HomeMy WebLinkAbout2002.02.19_OPWA Agendaim ),.W I
TYPE OF MEETING- Regular
DATE: February 19, 2002
TIME: 6:30 p.m.
PLACE- Council Chambers, (J"wasso Cornmunity Center
Notice and agenda filed in the office of the City Clerk- and posted at City Hall at 4:00 p.m. on
Friday, February 15, 2001
—N"uwell,' aAutl
Marcia utwell, Authorit Secretary
1. Call to Order
Chairman Barnhouse
2. Flag Salute
3. Roll Call
4. Consideration and Appropriate Action Relating to a Request for Approval of the Consent
Agenda. All matters listed under "Consent" are considered by the Trustees to be routine
and will be enacted by one motion. Any Trustee may, however, remove an item from
consent by request. A motion to adopt the Consent Agenda is non-debatable.
A. Approval of the Minutes of February 5, 2002 Regular Meeting.
Attachment #4-A
Owasso Public Works Authority
February 19, 2002
Page 2
B. Approval of Claims,
Attachment #4-B
Consideration and Appropriate Action Relating to OPWA Resolution #200201, Providing
for a Twenty Percent Reduced Utility Rate for Water, Wastewater and Refuse for Certain
Persons Who Meet Specific Criteria.
Mr McElrath
Attachment #5
The staff will recommend City Council approval of OPWA Resolution #2002 -01.
6. Consideration and Appropriate Action Relating to Change Order #3, a Change Order to a
Contract Between the Owasso Public Works Authority and Sapulpa Digging Inc for the
Construction of the Ator Relief Line, and Authorization for Release of Retainage.
Mr Carr
Attachment #6
The staff will recommend Trustee approval of Change Order #3, in the amount of
$4,537.27, representing $3,400.00 for adjustments of quantities for additional boring and
36" steel encasement to avoid a gas line, and $1,137.27 authorized as Work Change
Directives for items required during construction; and authorization for release of retainage
in the amount of $40,240.65.
M.
Owasso Public Works Authority
February 19, 2002
Page 3
& Report from C)PWA. Attorney
90 New Business, (Now Business is any item of business which could not have been foreseen
at the time of posting of the agenda,)
10, Adjournment.
The Owasso Public Works Authority met in regular session on Tuesday, February 5, 2002 in the
Council Chambers at the Owasso Community Center per the Notice of Public Meeting and
Agenda posted on the City Hall bulletin board at 4:00 p.m. on Friday, February 1, 2001
ITEM 1: CALL TO ORDER
Chairman Barnhouse called the meeting to order at 6:40 p.m.
ITEM 2: FLAG SALUTE
The flag salute was held during the City Council meeting preceding this meeting.
Mary Lou Bainhouse, Chair
Randy Brogdon, Vice Chair
Will Williams, Trustee
Rebecca Armstrong, Trustee
Michael Helm, Trustee
STAFF
Rodney J Ray, City Manager
Ronald D Cates, Authority Attorney
Marcia Boutwell, Authority Secretary
=C113
ITEM 4: REQUEST APPROVAL OF THE CONSENT AGENDA.
A. Approval of the Minutes of January 22, 2002 Regular Meeting.
B. Approval of Claims.
The consent agenda included minutes of the January 22, 2002 regular meeting, by reference
made a part hereto. Item B on the consent agenda included the following claims: (1) Owasso
Public Works Authority $60,393.03; (2) OPWA Capital Improvements Fund $100,952.53;
(3) OPWA Sales Tax Fund $133,173.16; (4) Payroll $36,995.47. Mr Williams moved, seconded
by Mr Helm to approve the consent agenda
AYE: Williams, Helm, Armstrong, Brogdon, Barnhouse
NAY: None
Motion carried 5-0.
Owasso Public Works Authority
No report.
ITEM 6: REPORT FROM OPWA ATTORNEY,
No report.
ITEM 7: NEW BUSINESS,
None.
ITEM 8: ADJOURNMENT
Mr Helm moved, seconded by Mr Williams to adjourn,
AYE: Helm, Williams, Armstrong, Brogdon, Barnhouse
NAY: None
Motion carried 5-0, and the meeting was adjourned at 6:41 p.m.
Marcia Boutwell, Authority Secretary
-2-
January 22, 2002
Mary Lou Bamhouse, Chair
OPWA
CLAIMS TO BE PAID 2/19/02
VENDOR NAME
MAILBOXES ETC
WAL -MART
XPEDX
TUCKER JANITORIAL
RONALD D CATES, ATTORNEY
PSO
OKLAHOMA NATURAL. GAS
IKON OFFICE SOLUTIONS
SOUTHWESTERN BELL
PUBLIC WORKS ADMINISTRATION
DETAILe.(].I~SCRIPTION
BLUEPRINTS
OFFICE SUPPLIES
COPY PAPER
CLEANING SUPPLIES
LEGAL SERVICES
01/02 USE
01/02 USE
COPIER MAINTENANCE
01/02 USE
OSCAR MCLAURIN METER READINGS
BRANDON HAMILTON METER READINGS
TECHNICAL PROGRAMMING SVC BILLING SERVICE
UTILITY BILLING DEPT
OWASSO STAFFING, LLC
CUNNINGHAM PLUMBING INC
WATER PRODUCTS INC
WATER PRODUCTS INC
CROW BURLINGAME
GEORGE & GEORGE SAFETY
WATER PRODUCTS INC
WATER PRODUCTS INC
TREASURER PETTY CASH
ROARK TRUE VALUE HARDWARE
SUPERIOR READY MIX
MILL CREEK LUMBER & SUPPLY
COOPER SUPPLY
CITY GARAGE CITY OF OWASSO
FUELMAN
FARM PLAN
CROW BURLINGAME
CITY OF TULSA UTILITIES SVC
PSO
SOUTH KANSAS & OKLA RR
SOUTHWESTERN BELL
SOUTHWESTERN BELL
WATER DEPT
MILL CREEK LUMBER & SUPPLY
WAL -MART
ROARK TRUE VALUE HARDWARE
BRENNTAG- SOUTHWEST INC
GEORGE & GEORGE SAFETY
KIMBALL ACE HARDWARE
CITY GARAGE CITY OF OWASSO
FUELMAN
HARP ELECTRIC CO
WASTE MANAGEMENT OF OK
PSO
SOUTHWESTERN BELL
LOWE'S HOME CENTER
WASTEWATER TREATMENT PLANT
TEMP STAFF
METER SETS 6/19/01
WATER METERS 6/19/01
METER SET MATERIALS
REPAIR/MAINT SUPPLIES
SAFETY SUPPLIES
REPAIR/MAINT SUPPLIES
REPAIR/MAINT SUPPLIES
REPAIR SUPPLIES
REPAIR/MAINT SUPPLIES
CONCRETE
REPAIR/MAINT SUPPLIES
HYDRANT REPAIR KIT
VEH MAINT
FUEL
TOOLS
TOOLS
PURCHASED WATER -01/02
01/02 USE
RIGHT OF LEASE LEASE
NON- PLEXAR
01/02 USE
REPAIR/MAINT SUPPLIES
MAINT SUPPLIES
REPAIR/MAINT SUPPLIES
CHEMICALS
SAFETY SUPPLIES
REPAIR SUPPLIES
VEH MAINT
FUEL
EMERGENCY LIGHT INSTALL
TIPPING FEES
01/02 USE
01/02 USE
CONST MATERIALS
a -
3.98
6.97
78.75
37.85
700.00
659.29
367.30
53.56
190.80
126.90
151.65
933.81
1,096.98
6,521.42
3,740.00
141.91
5.91
69.42
2,693.00
623.89
10.00
8.04
338.50
36.33
82.68
180.24
438.15
78.79
69.54
117,284.05
262.68
268.00
71.83
16.70
23.74
9.96
5.29
1,186.50
69.42
68.31
590.88
64.33
160.75
858.76
6,848.19
65.38
1,784.03
2,098.50
1,212.36
134,038.06
11,735.54
FUND TOTAL
VENDOR NAME
DETAIL -DIESLRIEION
AMOUNTS
DEPT j-QIA-I
FARM PLAN
MAINT SUPPLIES
14.25
WAL-MART
CHEMICALS
28.24
GEORGE & GEORGE SAFETY
SAFETY SUPPLIES
69.41
LOWE'S HOME CENTER
BUILDING SUPPLIES
18.45
WATER PRODUCTS INC
REPAIR/MAINT SUPPLIES
65.99
WW GRAINGER INC
SUMP PUMP
105.57
BROKEN ARROW ELECTRIC
REPAIR PARTS
880.99
HAJOCA CORPORATION
REPAIR SUPPLIES
154.74
CITY GARAGE CITY OF OWASSO
VEH MAINT
353.89
TREASURER PETTY CASH
VEHICLE WASH
9.00
BAILEY EQUIPMENT
EQUIPMENT REPAIR
95.27
FUELMAN
FUEL
209.74
PHILLIPS WASTEWATER INC
TV INSPECTION
790.00
ONYX INDUSTRIAL SERVICES INC
VACTOR TRUCK RENTAL
2,806.00
ONYX INDUSTRIAL SERVICES INC
VACTOR TRUCK RENTAL
2,403.50
ERS
VACTOR TRUCK SERVICE
975.00
PSO
01/02 USE
1,661.19
B & B ELECTRIC
PUMP REPAIR
1,156.00
HARP ELECTRIC CO
REPAIR ASSESSMENT
690.00
SOUTH KANSAS & OKLA RR
RIGHT OF WAY LEASE
260.00
UNITED RENTALS
SUMP PUMP RENTAL
300.00
SOUTHWESTERN BELL
NON-PLEXAR
366.55
WASTEWATER COLLECTIONS DEPT
13,413.78
GEORGE & GEORGE SAFETY
SAFETY SUPPLIES
69.41
CITY GARAGE CITY OF OWASSO
VEH MAINT
8,717.69
FUELMAN
FUEL
909.25
WASTE MANAGEMENT OF OK
TIPPING FEES
4,835.62
LOWE'S HOME CENTER
BUILDING SUPPLIES
68.34
EQUIPMENT ONE
EQUIPMENT RENTAL
48.16
REFUSE COLLECTIONS DEPT
14,648.47
PSO
01/02 USE
56.44
SOUTHWESTERN BELL
01102 USE
12.70
WASTE MANAGEMENT OF OK
RECYCLE REFUSE
2,590.22
WASTE MANAGEMENT OF OK
RECYCLE REFUSE
2,224.32
WASTE MANAGEMENT OF OK
TIPPING FEES
1,406.48
RECYCLE CENTER
6,290.16
OPWA OPERATING FUND TOTAL
GARVER ENGINEERS
SYSTEMS IMPROVEMENTS
15,870.00
LAMAR INDUSTRIES
CONST-WWTP 11116/01
19,129.32
SAPULPA DIGGING INC
ATOR RELIEF LINE 1/16/01
11,200.00
OPWA CAPITAL IMPROVEMENTS FUND
FIRST BANK OF OWASSO ELM CREEK NOTE 23,000.00
OPWA SEWERLINE EXT FUND
FUND TOTAL
183,436.87
46,199.32
23,000.00
OPWA FUND GRAND TOTAL 252,636.19
OWASSO PUBLIC WORKS AUTHORITY
PAYROLL PAYMENT REPORT
111"IMMITImm
02/09/02
OVERTIME TOTAL
EXPENSES EXPENSES
inis ra ion-:,
... .. ......
8'M,81'
Utility Billing 0.00 1,855.73
Wastewater 133.69 8,122.
I OMNI On=
11h.
Refuse 36.60 4,341.
0 UK N r0ATA A
I
ld"]Ijrkrli 111) i Nux"V11-111FAM111
TO: THE HONORABLE CHAIR AND TRUSTEES
OWASSO PUBLIC WORKS AUTHORITY
FROM. JIM McELRATH
DIRECTOR OF SUPPORT SERVICES
SUBJECT: UTILITY RATE REDUCTION PROGRAM
DATE- February 139 2002
101��-H
2. To enhance accessibility of the program to those in need, advertisement of the program will
be made on a regular basis on the utility bill and/or in other venues deemed most suitable by
the City Manager.
3. The applications will be made available at City Hall Utility Billing and at other locations
deemed appropriate by the City Manager and reviewed for approval by the City Manager or
his designee(s).
February 13, 2002
PAGE 2
RF-COMMEN .AT N
Staff recommends Trustee adoption of OPWA Resolution #2002 -01 continuing the spirit of
Resolution #9203 and specifying annually - updated income eligibility guidelines, in accord with
the issuance of updated Federal guidelines in October of each year by the Department of Human
Services.
A TAC MEN`D`S
10 OPWA Resolution #2002-01
2. Attachment "A" Current Food Stamp Guidelines
3. Attachment "F3" Application Procedures
I
W= N Man as w" a
Mary Lou Bamhouse, Chairperson
ATTEST:
Marcia Boutwell, Trust Secretary
Ronald D. Cates, Trust Attorney
As provided by the State of Oklahoma Department of Human Services FY 02,
Household Size *Monthly_-Lnqome
1
$ 931
2
$1,258
3
$1,585
4
$1,913
5
$2,240
6
$2,567
7
$2,894
8
$3,221
Add'l person
+$328
*as determined and stated in FS Guidelines APPNC3 — MAXIMUM FOOD STAMP
BENEFIT ALLOTMENTS AND STANDARDS FOR DEDUCTIONS, MAXIMUM
INCOME, AND UTITIES EFFECTIVE DATE: October 1, 2001.
ATTACHMENT "B"
Policies and Procedures for implementation and maintenance of City of Owasso Reduced
Utility Rates.
A. APPLICATION PROCEDURES
1. Applications maybe obtained at Owasso City Hall Utility Billing Department or at other
venues designated by the City Manager.
2. Applicants may be asked to meet with the City Manager or his designee(s) to verify
identity and discuss supporting documentation.
B. ELIGIBILITY:
1. "AUTOMATIC". THROUGH CERTIFICATION FROM OTHER ASSISTANCE
PROGRAMS
If applicant is currently certified for one of the following programs, approval is automatic
upon verification of documentation requested:
a. If applicant does not receive Food Stamps, Aid for Dependent Children, or Medicaid,
household income shall be verified by furnishing two of the following three items for
validation:
(1) Three (3) consecutive months bank statements
(2) Three (3) consecutive months payroll check stubs
(3) Previous year income tax return (either Federal or State)
b. Household income shall include all of the following sources:
(1) Earnings from work: wages/salaries/tips, strike benefits, unemployment
compensation, worker's compensation, net income from self-owned business or
farm and contract labor payments
ATTACHMENT "B"
APPLICATION PROCEDURES
PAGE 2
(2) Welfare /Child Support /Alimony: public assistance payments, welfare payments,
alimony, child support payments
(3) Pensions /Retirement /Social Security: pensions, supplemental social security
income, retirement income, veteran's payments, social security
(4) Other income: all other sources, including but not limited to, disability benefits,
cash withdrawn from savings, interest /dividends, income from
estates /tr-usts /investments, regular contributions from persons not living in the
household, net royalties /annuities /net rental income, any other income including
gifts of cash
R S
1. If approval status is granted, the name of the applicant shall be transmitted to the Utility
Billing clerk. If the approval is denied, the applicant shall be notified in writing, briefly
outlining the reason(s) for denial.
2. Notification of approval or denial shall be sent to the applicant within five days of
submission. If approved, reduced rates will be effective on the next billing cycle.
3. If the application is denied, applicant may appeal to the City Manager, whose decision
shall be final.
In order to continue on the reduction program, the customer is responsible to re-certify
eligibility twice yearly m_ during the months of April and October. Failure to do so shall
result in automatic termination of the reduced rates upon the next billing cycle. In order to
ensure accuracy, Utility Billing shall be supplied with an updated list of all approved re-
applicants during the first weeks of May and November, respectively. The necessity for the
first time of re-certification may be waived if the initial application is made within three
months of the first re-certification period.
SUBJECT. AT OR RELIEF LINE
CHANGE ORDER NUMBER 3 AND RELEASE OF RETAINAGE
DATE- February 13, 2002
Over the period of mid-November through January various cleanup items were completed that
included: hauling excess trench material, final grading, seeding, fencing, replanting of trees and
shrubs-, removal of the M-bf ILFTO*f�, r-Amid1ii-mptif PxW
course tee boxes and installation of a service line to the Mills residence. Final inspection was
conducted on January 23, 2002.
V W
- AMORMNI-ItU
&SOJUP-0,21MIL INK-%VE91
xrg-
This change order extended the initial Construction Deadline by 81 days from August 25,
2001 to November 15, 2001. In exchange, the Contractor agreed not to ask for any additional
payment for changed conditions due to hard rock being encountered. There was no change to
the contract amount.
Change Order #2 (approved by the Trustees on December 11, 200 1)
This change order ratified the approval of payment for three items included under the $25,000
project allowance, including:
Creek crossing stabilization on McCarty property $5,160.00
Additional 18" ductile iron pipe $8,680.00
Relocation of existing 12" water line JE673.53
Total Cost $23,513.53
Page 2
Ator Relief Line
A final change order to complete the project is needed to adjust pay quantities and incorporate Work
Change Directives authorized during construction. These items are included in Change Order 9-3.
The following items are adjustments of quantities based on unit prices bid for items included in
the contract:
Boring and 36" Steel Encasement
(20 feet added to contract to avoid gas line)
Deduct 4'-0" diameter manhole not used - 3 .,00 0. 0 0
Total Quantity Adjustments $39400.00
The following items were authorized as Work Change Directives for items required during
construction:
M!3111511 111 !111 1 -s - I =I sM
Original contract amount
$818,270.00
less project allowance
- $25,000.00
plus Change Order #2
$23,499.11
plus Change Order #3 - quantity adjustments
$3,400.00
plus Change Order #3 - Work Change Directives
---�IJ37,27
Revised Contract Total
$821,306.38
These adjustments reflect a net increase in the amount of $3,036.38. Funding for the project has been
a loan from the Oklahoma Water Resources Board. Staff will explore the means that the additional
costs should be able to be included in the final loan documents.
Page 3
Ator Relief Line
RETAINAGE REDUCTION:
Typically, following submittal of final pay request and the final project inspection, contract pay item
adjustments, acceptance of the maintenance bands, release of the retaina e and closing of the contract
will be performed. One contracted work item remains to be completed, however.
RECOMMENDATION #1®
Staff recommends `trustee approval of Change Order #3 to the contract with Sapulpa Digging Inc, in
the amount of $4,537.27 resulting in a revised total contract of $821,3060384
Digging, Inc. and authorization for payment.
1. Change Order b.
2. Work f'
3. Pay Request • release of retainag*
PROJECT: Ator Relief Line
TO CONTRACTOR:
Sapulpa Digging Inc
P.O. Box 1105
Sapulpa, OIL 71067
The Contract is changed as follows:
DATE: January 30, 2002
CONTRACT DATE: January 16, 7001
CONTRACT FOR: Suer Line Upgrade and
Elimination of Lift Station
Into oration of Work Items No.4 throu h 7 into the ro'ect udder the Contact Allowance and adjustment of cluaniities
to Bid Items 6 and 10.
Not valid until signed by the Owner and Contractor
Note (1): See attached spreadsheet for calculation.
Sa ul a Digging
CONTRACTOR
ADDRESS
IMIM
Owasso Public Works Authority
OWNER
Im
DATE DATE
Unit of
Quantity
Contract
Amount
Contract
Amount
Measure Billed
Unit Price
billed
Amount
LS
1
$ 175.00
$ 175.00
request ratification by Change Order #3
LS
1
$ 250.00
$ 250.00
request ratification by Change Order 93
LF
662
$13.09
$ 8,665.58
approved by Change Order #2
CY
43
$ 120-00
$ 5,160-00
approved by Change Order #2
LS
1
$ 9,673.53
$ 9,673.53
approved by Change Order #2
allow.
1
$ 25,000.00
$23,924.11
requested as of January 28,2002 invoices
Nursery invoice - trees for Ms. Mills LS 1 $ 406.50 $ 406.50 (not billed yet) request approval by Change Order #3
Irrigation Piping for golf course LS 1 $ 305.77 $ 305.77 (not billed yet) request approval by Change Order #3
,712.27 to be requested in final invoice
item Description
6 Boring and 36" Steel Encasemenj
10 4'-0" diameter manhole
Right of Way Restoration - Option
16 No. 2 - Solid Slab Sodding
Unit of Contract
Contract
Variance
Total Quantity From
Contract
Amount
DoHar
Variance
Measure Quantifly
Bid Price
Amount
Billed Contract
billed
from Contrac
LP 200
$ 320.00
$64,000.00
220 20
$70,400.00
$ 5,400.00
EA 1
$ 3,000.00
$ 3,000.00
0 -1
$ -
$ (3,000.00
SY 6000
$ 1.50
$ 9,000.00
3000 -3000
$ 4,500.00
$ (4,500.00
Original Contract Sum $818,270.00
less allowance for additional work of $ (25,000.00)
plus additional work of Change Order #2 $ 23,499.11
plus additional work of Change Order #3 1,137.27
;*llus quantity adjustment • Change Order #3 $ 3,400.00
$821,306.38
11 0
DATE: 12-1-2001
PROJECT- ATOR RELLEF LINE
OWNER OWASSO PUBLIC WORKS AUTHORITY
ENGINEER- GARVER ENGINEERS
CONTRACTOR: SAPULPA DIGPING fl!LC.
The following work or other items are requested for implementation in accordance with-
1. Installation of :33 trees to replace trees removed duriqg-gggs cti ®� at est° aced cost of X450°
2. Pure e at estimated cost of $305.77.
Justification or Goal: The trees will sati-f-A s. Mill that !niq-��valu�eis lostand �no mention
t.
mention of Ue pg thi qg wa� made in the contract.
Dlac' -ITS p1pil _—
Date to begin work: December 10,
2001 Addl Calendar Days: 0
ITEM DESCRIPTION COST
TOTAL TO DATE
Materials
Previous WDC
Labor Trees and W in
$712.27
Equipment
0
Total with this VVD
Payroll Additive &
0
Overhead @ 30%
Subtotal
0
Profit 10%
0
T ®TAI.
X712.27
REQUESTED BY:
CONTRACTOR
DATE
RECOMMENDED BY:
ENGINEER
DATE
AUTHORIZED BY:
OWNER
DATE
FROM (Contractor): Sapulpa Digging, Inc
P.O. Box 1105
Sa-oul_-oa, OK 74-067
PROJECT�
Period To-.— 2/12/02
Distribution To:
CON" RACTFOR: Owasso Wastewater Collection System
Improvement ,t - TOR Releif Line
Owner
Architect
Contractor
En-W incer
Application is made for payment, as shown below, in comiection with the Contract
Continuation sheet is attached.
L -
Original Contract Sum
$111-1
9270 -00
2.
Not Change by Change Orders
_
—__j L �36 - �9
1
Contract Sum to Date (Line I & 2)
$
821,306.78
4.
Total Completed & Stored to Date
90
(Column G on Continuation Sheet)
j r&
5.
Retainage: a.—% of Completed Work
(Column D & E on Continuation
Sheet) - FINAL
b,% of Stored Material
(Column F on Continuation Sheet)
Total Retainage (Line Sa & 5b)
0
6.
Total Earned Less Retainage
$
'Vo
(Line 4 less Line 5 Total)
7V
7.
Less Previous Certificates for Payment
$__17
5, P41:1 ® 4 6
AGREEWNT
099 � 00300 - 8 of 13
9. Balance to Finish, Plus Retainaae
(Line 3 less Line 6)
CHANGE ORDER SUMMARY:
$ ® / 7 S 7, T
57 0 0, 0 0
Cheinge Orders approved in previous
months by OWWER
T 39036.3
Approved this month
Nurnber
Date Approved 1/19/02 TOTALS $ 3,036. �8
Net change by Change Orders
0
DEDUCTIONS
0
$_2s,036.311
M 2,
belief, the WORK covered by this Application for Payment has been completed in accordance with
the Contract Documents, that all amounts have been paid by the Contractor for Work for which
previous Certificates for Payment were issued and payments received from the Owner, and that
current payment shown herein is now due.
CONTRACTO -
By: Date:— 2/12/02
STATE OF OKLAHOMA )
tA )SS
COUNTY OF 1 1)
Subscribed and sworn to before me this 12t)dayof February 202-1.
MY Commission Expires:—J---6 —
AGREEMENT
003 00 - 9 of 13
CONTINUA MN SHEET Page
of 7
Application Number: a Application Date:
Period To: 2112102
In tabulations below, amounts are stated to tbe'nem-est dollar. Use Colurym I on Contracts where
variable retainage for line items may apply.
D --AKnt-
-- (cont) F
— G
— H
I —
MATERIALS
TOTALCOMPLUMI) %
BALAN
AINAGE
PRESENTLY STORED
AND STORED
TO FINISH
(NOT IN D OR E)
TO DATE
(C-0)
(D+E+P)
0
TO
i r
AGREEWNT
0599 00300 - 11 of 13
In accordance with the contract documents, based on on�R 1k xrml-
the above application, the Architeaffingincer certifies to the Owner that to the best of the
Architect's/Engineer's knowledge, information and belief, the Work has Progressed as indicated, the
quality of the Work is in accordance with the Contract Docurnents, and the Contractor is entitled to
PaYment of the amount certified.
AMOUNT CERTWMD
(Attach Explanation if amount cep fifeWd differs from the amount applied for.)
ARCWTECT / ENGINEER:
BY: -- 9- � end �u I I �— & —n/& Date:-a=LL �,�9�9
This cerfificm-IS nOt negotiable. The AMOUNT CERTHqM is payable only to the contmtor
named herein. Issuance, payment and acceptance Of PaYment without prejudice to any lights of the
Owner or Contractor under this Contsma
00300 - 10 of 13