contract agreement · E-3
Approval of Pay Application #1 – Neumiller Electric, Inc – Roberts Ferry Rd & Village Drive Traffic Signal Improvements — E-3
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Text read by the vision model; check the PDF for anything that matters.Contractor's Application for Payment
Owner: City of Tiffin
Engineer: MSA Professional Services
Contractor: Neumiller Electric, Inc
Project: Roberts Ferry Rd & Village Dr Traffic Signal Improvements
Contract: Traffic Signal Improvements
Owner's Project No.: _______________________
Engineer's Project No.: 13603030
Contractor's Project No.: 26-084-U
Application No.: 1
Application Date: 9/25/2026
Application Period: From 6/2/2026 to 9/20/2026
<table>
<tr>
<th> </th>
<th> </th>
<th> </th>
</tr>
<tr>
<td>1. Original Contract Price</td>
<td>$367,853.75</td>
<td></td>
</tr>
<tr>
<td>2. Net change by Change Orders</td>
<td>$-</td>
<td></td>
</tr>
<tr>
<td>3. Current Contract Price (Line 1 + Line 2)</td>
<td>$367,853.75</td>
<td></td>
</tr>
<tr>
<td>4. Total Work completed and materials stored to date<br>(Sum of Column G Lump Sum Total and Column G Unit Price Total)</td>
<td>$209,767.29</td>
<td></td>
</tr>
<tr>
<td>5. Retainage<br>a. 3% X $112,387.29 Work Completed</td>
<td>$3,371.62</td>
<td></td>
</tr>
<tr>
<td>b. 3% X $97,380.00 Stored Materials</td>
<td>$2,921.40</td>
<td></td>
</tr>
<tr>
<td>c. Total Retainage (Line 5.a + Line 5.b)</td>
<td>$6,293.02</td>
<td></td>
</tr>
<tr>
<td>6. Amount eligible to date (Line 4 - Line 5.c)</td>
<td>$203,474.27</td>
<td></td>
</tr>
<tr>
<td>7. Less previous payments (Line 6 from prior application)</td>
<td>$-</td>
<td></td>
</tr>
<tr>
<td>8. Amount due this application</td>
<td>$203,474.27</td>
<td></td>
</tr>
<tr>
<td>9. Balance to finish, including retainage (Line 3 - Line 4, plus 5c)</td>
<td>$164,379.48</td>
<td></td>
</tr>
</table>
Contractor's Certification
The undersigned Contractor certifies, to the best of its knowledge, the following:
Contractor: Neumiller Electric, Inc.
Signature: [signature]
Date: 9-28-2026
PAYMENT OF: $203,474.27
(line 8 or other - attach explanation of the other amount)
Recommended by Engineer
By: [signature]
Title: Project Manager
Date: 09/29/2026
Approved by Owner
By:
Title:
Date:
Approved by Funding Agency
By:
Title:
Date:
Sources
- revize: E-3 (pD5y6iEeRYwUDWA3d5zB3yktkYvu3W.pdf) — where it was found ↗ first seen Oct 12, 2026
Attached to agenda item: E-3 Approval of Pay Application #1 – Neumiller Electric, Inc – Roberts Ferry Rd & Village...
Data last updated October 15, 2026. Built from the archive's documents; see how the data is built.