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DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />PROJECT CONTRUCTION CHECKLIST <br />Project No. 117-055A NTP 9/28/2018 <br />LINCOLN WAY EAST CORRIDOR IMPROVEMENTS - SAMPLE <br />Project Name STREET TO TWYCKENHAM DRIVE Sub. Comp. <br />Contractor Walsh & Kelly, Inc. Final Comp. 11/2/2018 <br />Inspector JJE Today's Date 6/21/2019 <br />PAY APPLICATIONS & CHANGE ORDERS CHART <br />�........o <br />1 <br />1 /1 /2019 3/1 /2019 <br />5/1 /2019 <br />PAYMENT APPLICATION SUMMARY <br />End Date <br />Total <br />Deductions <br />Sub Total <br />Prev. Pmts <br />Amount <br />Prev Pmt Error <br />1 <br />11/13/18 <br />$234,846.75 <br />$11,742.34 <br />$223,104.41 <br />$0.00 <br />$223,104.41 <br />- <br />2 <br />12/31/18 <br />$456,666.35 <br />$22,833.32 <br />$433,833.03 <br />$223,104.41 <br />$210,728.61 <br />3 <br />4 <br />5 <br />S <br />- <br />- <br />- <br />- <br />$223.,104.41 <br />$433 833.02 <br />CHANGE ORDER SUMMARY <br />Date Prv. Contract Change Amt. New Contract Change % Total % Added Davs <br />1 11/27/18 $459,000.00 $16,385.00 $475,385.00 3.57% 3.57% 0 <br />2 5/28/19 $475,385.00 $7,043.89 $482,428.89 1.48% 5.10% 0 <br />3 <br />4 <br />5 <br />S $23,428.89 5.10% 11/2/2018 <br />POST -CONSTRUCTION DOCUMENT CHECKLIST <br />Items <br />Notes <br />Date Rec'D <br />1 <br />Final Pa Application <br />2 <br />Project Completion Affidavit <br />3 <br />Final Waiver of Lien <br />4 <br />Final Change Order <br />5 <br />Complete Certified Par Is <br />6 <br />As -Built Documents <br />7 <br />Testing Re orts <br />8 <br />Warrant Information <br />Signature: Date: <br />