 13,275.00 0.00 0.00 13,275.00 100 0.00 0.00 631 Layout 16,225.00 16,225.00 0.00 0.00 16,225.00 100 0.00 0.00 632 Backfill Around RPS-7 Elect. 36,624.00 36,624.00 0.00 0.00 36,624.00 100 0.00 0.00 Building 633 Fine Grade Elect. Building 5,900.00 5,900.00 0.00 0.00 5,900.00 100 0.00 0.00 634 Haul Off Spoils 4,361.00 4,361.00 0.00 0.00 4,361.00 100 0.00 0.00 635 Place Sidewalks On 02C01 11,815.00 11,815.00 0.00 0.00 11,815.00 100 0.00 0.00 636 Fine Grade Sidewalks 5,605.00 5,605.00 0.00 0.00 5,605.00 100 0.00 0.00 637 Fine Grade Generator 6,195.00 6,195.00 0.00 0.00 6,195.00 100 0.00 0.00 BA2.1 SDS-2 ELECTRICAL EQUIP. 638 Procure Vista Switch 128,250.00 128,250.00 0.00 0.00 128,250.00 100 0.00 0.00 639 Procure PA31 Pad Mounted 47,532.00 47,532.00 0.00 0.00 47,532.00 100 0.00 0.00 Transformer 640 Procure MCC-SD2 58,344.00 58,344.00 0.00 0.00 58,344.00 100 0.00 0.00 641 Procure Gen. Quick Connect 16,497.00 16,497.00 0.00 0.00 16,497.00 100 0.00 0.00 Cabinet 642 Procure 25KVA Transformer 5,459.00 5,459.00 0.00 0.00 5,459.00 100 0.00 0.00 Page 34 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY, PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) BA2.1 SDS-2 ELECTRICAL EOUIP. 643 Procure PP-CHL & LP-CHL 6,102.00 6,102.00 0.00 0.00 6,102.00 100 0.00 0.00 Panelboard 644 Procure Eddy Clutch 16,555.00 16,555.00 0.00 0.00 16,555.00 100 0.00 0.00 645 Equipment Startup 9,098.00 9,098.00 0.00 0.00 9,098.00 100 0.00 0.00 BA2.2 SDS-2 ELECTRICAL WORK 646 Install Vista Switch 10,555.00 10,555.00 0.00 0.00 10,555.00 100 0.00 0.00 647 Pull Vista Feeder Cable 6,055.00 6,055.00 0.00 0.00 6,055.00 100 0.00 0.00 648 Test Vista Feeder Cable 4,555.00 4,555.00 0.00 0.00 4,555.00 100 0.00 0.00 649 Terminate Vista Feeder Cable 2,722.00 2,722.00 0.00 0.00 2,722.00 100 0.00 0.00 650 Install PA31 Pad Mounted 10,555.00 10,555.00 0.00 0.00 10,555.00 100 0.00 0.00 Transformer 651 Pull PA31 Feeder Cable 6,055.00 6,055.00 0.00 0.00 6,055.00 100 0.00 0.00 652 Test PA31 Feeder Cable 4,555.00 4,555.00 0.00 0.00 4,555.00 100 0.00 0.00 653 Terminate PA31 Feeder Cable 2,722.00 2,722.00 0.00 0.00 2,722.00 100 0.00 0.00 654 Install MCC-SD2 & Eddy Current 10,555.00 10,555.00 0.00 0.00 10,555.00 100 0.00 0.00 CNTRL 655 Pull MCC-SD2 Feeder Cable 6,055.00 6,055.00 0.00 0.00 6,055.00 100 0.00 0.00 656 Test MCC-SD2 Feeder Cable 2,722.00 2,722.00 0.00 0.00 2,722.00 100 0.00 0.00 657 Terminate MCC-SD2 Feeder 2,722.00 2,722,00 0.00 0.00 2,722.00 100 0.00 0.00 Cable 658 Pull Eddy CNTRL Feeder Cable 3,805.00 3,805.00 0.00 0.00 3,805.00 100 0.00 0.00 659 Test Eddy CNTRL Feeder Cable 2,722.00 2,722.00 0.00 0.00 2,722.00 100 0.00 0.00 660 Terminate Eddy CNTRL Feeder 2,722.00 2,722.00 0.00 0.00 2,722.00 100 0.00 0.00 Cable 661 Install PP-CHL 2,722.00 2,722.00 0.00 0.00 2,722.00 100 0.00 0.00 662 Pull PP-CHL Feeder Cable 6,055.00 6,055.00 0.00 0.00 6,055.00 100 0.00 0.00 663 Test PP-CHL Feeder Cable 2,722.00 2,722.00 0.00 0.00 2,722.00 100 0.00 0.00 664 Terminate PP-CHL Feeder Cable 2,722.00 2,722.00 0.00 0.00 2,722.00 100 0.00 0.00 665 Install TX-CHL & LP-CHL 4,222.00 4,222.00 0.00 0.00 4,222.00 100 0.00 0.00 Page 35 CONTINUATION SHEET Application Number: 29 Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK BILLED MATERIALS TOTAL % BALANCE TO RETAINAGE NO. VALUE STORED THIS COMPLETED G/C FINISH (C-G) FROM PREY. PERIOD AND STORED APPLICATION THIS PERIOD TO DATE (D+E+F) (D+E+F) BA2.2 SDS-2 ELECTRICAL WORK 666 Pull TX-CHL & LP-CHL Feeder 3,944.00 3,944.00 0.00 0.00 3,944.00 100 0.00 0.00 Cable 667 Test TX-CHL & LP-CHL Feeder 2,722.00 2,722.00 0.00 0.00 2,722.00 100 0.00 0.00 Cable 668 Terminate TX-CHL & LP-CHL 2,722.00 2,722.00 0.00 0.00 2,722.00 100 0.00 0.00 Feeder Cable 669 Terminate PP-CHL Branch 5,482.00 5,482.00 0.00 0.00 5,482.00 100 0.00 0.00 Curcits 670 Install Gen. Quick Connect 4,222.00 4,222.00 0.00 0.00 4,222.00 100 0.00 0.00 Cabinet 671 Pull Gen. Cabinet feeder Cable 3,944.00 3,944.00 0.00 0.00 3,944.00 100 0.00 0.00 672 Test Gen. Cabinet Feeder Cable 2,722.00 2,722.00 0.00 0.00 2,722.00 100 0.00 0.00 673 Terminate Gen. Cabinet Feeder 2,722.00 2,722.00 0.00 0.00 2,722.00 100 0.00 0.00 Cable BA2.3 SDS-2 ELECT. YARD WORK 674 Install Grounding 8,150.00 8,150.00 0.00 0.00 8,150.00 100 0.00 0.00 675 Demo 15KVA Switch & Cables 3,911.00 3,911.00 0.00 0.00 3,911.00 100 0.00 0.00 676 Demp Pad Mounted Transformer 3,911.00 3,911.00 0.00 0.00 3,911.00 100 0.00 0.00 & Cables 677 Demo MCC-SD2 & Cables 3,911.00 3,911.00 0.00 0.00 3,911.00 100 0.00 0.00 678 Demp Eddy Controller & Cables 3,911.00 3,911.00 0.00 0.00 3,911.00 100 0.00 0.00 679 Demo MCC-CHL & Cables 3,911.00 3,911.00 0.00 0.00 3,911.00 100 0.00 0.00 680 Install Duct Bank 1 On 06E12 10,659.00 10,659.00 0.00 0.00 10,659.00 100 0.00 0.00 681 Install Duct Bank 2 On 06E12 10,659.00 10,659.00 0.00 0.00 10,659.00 100 0.00 0.00 682 Install Duct Bank 3 On 06E12 10,659.00 10,659.00 0.00 0.00 10,659.00 100 0.00 0.00 683 Install Duct Bank 4 On 06E12 10,659.00 10,659.00 0.00 0.00 10,659.00 100 0.00 0.00 684 Install Duct Bank 3 On 06E02 10,659.00 10,659.00 0.00 0.00 10,659.00 100 0.00 0.00 BA2.4 SDS-1 INSTR. & CNTRL SYS 685 Procure LCP-2000 3,000.00 3,000.00 0.00 0.00 3,000.00 100 0.00 0.00 Page 36 CONTINUATION SHEET Application Number: 29 A B ITEM DESCRIPTION OF WORK NO. BA2.4 SDS-1 INSTR. & CNTRL SYS 686 Procure Weighted Float Level Switch 687 Procure Ultrasonic Level Transmitter 688 RTU 21 Modifications 689 Field Terminations BA2.5 SDS-2 STRUCTURAL 690 MCC & Eddy CNTRL Pad E Miscellaneous R Rental C001 Additional 84 calendar days on project for 600 v wire C002 Installation of newstarters for Pumps C003 CMR 02, CMR 03, CMR 04 Totals C SCHEDULED VALUE L7 E WORK BILLED FROM PREV. APPLICATION THIS PERIOD (D+E+F) Application Date: 6/27/2023 Period To: 6/30/2023 Project No: CO2648-II Invoice No: 2675-29 F G H I MATERIALS TOTAL % BALANCE TO RETAINAGE STORED THIS COMPLETED G/C FINISH (C-G) PERIOD AND STORED TO DATE (D+E+F) 2,011.00 2,011.00 0.00 0.00 2,011.00 100 0.00 0.00 3,066.00 3,066.00 0.00 0.00 3,066.00 100 0.00 0.00 6,340.00 6,340.00 0.00 0.00 6,340.00 100 0.00 0.00 6,875.00 6,875.00 0.00 0.00 6,875.00 100 0.00 0.00 12,500.00 12,500.00 0.00 0.00 12,500.00 100 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 0.00 0.00 85,755.00 85,755.00 0.00 0.00 85,755.00 100 0.00 0.00 19,186.00 19,186.00 0.00 0.00 19,186.00 100 0.00 0.00 8,752,787.00 8,752,787.00 0.00 0.00 8,752,787.00 100 0.00 0.00 CONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT PROJECT: Village Creek WRF Phase 2 PROJECT NUMBER: OWNER: City of Fort Worth CO2468-I1 CONTRACTOR: Acme Electric Company CS# ENGINEER: Gupta & Associates. Inc. On receipt by the signer of this document of a check from the City of Fort Worth in the sum of $437,639.35 payable to Acme Electric Comoanv [payee or payees of check] and when the check has been properly endorsed and has been paid by the bank on which it is drawn, this document becomes effective to release any mechanic's lien right, any right arising from a payment bond that complies with a state or federal statute, any common law payment bond right, any claim for payment, and any rights under any similar ordinance, rule, or statute related to claim or payment rights for persons in the signer's position that the signer has on the property of City of Fort Worth located at Villaoe Creek WRF Phase 2 to the following extent: Village Creek WRF Phase 2 ("Project'). "This release covers a final payment to the signer for all labor, services, equipment, or materials furnished to the property Project, or to City of Fort Worth. "Before any recipient of this document relies on this document, the recipient should verify evidence of payment to the signer. "The signer warrants that the signer has already paid or will use the funds received from this final payment to promptly pay in full all of the signer's laborers, subcontractors, materialmen, and suppliers for all work, materials, equipment, or services provided for or to the above referenced Project up to the date of this waiver and release. EXCEPTIONS: None CONTRACTOR/ Acme Electric Companv By I Title Vice President Subscribed and sworn to before me this A2 day of Notary Public: My Commission Expires: 10/% Z&/J Z5— <hw , 20 23 ��`"'r''v""'�RHONDA CASON Notary Public, State of Texas Comm. Expires 10-26-2025 Notary 1D 1007901-4 PRF9255022 OWNER CONSENT OF SURETY ARCHITECT ❑ TO FINAL PAYMENT CONTRACTOR Conforms with the American Institute of STY Architects, AIA Document G707 OTHER ❑ TO OWNER: CITY OF FORT WORTH ARCHITECT'S PROJECT NO.: (Name and address) CONTRACT FOR: $8, 752,787.00 PROJECT: VILLAGE CREEK WATER CONTRACT DATED: (Name and address) RECLAMATION FACILITY PHASE II 10/05/2020 ELECTRICAL IMPROVEMENTS In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (Insert name and address ofSurery) COLONIAL AMERICAN CASULATY AND SURETY COMPANY on bond of (Insert name and address of Contractor) WINSTON ELECTRIC, INC. DBA ACME ELECTRIC ,SURETY, ,CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations to (Insert name and address of Owner) CITY OF FORT WORTH as set forth in said Surety's bond. IN WITNESS WHEREOF, the Surety has hereunto set its hand on this date: (Insert in writing the month followed by the numeric date and year.) Attest: A GELYN SUMMERS LMS-12134 10/01 , OWNER, COLONIAL AMERICAN CASULATY AND SURETY COMPQW (Sure r� ) (Signature ofauthoreedrepres tive) A DAWN R. TAYLOR, ATTORNEY IN FACT' ', (Printed name and title) ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the Stale of Maryland (herein collectively called the "Companies"), by MICHAEL BOND, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof; do hereby nominate, constitute, and appoint J. Kirk KILLOUGH, C. Brent AYCOCK, Jeffery FOWLER and Dawn R. TAYLOR, all of Lubbock, Texas, EACH its true and lawful agent and Attorney -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, EXCEPT bonds on behalf of Independent Executors, Community Survivors and Community Guardians. and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fa11y and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its once in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 22nd day of February, A_D_ 2016. ATTEST: Secretary Eric D. Barnes ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND µ'cr+r wv otior� o�N SISAL -_� nee so IWO � AID Vice President Michael Bond State of Maryland County of Baltimore On this 22nd day of February, A.D. 2016, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, MICHAEL BOND, Vice President, and ERIC D. BARNES, Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly sworn, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the sigrmtute as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. ,��tnnUrl/ Maria D. Adamski, Notary Public My Commission Expires: July B, 2019 POA-F 168-0068 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attomevs-in-Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys -in -fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney -in -fact to affix the corporate seal thereto, and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE 1, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full farce and effect on the date of this certificate; and f do further certify that Article V, Section 8, of the By -Laws of the Companies is still in force_ This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998, RESOLVED: *That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney ... Any such Power or any certificate thereof boring such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the I Oth day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I TESTiMON HEREOF, I hove hgFunto subscribed my name and affixed the corporate scats of the said Companies, this dayofZOv� B AL < TWIN �,gp i `7 ,4a) a- At Gerald F. Haley, Vice President Texas Important Notice IMPORTANT NOTICE To obtain information or make a complaint: You may call Zurich North America's toll -free telephone number for information or to make a complaint at: 1-800-382-2150 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights, or complaints at: 1-800-252-3439 You may write the Texas Department of Insurance: P.O. Box 149104 Austin, TX 78714-9104 Fax: (512) 490-1007 Web: www.tdi.texas.gov E-mail: ConsumerProtection@tdi.texas.gov PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim, you should contact the company first. If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR POLICY: This notice is for information only and does not become a part or condition of the attached document. ZURICH' AVISO IMPORTANTE Para obtener informaci6n o para presentar una queja: Usted puede 11amar al numero de telefono gratuito de Zurich North America's para obtener informaci6n o para presenter una queja al: 1-800-382-2150 Usted puede comunicarse con el Departamento de Se- guros de Texas para obtener informaci6n sobre com- pahlas, coberturas, derechos, o quejas al: 1-800-252-3439 Usted puede escribir al Departamento de Seguros de Texas a: P.O. Box 149104 Austin, TX 78714-9104 Fax: (512) 490-1007 Sitio web: www.tdi.texas.gov E-mail: ConsumerProtection@tdi.texas.gov DISPUTAS POR PRIMAS DE SEGUROS O RECLAMACIONES: Si tiene una disputa relacionada con su prima de seguro o con una reclamaci6n, usted debe comunicarse con la compania primero. Si la disputa no es resuelta, usted puede comunicarse con el Departamento de Seguros de Texas. ADJUNTE ESTE AVISO A SU POLIZA: Este aviso es solamente para prop6sitos informativos y no se con- vierte en parte o en condici6n del documento adjunto. U-GU-296-E (06/15) Page 1 of 1 PROJECT: CO OWNER: Citv of Fort Worth CONTRACTOR: Acme Electric Company ENGINEER: Gupta & Associates, Inc. CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS PROJECT NUMBER: CO2468-11 CS# The Contractor, in accordance with the Contract Documents, hereby certifies that, except as listed below, all obligations for all materials and equipment furnished, for all work labor, and services performed, and for all known indebtedness and claims against the Contractor for damages arising in any manner in connection with the performance of the Contract referenced above for which the Owner or his property might in any way be held responsible have been paid in full or have otherwise been satisfied in full. EXCEPTIONS: None CONTRACTO/ Acme Electric Company BY �/`� ///� TITLE Vice President Subscribed and sworn to before me this Z% day of ��� any ���• RHONP,� r "JN Notary Public: -Ng1'ry ` c of Texas _'�: "-' 10-26-2025 1007901-4 My Commission Expires: