K-4 - Pay Application 3 - Kimberlite Street South Improvements

Page 4 of 4 CONTINUATION PAGE APPLICATION #: 3 PROJECT: Kimberlite St.-Tiffin Kimberlite St.-South Improvements DATE OF APPLICATION: 09/05/2024 PERIOD THRU: 09/05/2024 Payment Application containing Contractor's signature is attached. PROJECT #s: Cc D | E F G H J A B TOTAL % BALANCE _ | RETAINAGE STORED (If Variable) sa rorrerrmaa COMPLETED WORK AMOUNT AMOUNT MATERIALS | COMPLETED AND | COMP TO ITEM # WORK DESCRIPTION AMOUNT PREVIOUS | THISPERIOD |(NOT IND ORE) STORED (G/C)| COMPL ETION (D+E+F) (C-G) PERIODS QTY $ AMT $55.00 $0.00 $0.00 $0.00 $0.00 0% $55.00 33 Inlet Protection Device Maint. nn A.ee [ence voeeeneeees eeedheceeee s $55.00 PER Each | 1-0 0 0.0 0. 0.0 0. $0.00 i$0.00 $3,500.00 | 100% $0.00 34 Construction Survey $3,500.00 $3,500.00 ree sl PER LS od 1,00eee } 1,00. ...|!0.0 0... e e See 5OOO nnce cwon nos | oeeeeeseeee | . 35 Mobilization $3,500.00 $9,000.00 $9,000.00 $0.00 $0.00 $9,000.00 | 100% $0.00 LS od 1.00ed 1,00 PER0 0.00 f000ef0.00 0.00) dee eee [$9,000.0 TOTALS $248,581.55 $252,240.50 $0.00 $0.00 $252,240.50 | 101% ($3,658.95) Quantum Software Solutions, Inc. Document CONTINUATION PAGE