HomeMy WebLinkAboutInv# APP 1 - MILLS ELECTRIC SERVICE - 10/31/2024APPLICATION AND CERTIFICATE FOR PAYMENT
AIA DOCUMENT G702
ONE OF TWO
CONSTRUCTION MANAGER -ADVISER EDITION
TO: City of Dania Beach
Application No.:
1
Distribution to:
100 W Dania Beach Blvd
Dania Beach, FL 33004
PERIOD TO:
10/31/2024
OWNER
PROJECT No.:
61600
CONSTRUCTION
FROM: Mills Electric Service, Inc.
Contract No.
2024-00000241
MANAGER
830 NW 57th Ct
ARCHITECT
Ft Lauderdale, FL 33309
X CONTRACTOR
PROJECT TITLE: Solar Light Panel Replacement
CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract.
Continuation Sheet, AIA Document G703, is attached.
1. ORIGINAL CONTRACT SUM
2. Net change by Change Orders
3. CONTRACT SUM TO DATE (Line 1 t 2)
4. TOTAL COMPLETED & STORED TO DATE
(Column G on G702)
5. RETAINAGE:
a. 5 % of Completed Work
(Column D + E on G703)
5 % of Stored Material
(Column F on G703)
Total Retainage (Lines 5a + 5b or
Total in Column I of G703)
6. TOTAL EARNED LESS RETAINAGE
(Line 4 less Line 5 Total)
PAYMENT (Line 6 from prior Certificate)
8. CURRENT PAYMENT DUE
9. BALANCE TO FINISH, INCLUDING RETAINAGE
(Line 3 less Line 6)
in previous months by Owner
$3,608.07
5
$0.00
$3,608.07
$ 371,726.25
$ 0.00
$ 371,726.25
$ 72,161.46
$
$68,553.39
$0.00
$68,553.39
$303,172.86
0.00
Total approved this Month 1 0.00 10.00
TnTAI s 10.00 10,00
The undersigned Contractor certifies that to the best of the Contractor's knowledge,
information and belief the Work covered by this Application for Payment has been
completed in accordance with the Contract Documents, that all amounts have been paid by
the Contractor for Work for which previous Certificates for Payment were issued and
payments received from the Owner, and that current payment shown herein is now due.
state or: vioncia county or: Broward
Subscribed and sworn to before me this 2.9 -y ofClctnher 2024 4B`' Tammy Lemer
Notary Public: °;' Comm.: HH 442074
=oQ S� on4mm'e, g�Z My Commission Expires Expires: Jan. 5, 2028
Tammy Ldner Notary Public •State CE FIOfiC
In accordance with the Contract Documents, based on onsite observations and the data
comprising this application, the Construction Manager and Architect certify to the Owner that to
of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED
AMOUNT CERTIFIED ................$
(Attach explanation ifamount certified differs from the amount applied for. Initial all figures on
this Application and on the Continuation Sheet that changed to conform to the amount certified.)
CONSTRUCTION MANAGER:
By: Date:
ARCHITECT:
By. Date:
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor
named herein. Issuance, payment and acceptance of payment are without prejudice to any
rights of the Owner or Contractor under this Contract.
NET CHANGES by Change Orde 1 0.00 1 1
AIA DOCUMENT G702/CMe - APPLICATION AND CERTIFICATION FOR PAYMENT - CONSTRUCTION MIANAGER-ADVISER EDITION - 1992 EDITION - AIA- 019K G702/CMa-1992
THE AMERICAN INSTITUTE OFARCHITECTS,1745 NEW YORKAVE.,N.W., WASHNGTON, DC 20DOS-5292. Users nayMsInvafhr6noltNs dmutbymgms0igoftMkemeeacompiet"AIADwc rI D401-Certifaateof ANFeMci.
ITEM
NO.
DESCRIPTION OF WORK
SCHEDULED
VALUE
WORK
BILLED FROM
PREV
APPLICATION
WORK
BILLED THIS
PERIOD
STORED
MATERIALS
TOTAL
COMPLETED
AND STORED
TO DATE
%
BALANCE TO
FINISH
RETAINAGE
1
SOLAR PANELS
257,250.00
0.00
52,000.00
0.00
52,000.00
20
205,250.00
2,600.00
2
INSTALLATION
96,775.00
0.00
20,161.46
0.00
20,161.46
21
76,613.54
1,008.07
3
CONTINGENCY
17,701.25
0.00
0.00
0.00
0.00
0
17,701.25
0.00
TOTALS
371,726.25
0.00
72,161.46
0.00
72,161.46
19
299,564.79
3,608.07