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DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />PROJECT CONSTRUCTION CHECKLIST <br />Project No.122-032 NTP 8/15/2022 <br />Project Name 2022 Contractor Paving Round 2 Sub. Comp. <br />Contractor Rieth-Riley Construction Co., Inc.Final Comp.11/17/2022 <br />Inspector SRK Today's Date 3/20/2023 <br />PAY APPLICATIONS & CHANGE ORDERS CHART <br />Pay App Contract <br />EVA <br />8/15/2022 $0.00 $0.00 <br />9/14/2022 $75,346.00 <br />11/3/2022 $1,944,837.24 <br />11/17/2022 $2,051,402.83 <br />#REF! #REF! <br />#REF! #REF! <br />#REF! #REF! <br />#REF! #REF! <br />#REF! #REF! <br />#REF! #REF! <br />#REF! #REF! <br />#REF! #REF! <br />PAYMENT APPLICATION SUMMARY <br />End Date Total Deductions Sub Total Prev. Pmts Amount Prev Pmt Error <br />1 9/14/2022 $79,311.58 $3,965.58 $75,346.00 $0.00 $75,346.00 - <br />2 11/3/2022 $2,047,197.09 $102,359.85 $1,944,837.24 $75,346.00 $1,869,491.23 <br />3 11/17/2022 $2,051,402.83 $0.00 $2,051,402.83 $1,944,837.23 $106,565.60 <br />4 <br />S ----$1,944,837.23 $2,051,402.83 <br />CHANGE ORDER SUMMARY <br />Date Prv. Contract Change Amt. New Contract Change % Total % Added Days <br />1 9/27/2022 $2,090,801.00 $67,181.00 $2,157,982.00 3.21% 3.21%0 <br />2 11/17/2022 $2,157,982.00 -$106,579.17 $2,051,402.83 -4.94% -1.88%0 <br />S ---$39,398.17 ---1.88% 11/17/2022 <br />POST-CONSTRUCTION DOCUMENT CHECKLIST <br />Items Notes Date Rec'D <br />1 Final Pay Application <br />2 Project Completion Affidavit <br />3 Final Waiver of Lien <br />4 Final Change Order <br />5 Complete Certified Payrolls <br />6 As-Built Documents <br />7 Testing Reports <br />8 Warranty Information <br />Signature: Date:3/20/2023 <br />Type text here