Application for Payment 2 & Final
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APPLICATION FOR PAYl\'1T~r~T f10. 2 & Final
CONTRACTOR: The Brewer Company of Florida, Inc.
PROJECT NAftlE: Paving & Dra inage Improvements - Stock Is land
PROJECT NUI\IBER:
106~8004-01
OWNER:
Monroe County, I~lorida
rERIOD ENDING: January 1982
11 January 1982
l) A 'I' E J
U ~E Ar~10UNT EAR1'~Eu 1\0 OA'l'E
Item Description Unit ! e r--
'- r-~o . of' Item Unit Price Amount Quantit Amount cent
1. Clearing-'&
Grubbing ~cres 746.28 500.00 .67 500.00 100%
Earth Work 1 i L.S. 8000.0
2 . rJ 8000.0 1 8000.00 100%
H
3 . Stabilized
Subgrade 2060 S. Y. 2.62 2060 5397.20 100%
4. Limerock(6U)
Base Course 1430 S. Y. 8.46 12097. 1430 12097.8 100%
5. Prime Coat 145 Gals. 3.00 435.0 145 435.00 108%
6. Asph. Cone.
Type S-l(l") .... 1"507 S. Y. 5.50 8288.5 1507 8288.50 100%
7. Special Ditc 283 L.F. 10.00 2830.0 283 2830.00 100%
8. Drainage
Ditch 1 L.S. 1000.0 1000.0 1 1000.00 100%
9. Painting Tra fic Stri s I
A. Solid Traffi
Stripe 1400 L.F. .25 350.0 1400 350.00 100%1
B. Skip Traffic 100%'
Stripe 300 L.F. .20 60.0 300 60.00
10. High\vay Stop
Sign Install 2 ach 300.0 600.0 2 600.00 100%
11. Maintenance I
of Traffic 1 500.0 500.0 1 500. 00 1100%1
Cha~Order No. 1 It s:
1. (12 It ) Re infor ed I i
Cone. Pipe 1 L.S. 384.0 384.00 1 384.00 100~{
2. Handicapped
Approach Ram 1 L.S. 305.0 305.0 1 305.00 10O~~!
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/\11P]JICATION FOB PAY~1T~N'r r'IO'~_..2c_~_inal
CONTRACTOR. The Brewer Company of Florid9-.~
PROJECT NAME; Paving & Drainage Iml?rovement~__- Stock Island
!)ROJECT r~Ur.rnERt
OWNER:
106-8004-01
~'onroe County, Flol~i.da
PERIOD ENDINGs January 1982
Item Description
No. of Item
\
Chan e Orde
1. ( 12 It ) Re infor
Cone. Pipe
2. Drainage Ope
in Existing
Catch Basins
TO'fA L,S
I)A l' E J
11 Januarv 1982
- SCtIEDUrJ~ .. ~. AMO T EARNED TO DA rr E
Unit .c ~r-
Unit Price Amour'lt Amount cent
ems:
1 L.S. 580.00 580.0 1 580.00 100%
150. 00 100%'
1 L.S. 150.00 150.0
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4.1,477_50
41,477.50
Att~lchm0nt No. 1.
Page 1 of J
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3. of 4.
AI) P LIe A rr ION .::, :{ tr -::' r '-1 N C . 2 & Fin a 1
co~~rrRACTOR: __!~_~__~E~wer Company of FIor ida, Inc.
p R()JEC1' r~ArI1E: ~_k:.~ty_iI}g_..~__pra inage IIl.}J2royemen ts - Stock Is land
PROJECT NUi\1BER:
106-8004-01
Surr~mary of Job Status
Total ~/ork COlnp 1 e t e Li (h
~
Material Stored or1 Sit (: $
Sub-Total $
Less 10% Retainage $
I Sub-Total $
I.le s s Previous Payrnents $
Amount Due This Periou ~,
'-P
Original Contract Amount ,. $
Changes Through Change l)rder NO.b.$
Revised Contract Amount"'!' $
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Notice to Proceed Cont.Dqte 4~21-81
Calendar Days to CampI c te 45
Extension to Date
Comple t i on D;-i te
41,477.50
41,477.50
41,477.50
33,755.51
7,721.99
40.058..50
1,419.00
41,477.50
Contractor's Affidavit: ~
The undersigned Contractor hereby certifies that all information
,contained in this Contractor's Application and Certificate for Payment,
including the Progre:3s Paymen t Ai'fidavi t, is, to the best of his know-
ledge, true, complete and correct. He further understands that the
payment of this request does nnt constitute acceptance of the work
proposed.
APPI~OVEr) :
PAYf,lEN'r REQIJESTED:
The B~.~~~~~~~~~F_~~~r~) Florida, Inc.
B y :/~~- (J:'If.:/. /-- ..-
W.R.Brewer,Ass!s~ant Vice-President
( Ovme r' )
LJA'r E :
APPROVl~D FOR PAY;-lEf'fl'l
[) A l' E :
(!~nginf:er)
BY:
11 January 1982
/-\ tt.3.chment No. 1
P .'1 e~ (~ 2 0 f ~~
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Page
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of 4.
APPLICATIori It'OH rAY~!ErlT Ar'FI I)A VIT
STATE OF Florida
COUNTY OF Dade
The undersigned Contractor certifies that the Work covered by this
Application for Payment has been completed in accordance with the Con-
t Documents, th~t all amounts have been paid by him for Work for which
previous Certific~tes for Payment were issued and payments were received
from the Owner and that ai' persons have been paid except those listed
below and t hat the cur r en t p ,-ry men t 0 f $ 7 I 7 2 1 . 99
, shown herein, is
non' du'e~
NAME
- ~
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ADDRESS
AMOUNT DUE
is
COtJTRAC~/~~: T'he Br~w.er_C.QrnpanY---9-L.E..LCl._J.11C.
BY: > ~:,;;,A'i .. .-.-..-- ....
W.R.Brewer,Assistant Vice-President
DATE: 1-11-82
SuL,>cribcd .1ndsworn to before me thh ..J..Ltbd.3Y of Jcw.uary
A.D., 19 82
My C Ontn i S 5 ; 0 n E)( p ire 5 :
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Attacrlment f'lo. 1
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