2004-08-06 Application for Payment No. 4
.J
Westwood Professional Services, Inc.
h"U /'71
"~
oV
1>\!J
7599 Anagram Drive
Eden Prairie, MN 55344
(952) 937-5150
-1t:::~
Application for Payment No.4
CPDC - Albertville - Towne Lakes 5th Addition
OWNER'S PROJECT#: N/ A
ENGINEER'S PROJECT #: 99360.05
CONTRACTOR: Hennen Construction
CONTRACT FOR: Utilities and Street Construction
CONTRACT DATE: August 6, 2004
FOR WORK ACCOMPLISHED THROUGH THE DATE OF: July 8, 2005
STATEMENT OF WORK:
Original Contract Amount
Net Change Orders
(thru No.4)
Current Contract Amount
1,149,193.03
~
(1,120.25)
1,148,072.78
CONTRACTOR'S CERTIFICATION:
Total Amount Due
Less Amount Retained (5%)
Amount Due to Date
Previous Payments Recommended
Amount Due This Application
883,011.63
44,150.58
838,861.05
660,486.72
178,374.33
The undersigned CONTRACTOR certifies that: (1) all previous progress payments received from OWNER on account of
work done under the Contract referred to above have been applied to discharge in full all obligations of CONTRACTOR
incurred in connection with Work covered by prior Applications of Payment numbered 1 through 2 inclusive; and (2) title
to all work, materials and equipment incorporated in said Work or otherwise listed in, or covered by this Application for
Payment will pass to OWNER at time of payment free and clear of all liens, claims, security, interest and encumbrances
(except such as are covered by Bond acceptable to OWNER indemnifying OWNER against any such lien, claim, security
interest or encumbrance); and (3) all Work covered by this Application for Payment in accordance with the Contract
Documents and not defective as that term is defined in the Contract Documents.
Dated
,20_
ENGINEER'S RECOMMENDATION:
Hennen Construction Co
(Contractor)
By:
This application (with accompanying documentation) meets the requirements of the Contract Documents and
payment of the above AMOUNT DUE THIS APPLICATION is recommended.
Dated
~/tX
I
20 65'""
,-
Pay Summary:
Pay Application No. I
Pay Application No.2
Pay Application No.3
Pay Application No.4
Total to Date
203,133.75
329,210.63
128,142.34
178,374.33
838,861.05
WESTWOOD PROFESSIONAL SERVICES, lNC.
(Engineer)
By:
y .&A~
By:
<{)
0
0
N
N c
c "
00 0
~ C
" <
u c
" ~
U "
E u
"
6
u
-"'~
au
~ c
~
"
u
~ c
"
.g 0
0.. "
.;:
" ~
f .g
0..
"
6
u
~I~
.g
0..
!!
!! ~
~ g
0 C
I- "
.. 0
"
i .;:
"
6
u !!
~ ~
0
~ I~
v
0
Z
c: C
.Q
1ii g
.2 e
Ci 13 <(
Q. ~
<( "
>- 0
l'O U
Q.
I~
..
.c u
..:
;:) 0..
.c
;:)
u
u
<(
.s::
iO
II)
Q)
-"
l'O
...J
Q)
c:
~
o
I-
"
~
000000000000000000000000000000
00000000000
00000000000
o .~o\ooOcicir--:oci
000'\0' "tt V\OON\OC>
C>O"f"")r--Nr-V)\O 0\
00 .. -=-~cxi""'N-
00000000000,00
00000000000000
ovlocicic:icici-.iNOOO
"''''000 ('f')N\OONOO\OC>
ONr-f'")-r-r- OrlV
'f!:t'~v" V)Mf'iv"rJ''' v"
N - N
MNr-ONOO OOOOOOON
VlOOV\OOOV')Vt-Vt""'l
M co '^
~M~~~~~~~~gc>
- c-t) V N
N
00000000000
00000000000
d ....,:o'docidc:i....:cic:i
OC>O\O\~V)OON\DO
OO\f"'\r-_Nt-V)\O_o-
00 -: "':r-"'OO"'MN"
0000000000000
~~~~~qqqqqqqq.
C)V)OOOOOC>VNC>OC>
\O\OOOOI"'\N..oONOO\OO
ONt-M-r-r- Of"'\V
~v'" ""~NV"'N-: ~
N - N
MMr-ONoa-OOOOOOON
V)oov\OooV)vr-Vl"f'l
M co '^
Vlt""'lv..oOOVNOONNOC>
_ _vvNO\.V)r-r-c>
- t""') v N
N
00000000000000000000000000000,,",
ooooooooooooooooooooooooooooov)
oMNd~~cici~~d~~dcicici~dcicicidciNMcic:id~
Ov)"'v)~MO\Or--\OOO\-..oV)"'\OOO~OOM~~OO~~~v
O~~OO-~~N~M~~O~~~ OON~~-~NMOMV~
00 ~ ~~~~N~ ~N~O~ O~~OMN~M~ ~~
__ NN-- N N N -
~~OMM~OO~NN~ v~~N-MM ~OOv~~MN~
~oo~~~~~~VM~~~~~ - M~VN~~~~~~
N M
ggggggg8ggggggggggggggggggggg~
o~~~~~N~~~ci~~~o~o~cioo~~~N~~~No
O--___MNMNMV~~~~M~OO~O~-- - N
o '-0....- - -
00 ~-=
x xxxx xx xx
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
w~~~~~~~~~~~~~~~wwww>>WW>~WWI-~
..
c
o
N
..:
o
:;.
Cl::
I&l
~
I&l
'"
>
Cl::
<(
!-
Z
<(
'"
_______ :22:2:2::2
--5-=-5-=-5-5-5 o..o.c..o.c..
afrfrfrfrfrfrfr~::2o~ooo 2 ~
.. 0 0 0 0 0 Cl Cl fr i5.~ _ _ _ _ i5. ii: ~
~~~~~~~~~~~~~;:~ ~ I ~
~e~~~~~~=N~~~~~~ e ~ ~ ~
t)tiittut~t:::'=~~~~~ ~ .g t u
~~~~~~~~~~~~~~~~ ~ ~u~&~ ~
.'2 ~ ~ ~ ~ ~ ~ ~ ~~ '" ~ ~ ~ ~ ~ :::E .!! >.~ ii: ~ ~ ~
~~~~~~~~~~~~~~~~ t ~~~~~~~~~
~~~~~~~~~~~~~~~~ ~ '=N~.~~uESoo
~~~~:::::~~~~~~~ .~ ~~c~::~~~
.~MMMNNMNNNN~~~~~ ~c~ ~~OONNNN._~
w~~~~~~~~'^'^ClClClClO~~~o ~uU~~~~i~
oClClClOClClClCl~~",,,,,,,,,,,,,2~v~ti5.>~ClClClCl,,,~
:: U? tI) (I') tI'J en en Ul en U U U U U U U g... u"'O r.'J .!!! u c.. _ Ul tI) en U) Ui u
\:luuuUUUUUC.dl..>>>>>u> :a:::E~Cl: oUUUU~.!!!
2~~~~~~~~OO~~~~~~~~~~~~~~~~~~~
8~~~~~~~~~~~~~~o~o~5c~~~~~~~~~
=
=
o
co
M
'"
::l
=
=
o
co
M
'"
::l
on
::l
-
M
.,,;
v
M
...
..
~
..
'"
>.
...
S
."
..
'"
'3
:0
j;j
~
'"
0000'00000000000
00000000
00000000
ociciciocido
o~oooooo
o-o~voov-
N -" 00 0 00..0 ..
V N-
"N 0 0 0 00 00
'" 0 on
N -
M -
00000000
00000000
ciciciciciooo
o~oooooo
o or-......oov-
N-~OoO...o ."
v N-
NOOOOOOO
'" 0 '^
N -
M-
0000
~ooo
",ocid
NV.......V
'" '"
"")00",00-
N
-OON.......N
V'lr--r-
N '^
- N
0000
0000
~cicici
N~~~
MoOvlcO
N
OOM~N
'0....... - ~
N '^
N
=
=
on
:!;
..E
v
=
=
on
....
..E
:!;
0000000000.000 Q
00000000000'00 ~
g~g~g~gggg~g~ ;::
o_...,.~t-..o..._V)oo..oo'C c
N~O":Or-:-: MoO\C500 f'<'i'
~NN N tn
N-..o 0.0-
0\;,0 -
MN
M-
000000000'0
oOOC>OOOOOVl
g~~~g~gggM
0: r<"\OOV-V\
...: N"
..0 NOON
Vl~O~
'^ '"
- N
0==
0=0
cicici
N-N
x xxxxx x x
~~~~~~~~~ai~~~
W~~~WWLUWW~W~W
c
.~
:::E
~
u
'"
~~~-;;;-
~-5.sE. to
0.0.0 E
.~ ~ ~ ~ ::l
~ :;( :;( ~ ~ .5
::--Ct\; :;:: e;,
~ .~ .~ ~ > 0 8
2:::E:::E..~>c Cc" .~~
8~B~2~ .~.geo.tlco
-g~~~~adu~~~~~:€
co o<(t)>X)('':::cc;~
19 ~ ~ ~ ~ ~ ~ ~ g .~ ~ g-
"-uuu~>~~ce.5l:;cJi
~UU~ c.!! ,">-15 \!' e-g;-e
~ ~ ~ ~ -15 0 ? .!! ~.W 8 (3 8
~~~of~oo~i1:~:...=-
z
'<
::;:
Cl::
I&l
!-
<(
~
Q)
co
l'O
Q.
c
..
::;:
...
..
OJ
~
'3
o
j;j
~
'"
on
<:>
<:>
N
N
;:0
~
o
z
c:
.Q
'iil
.Q
a.
a.
<(
>-
'"
Q..
"0
"0
<(
J:::
iO
..
G>
"""
..
..J
G>
c:
~
o
I-
Q ~
"'-
{.!., ~
\n \()
~
c g
~ .;:
e c
" 1:!
" "
]'-'
o
~ ~
o
~ E
1:!
"
'-'
<:> <:>
<:> <:>
g ~
<:> N
N N
00'0-0000'\
E
.~ g
0.. .;(
~ .g
-go..
o
u
~I€
o
.C
0..
<:>
<:>
o
<:>
-0
OONooooa
.!!
So
Os
~ ~
o
" "
U
~.;(
o
U !!
-gO
~ 0
I-
ieS
00
00
cid
00
-00
N
00....
0'000'
E
:s
o
"
c:;<
b
"
o
U
OOOOOONO GO
00000001'-0 C\
..ooricicicici\€5ci ~
MOOOO,,","'OVl e
M..oMO-V-r- ~
-eiNr-\NM-=-O-n c
M - - c
....
s
OItO--V\\ONM
~"'- ..... on.....
-0 ~ ~
~ 00
..
'c .g
~o..
000000<00
....."'OOOOMO
r--:"';cicio-nNO
OOO'\VNVl
MO N N
N
.c
~
X XX X
. .U .uu .U
~~i5ji5i5~i5
"
g
c
~~
ci3~
tll.<>
<8
.<,..
on 0
E~
U'<>
~-gi
. '" u
g 'o.e
;;~m
E e u
I-....s=
.~';;'e ~-:::-~
~.g~ 8.~:a
(J ('Q - .... Q..E U)
:26~_8.tcna.
....ij-=e';'.B=!!~
~;...ooo E ~~:c~
)( 1; :; <3 Vi .~~ ~
.g>~~~~.g.E
.- .. .- E E ...- :l
~g~EE~~1l
eoCOJ.L.f-f-tIlMtL.
o
o
o
on
.....
N
<:>
r-
-<i
on
00
..;
on
00
'"'
....
~
r-
~
.....
00
.....
,.:
0\
....
00
....
.....
'"
-
..
..
...
Vi
S
o
.c
::s
en
o
z
~
~
l2
o
U
00'000
00000
00000
..000....-1"":0
0000"_00-.
-"""'''''Noo
M N .,; ..0 0\"
OONM V)
-\Or-v-
-MM-N
000'00
000000
..ooOM...tO
0000-00\
-MNNOO
.....\N'vl...oo-.-
OONM Vl
-..or-v
-MM-N
00000
00000
oO..t...tr--i",
'VV\Vl-Q\
MO'\-V\t""'l
MN-D...oO
00000
or:i-:'or:ioO..o
NOOO'VN
-MM-N
00000
0000'0
r-:or:i-:'or:i..o
NM'V'VV
~~~~~
....i...L..L-i....i
~
~
~
~
CIl
~
~
<(
!:;
z
<(
CIl
~:2J::2~
E.aao-cs..
U U OJ G) V
00000
~CobM;"
-:-;~~~
~'oOoON
::.::::.::::.~c:!.
ti i:i i:i i; ~
~ ~ ~ ~ ~
u u u u v
en CI) CIl en ell
CCCCC
S.!!!!S5
.c '2 .c 'c 'c
<<II co = co co
u)VJVJUlC'-l
\()..o ~ \0 ..0
NNNNN
~~~~~
00000
en VJ en CI) CI')
uuuuu
>>>>>
c..o..o..c.. ~
~~~~~
o
'=l
-
00
00
v:r
~
c:>
5
00
GO
v:r
~
c:>
c:>
..;
'"'
'"l
0\
~
.,
c
.g
:;;
."
.<
S
o
.c
::s
CIl
I
oooooooc
00000000
00000000
-.ioeocicioocio
OQ\-OrDV'IIOOO
r-O\OI'"'\O\NNOO
.nNv\O...oVN
NN --
q~qqqoC:o
......-vOO\O ."It' .
NOOo\......NOOO'-C
-r1r"l-N......--
00000000
000000'00
~ociviovl.nNO
......"'\OI'r-O-1II\
~~~~~~~~
....i....i....i....i....i>>>
~
~
~
lol
CIl
?;:
<(
!:;
z
<
CIl
2'2"J:~J:
ao.aa.E.
U II) U U U
00000
~\oaobN
~~~'7~
N;;"'oaoO
t:!.t:!.~~c~
tuttt]
~ ~ ~ ~ ~ f.i
~~~~~~
C C C C C u .e.
.~ .~ .~ .~ .~ ~ ~
~ ~ 5 ~ :; <<II ~
~~~~~o~
NNNNN~..o
~~~~~~~
SlSlSlSlSl-aou
u u u u u .. '" .~
>>>>>ou~
~~~~~ ~f,: g-
~~~~~~~O
c:>
Q
.,;
.....
0\
,..:
00
~
~
u
co
b
.<>
::s
CIl
;;;
c
.c
::s
en
c:>
'=l
00
00
v:r
~
c:>
'=l
00
GO
v:r
~
s
c:>
..;
'"'
....
.to
!:!..
6
Z
...
..
."
...
o
..
...
c
co
.c
U
;;;
B
.<>
::s
CIl
.....
6
Z
...
.,
."
...
o
.,
...
c
co
.c
U
o
o Q
o Q
oci oci
,.., .....
on on
r<1' ~
'"
'"
r-
o
o
00
,..,
on
..;
c:>
c:>
00
:;j
..;
'"
'"'
r-
o c:>
o c:>
cO cO
..... .....
on ....
M M
<"l
G>
(])
'"
Q..
'"
\0
r-
o
o
N
ci
>
c
..
t
;>
..
Co
~
'"
.<>
'"
:s
o
c
.s
B
:0
N
C
E
o
Co
E
..
I-
....
6
Z
...
..
."
...
o
.,
...
c
co
.c
U
~
oS
.0
::s
CIl
<()
o
o
N
N
ii3
v
o
z
c:
o
~
.~
a.
D-
c(
>.
IV
Q.
'0
'0
c(
.<:::
ii)
U)
CD
"'"
IV
....J
CD
c:
~
o
I-
E g
~ ~
U E
" ~
-rG
E
o
U
-g5
~ "
~
"
U
00 V">
NO V">
~o.rioo
"" -0 0
r--oN
V-O~
"" --
-o-a-
t- - 0
t- r- V">
""
~ "
.g g
0..:;:
" ~
Ii .9
get
(;
U
~~
.g
0..
000
.!!
~O
o B
~ ~
o
.!! e
]<
(;
~ .!!
So
~ 0
I-
5
o o V">
.....OV">
O-:v\oO
""..,0
t- .., .....
..rOM
.... --
-0 a-
t- - 0
t- t- '"
....
c
='
o
'"
:;:
~
13
U
00'"
.....0'"
~vioO
.... -0 00
t- -0.....
~OM
.... --
~
.., - a-
t- - 00
t- t- '"
....
u
'a .g
;:)0..
00'"
..... 0 a-
0: vi vi
- .....
.c
;:)
>>>
uivivi
'"
~
u
> Co
e -
.... 0 o<l
o ].!!~
~ -g ~~
~ ~~~
~iii~
OQ _ _ t""'\
C UU.....
(II "t:I: : 0
o ~~~
u
"0
>.
<>
~
'"
'"
'"
..
(3
.r.
t-
N
..,
00
on
on
t-
N
:0
00
on
on
0-
N
:0
00
on
c
~
:;;
..,
<(
~
o
.0
:;l
II>
I
00
N 00
'n ~
"" 00
'D 'D
0:-00
-0 -0
t- t-
t- r-
'" ....
00
00
..... 00
vi~
.... 00
.0 .0
0:00
.0 ..,
t- t-
t- t-
.... ....
00
..... 00
.n~
.... 00
.0 \0
0:00
.., -0
t- t-
t- t-
.... ....
00
..... ....
vlM
>>
vi vi
~c;::
!::.~
lD'O
~~
a- '"
~8
b~
~~
2 !;!
..: <0
<olD
.Ii !!
cc ~
2 e
~ <It
3~
C",
e .
?u
Co=.
- -0
s
o
o
M
....
00
~
~
o
o
o
N
"l.
00
~
-
o
o
o
N
....
00
~
c
~
u
co
l::
.c
:;l
II>
Cii
~
.0
:;l
II>
.r.
t-
N
a-
M
o
....
00000
~oooo
~g~gg
q q N~t""')
-.... ....
t- .....
00000
on
0-
....
0-
N
0-
....
00000
00000
.noocio
..ooV)oo
qq "!.f"'1
v- ....
t- .....
on
0-
....
0-
....
0-
....
00000
00000
vicoco
\00,,",00
q q "t't .-.
t-
.... -
00000
OOOOIln
",ccioN
-Vl~O-
..... "!.
:t::t::t:
~uuu>
. c( c(c( .
...:lUlUlUlU
....
.,;
z
..
..
..,
..
o
..
""
c
co
.<:
U
~
E
.c
:;l
II>
v
.,;
z
..
..
....
.....
o
o
or;
..,
,.;
<:>
t-
.;
V.
00
,.;
v.
00000000
~ ~ ~ ~~:3 I .
OO'V\CI~OOf"")
N \CI....... 00 ItIl
O:~\&J~~~
~'Vf"")N-.::r
_ _ N_
<:>
<:>
:i
...
,.;
C::>OC:>OOOCWlO
OOIl)f"")Oc.....O
e.nr-ir..:"';oOMwl
OO"-\oo\OOt"')Q'l._
N_\CW;OCtt)N1\O
c;";..coCvSMO~
f"'}"ltf"'}I'--.:r f"")
_ _ NN
<:>
<:>
wi
:0
,.;
-
W')OOOOQlOII)O
VlO V'} 0'0 c::>c.....c
":":f"i-.DloCSoONwl
_.....oc\Cf"')o,\_
NO\Of'f')W)V)NItC
..c~~=oOMO~
"l:l'tnvOf"") rr)
N-NVl-
v
.,;
z
..
..
..,
..
o
..
..
c
co
.<:
U
- MI f'l") "":t'
o c 0 c
zzzz
..
GI 1.0 I.. Lo ...
~.5t ~.g~~
tl)ClJ~ 0000
C~~WJCUCUCUlU
:!. t E cu ~ ~ ~ ~
>c=6~~~~~
ll:~~ciiciiuuuu
~~~~S]]5~
~ 0 0 coo coo
--~-----
.&J~.s::J.&J.s::.&J.&J.&J
::s ::s ::J ::s ::s ::s = ::s
(,I}{,I}rnrnrnU)CI)tI)U)
~
o
.0
:;l
<Il
on <:>
t- <:>
N'I1
a-
M '"
o~
....
on
....
....
'"
t-
..:
~
00
....
.,;
....
....
oil
0-
..,
....
"!
;;;
..;
00
00
00
0-
....
0-
o
00
~
v
CD
'"
IV
Q.
...:l
<(
f-o
o
f-o