Public Building Commission of Chicago Contractor Payment Information

Transcription

1 Public Building Commission of Chicago Contractor Payment Information Project: 2015 CPS Air Conditioner Project - Region A Contract Number: 1570A General Contractor: Broadway Electric, Inc. Payment Application: #1 Amount Paid: $1,102, Date of Payment to General Contractor: 9/15/15 The posting of all or any portion of a contractor s payment application on the PBC s website is done solely for the purpose of providing information to subcontractors with respect the amount the contractor has requested as payment for its subcontractors on the posted portion of the payment application. The posting of this information is provided for in the PBC s Standard Terms and Conditions for Construction Contracts Section entitled, Prompt Payment to Subcontractors. The PBC makes no representations or warranties with respect to any of the information provided by contractors on the contractors payment applications. If you are a subcontractor, and have any questions regarding the information on a posted payment application, you should contact the general contractor. Follow this project on #AC

2 APPLICATION AND CERTIFICATE FOR PAYMENT,q-LA, n o t uun ur G 7 o 2 /c Ma I Distribution to: Broadway Electric, Inc. 831 Oakton Street Elk Grove Village, IL oznvrsf_lowner l--lconsrnucrton The undersigned Contractor certifies that to the best ofthe Contractor's knorvledge. information and belief the Work covered by this Application lor Payntent has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor fbr Work fbr which previous Certificates for Payment rvere issued and puynr.nt. received from the Owner, and that current payment shown herein is now due. Broadway Electric, Inc John R Oehler In accordance with the Contract Documents, based on on-site observations and dre data cornprising this application, the Construction Manager and Architect certify to the Owner that to the best of their knowledge, information and belielthe Work has progressed as indicated, the quality ofthe Work is in accordance rvith the Contract Documents, and the contractor is entitled to payment of the AMOUNT CERTIFIED. 'l'otal changes approved in previous months by Owner Total aoproved this Month County of: Cook My commissio" ""ei*, 7 I A6Ll 11.luly 31,2015 This Certificate is not negotiable. The AMOUNT CERTIFTED is payable only to the Contractor narned herein. lssuance, payment and acceptance ofpayrnent are withottt prejudice to any rights ofthe Owner or Contractor under this Contract'

3 Contractor's signed certification is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply Roughin Labor Roughin Material Pull and Trim Labor Roller Shades Punch List/Closeout Contingency /ilv- bol - cv%- ea 5 'o7 t b

4 AIA Document G702, APPLICATION AND CERTIFICATION FOR T VON LiNNE Contracto/s signed cenification is attached. In tabulations below, amounts are stated lo the nearest dollar. Use Column I on Contracts where variable relainage for line items may apply. Roughin Labor Roughin Material Distribution Labor Distribution Material Pull and Trim Labor Roller Shades Punch List/Closeout Contingency tav -ool -ct5qa- ao)5-07tv

5 AIA Document G702, APPLICATION AND CERTIFICATION FOR T VON L NNE Contractor's signed certification is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply Roughin Labor Roughin Material Distribution Labor Distribution Material Pull and Trim Labor Pull and Trim Materials Roller Shades Punch List/Closeout Contingency 3o/5-6vl

6 Contractor's signed certification is attached. ln tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. Roughin Labor Rouehin Material Distribution Labor Distribution Material Pull and Trim Labor Pull and Trim Materials Roller Shades Punch List/Closeout Contingency,)\u- ool- cbqa -Qd5-07/ L

7 AIA Document G702, APPLICATION AND CERTIFICATION FOR PA VON L NNE Contractor's signed certifi cation is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may appiy. Roughin Labor Roughin Material Distribution Labor Distribution Material Pull and Trim Materials Roller Shades Punch List/Closeout Contingency S..r.rw - oo\ - c.\6c\a -Ao\ -o\\6

8 Mobilization Roughin Labor Roughin Material Distribution Labor Distribution Material Pull and Trim Labor Pull and Trim Materials Roller Shades Punch List/Closeout Contingency

9 AIA Document G702, APPLICATION AND CERTIFICATION FOR T VON L NNE Contractor's signed certifi cation is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. Roughin Labor Roughin Material Distribution Labor Distribution Material Pull and Trim Materials Roller Shades Punch List/Closeout Contingency

10 Roughin Labor Roughin Material Distribution Labor Distribution Material Pull and Trim Labor Pull and Trim Materials Roller Shades Punch List/Closeout Contingency

11 AIA Document G702, APPLICATION AND CERTIFICATION FOR I VON LiNNC Contracto/s signed certification is attached. In tabulations below, amounts are staled to the nearest dollar. Use Column I on Contracts where variable retainage for line ilems may apply. Roughin Labor Roughin Material Pull and Trim Labor Pull and Trim Materials Roller Shades Punch List/Closeout Contingency

12 AIA Document G702, APPLICATION AND CERTIFICATION FOR T VON LiNNC Contractor's signed certification is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. Roushin Labor Roughin Material Distribution Labor Distribution Material Pull and Trim Labor Pull and Trim Materials Roller Shades Punch List/Closeout Contingency

13 Roughin Labor Roughin Material Distribution Labor Distribution Material Pull and Trim Labor Pull and Trim Materials Electric Service Upgrade (ComEd to MSB)- Elec. Material Elec. Service Upgrade (ComEd to MSB)- General Trades Roller Shades Punch List/Closeout :ontingency

14 Rouehin Labor Roughin Material Distribution Labor Distribution Material Pull and Trim Labor Pull and Trim Materials Roller Shades Punch List/Closeout Contingencv

15 Name of Project: Monthly Estimate No.! Date: PUBLIC BUILDING COMMISSION OF CHICAGO STATUS REPORT OF MBEMBE (SUB) CONTRACT PAYMENTS (1 of 2) CPS 2015 AC Program Region A Proiect Julv Contract Number: Cl570A 1'59lrE1r5qFiI5904, 0s905, 05906, 05908, PBC Project No.: 05911, 05911, 05914, 05918, 05920, 05921, STATE OF ILLINOIS })ss countyofcook ) In connection with the above-captioned contract: I HEREBY DECLARE AND AFFIRM that I, John R Oehler, am Authorized Agent and duly authorized representative of Broadway Electric, lnc., whose address is 831 Oakton Street, Elk Grove Village, IL and that the following Minority and Women Business Enterprises have been contracted with and have fumished, or are fumishing and preparing material for, and have done or are doing labor on the above-captioned contracqthat there is due and to become due them,respectively, the amounts set opposite their names for materials or labor as stated;and that this is a full, true, and complete statement of all such MBES/WBEs and ofthe amounts paid,due,and to be come due to them: MBE/WBE Name Contract For Amount of Total Previous Amount This Balance to Pagoda Electnc & Construction, lnc. $ Evergreen Supply Supplier $79,42s.00 $34, $0.00

16 Date On this 3lst day of July before me, John R Oehler, the undersigned officer, personally appeared at Chicago-llfinolg, known to me to be the person described in the foregoing Affidavit and acknowledged that he (she) executed the same in the capacity therein stated and for the purposes therein contained. In witness thereof, I hereunto set my hand and official seal. Commission Expires

17 CONY O[ CMK } tut k fotlwi4 otmb e m& fs lh. Fry of FEdq! Fnil FFEI o That the work lor which payment is requested has boon completed, fres and clear of any and all claims. lieng' charges, and gxpenses ol any kind or nalure what3@vor, and in full compliance with docum ntr and the requirement3 oi said owner under them. That for the purposos of said contract the following p"oons rrir" o."n with, and have fumishsd or prepared materials, equipmonl, supplies, and seryicos for, and-having done labor on said improvement' That tho r speclive "onrraciod amountg got fonh opposite thelr names is ihe lull amount of money dus a;d lo become due to sach ofth6m respoctivgly' Thst this stalement is a full, tru6, and complete statement ot a[ su;h persons and ofth full amount now duo;nd lhe amount heretofor paid to 6ach of them for such labor' maledals' "qrip."ni, irppriit, seryices, lumished or propared by each ot lh m to or on account of said work as statsd; "nd r-am-l Excavation E Concreta Suoolier Asbestos Mechanical

18 &jddcddm -work completd- 0, , , o ,00 o o.oo , o camera equrp ,BC commigsion's o.o SUBTOTAL page subtotal page 1 1,702, ,702, ,225, ,225, ,102, ,