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Change Order No 2 - North Station Well No 1 Replacement Project No 117-031R - Peerless Midwest Inc
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Change Order No 2 - North Station Well No 1 Replacement Project No 117-031R - Peerless Midwest Inc
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4/7/2025 12:54:02 PM
Creation date
9/11/2019 10:14:13 AM
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Board of Public Works
Document Type
Projects
Document Date
9/10/2019
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DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />PROJECT CONTRUCTION CHECKLIST <br />Project No. 117-031 R <br />Project Name Water Works North Pumping Station Well Replacement <br />Contractor Peerless Midwest, Inc. <br />Inspector JJE <br />PAY APPLICATIONS & CHANGE ORDERS CHART <br />Pay APP 0 Contract rrr EVA <br />NTP <br />3/26/2019 <br />Sub. Comp. <br />11/21/2019 <br />Final Comp. <br />12/21/2019 <br />Today's Date <br />8/28/2019 <br />$200,000 00 <br />7/1 /2019 911 /2019 11 /1 /2019 <br />PAYMENT APPLICATION SUMMARY <br />End Date Total Deductions Sub Total <br />Prev. Pmts Amount Prev Pmt Error <br />1 7/12/19 $117,207.86 $5,860.39 $111,347.47 <br />$0.00 $111,,347.39 - <br />2 <br />3 <br />4 <br />5 <br />6 <br />7 <br />8 <br />9 <br />10 <br />11 <br />12 <br />S <br />- <br />- <br />- <br />$0.00 <br />$111347.39 <br />CHANGE <br />ORDER SUMMARY <br />Date <br />Prv. Contract Change Amt. <br />New Contract Change % Total % Added Days <br />1 <br />6/18/2019 <br />$532,763.00 $9,462.72 <br />$542,225.72 1.78% 1.78% 0 <br />2 <br />8/28/19 <br />$542,225.72 $1,345.00 <br />$543,570.72 0.25% 2.03% 0 <br />3 <br />4 <br />5 <br />S <br />- <br />- $10 807.72 <br />- <br />- <br />2.03% <br />12/21/2019 <br />POST -CONSTRUCTION DOCUMENT CHECKLIST <br />Items Notes Date Rec'D <br />1 Final Pay Application <br />2 <br />Project Completion Affidavit <br />3 <br />Final Waiver of Lien <br />4 <br />Final Change Order <br />5 <br />Com lete Certified Payrolls <br />6 <br />As -Built Documents <br />7 <br />Testing Reports <br />8 <br />Warrant Information <br />Signature: "+� <br />Date: <br />
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