HomeMy WebLinkAboutInv# INV 5 - MILLS ELECTRIC SERVICE - 11/27/2024APPLICATION AND CERTIFICATE FOR PAYMENT
AIA DOCUMENT G702
ONE OF TWO
CONSTRUCTION MANAGER -ADVISER EDITION
TO: City of Dania Beach
Application No.:
5
Distribution to:
100 W Dania Beach Blvd
Dania Beach, FL 33004
PERIOD TO:
11/27/2024
OWNER
PROJECT No.:
61600
CONSTRUCTION
FROM: Mills Electric
Contract No.
2024-00000241
MANAGER
830 NW 57th Ct
ARCHITECT
Ft Lauderdale, FL 33309
xsxrx CONTRACTOR
PROJECT TITLE: Solar Light Panel Replacement
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment, as shown below, in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet, AIA Document G703, is attached. 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.
1. ORIGINAL CONTRACT SUM
2. Net change by Change Orders
3. CONTRACT SUM TO DATE (Line 1 ±2)
4. TOTAL COMPLETED & STORED TO DATE
(Column G on G702)
5. RETAINAGE:
a. 5 % of Completed Work
(Column D + E on G703)
b. 0 % 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)
B. CURRENT PAYMENT DUE
9. BALANCE TO FINISH, INCLUDING RETAINAGE
(Line 3 less Line 6)
in previous months by Owner
Total approved this Month
TOTALS
NET CHANGES by Change Orde
$ 371,726.25
$ 0.00
$ 371,726.25
S 354.0 5.00
SUB — CONTRACTOR :Mills Electric Service Inc
By.
James F. Stubblefield DATE
Slate of: Florida County of: Broward
I pGa,,
Tammy 1-emer
$17,701.25
Subscribed and sworn to before me this day of p�rPmhe 2024
;a°r""
_. :
COMM.: HH 442074
$
Notary Publi :
°;�•%rat
Expires: Jan. 5, 2028
$0.00
,
public • Stale of Floric
$17,701.25
TanY Lerner My Commission Expires: 1/5/2028
$
CERTIFICATE FOR PAYMENT
$ 336,323.75
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
$ 246,539.71
of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment
of the AMOUNT CERTIFIED
$ 102,111.06
$17.701.25
AMOUNT CERTIFIED ................$
(Attach explanation if amount certified differs from the amount applied for Initial all figures on
ADDITIONS
DEDUCTIONS
this Application and on the Continuation Sheet that changed to conform to the amount certified.)
CONSTRUCTION MANAGER:
0.00
By: Date:
0.00
ARCHITECT:
By: Dale:
0.00
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.
0.00
AIA DO CUTAENr G70VCI.1a • APPUCATION AND CERTIFICATION FOR PAYMENT- CONSTRUCTION hW NAGER-ADVISER EDITION- 1992 EDITION - AIA - 01992
THE WERICAN IN STRUTE OF ARCHITECTS, 17A5 NEW YORKAV E, N.W., WASHINGTON. DC 20000-5292. Usere may odaln valtlaEan of Uis tlocvnent bi requesting o/the rcereee a rompleleG AIA Oociment D,101 - CeN fcale & ANhenlcky.
G702JCPM-1092
ITEM
DESCRIPTION OF WORK
SCHEDULED
WORK BILLED
WORK BILLED
MATERIALS
TOTAL
%
BALANCE TO
RETAINAGE
NO.
VALUE
FROM PREV
THIS PERIOD
STORED THIS
COMPLETED
(G/
FINISH (C-G)
APPLICATION
PERIOD
AND STORED
C)
(D+E+F)
TO DATE
D+E+F)
1
SOLAR PANELS
257,250.00
177,991.00
78,750.00
0.00
256,491.00
100
0.00
12,824.55
2
INSTALLATION
96,775.00
68,548.71
28,985.29
0.00
97,534.00
100
0.00
4,876.70
3
CONTINGENCY
17,701.25 1
0.00
0.00 1
0.00
0.00
0
17,701.25 1
0.00
371,726.25 1 246,539.71 1 107,485.291 0.00 1 354,025.00 1 1001 17,701.25 1 17,701.25