I-5 - Resolution 2025-068 - Approving Partial Release of Escrow for Tiffin West

TO (OWNER): Honey Lane Development 740 Kacena Rd Hiawatha, IA 52233 PROJECT: Tiffin West Phase 1 3287 Ireland Ave Tiffin, IA 52340 APPLICATION NO.: 11 PERIOD TO: 5/31/2025 DISTRIBUTION TO: - OWNER - ARCHITECT - CONTRACTOR FROM (CONTRACTOR): Schrader Excavating & Grading 300 Hwy 151 E P.O. Box 270 Walford, IA 52351 VIA (ARCHITECT): Burrington Group ARCHITECT'S PROJECT NO: CONTRACT FOR: 1523 CONTRACT DATE: 2/28/2024 CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for Payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Type Document is attached. 1. ORIGINAL CONTRACT SUM ......................... $ 1,088,518.99 2. Net Change by Change Orders .................... $ 728,563.71 3. CONTRACT SUM TO DATE (Line 1 + 2) ............. $ 1,817,082.70 4. TOTAL COMPLETED AND STORED TO DATE .......... $ 1,817,082.70 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. CONTRACTOR: Schrader Excavating & Grading 300 Hwy 151 E P.O. Box 270 Walford, IA 52351 By: /s/ Kyle Nordman Kyle Nordman / Vice President State of: IA County of: Linn Subscribed and Sworn to before me this 29th Day of May 2025 Notary Public: Alena Frederick My Commission Expires: June 27, 2025 5. RETAINAGE: a. 5.00 % of Completed Work $ 90,854.15 b. 0.00 % of Stored Material $ 0.00 Total retainage (Line 5a + 5b) ..................... $ 90,854.15 6. TOTAL EARNED LESS RETAINAGE ............... $ 1,726,228.55 (Line 4 less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) .................... $ 1,264,375.19 8. CURRENT PAYMENT DUE .......................... $ 461,853.36 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) ................................ $ 90,854.15 <table> <tr> <th>CHANGE ORDER SUMMARY</th> <th>ADDITIONS</th> <th>DEDUCTIONS</th> </tr> <tr> <td>Total changes approved in previous months by Owner</td> <td>996,611.20</td> <td>-328,822.99</td> </tr> <tr> <td>Total approved this Month</td> <td>68,110.50</td> <td>-7,535.00</td> </tr> <tr> <td>TOTALS</td> <td>1,064,921.70</td> <td>-336,357.99</td> </tr> <tr> <td>NET CHANGES by Change Order</td> <td>728,563.71</td> <td></td> </tr> </table> ARCHITECT'S CERTIFICATE FOR PAYMENT In Accordance with the Contract Documents, based on on-site observations and the data comprising the above application, the Architect certifies to owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated, the quality 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 if amount certified differs from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are changed to conform to the amount certified.) 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.