Approval of State Revolving Fund (SRF) Reimbursement Request #7 - Water Treatment Facility Upgrade Project — E-4

Progress Estimate - Lump Sum Work Contractor's Application for Payment Owner: City of Tiffin Owner's Project No.: Engineer: MSA Professional Services Engineer's Project No.: 13603016 Contractor: Tricon Construction Group Contractor's Project No.: Project: Water Treatment Plant Upgrades - City of Tiffin Contract: Application No.: 12 Application Period: From 06/27/26 to 07/23/26 Application Date: 07/24/26 Change Orders 238 Change Order #1 - - 239 Electrical Controls Changes $12,420.34 - - 0% 12,420.34 240 - - - 241 Change Order #2 - - - 242 COR #003R2-Water Service Addition 3,454.10 - 3,018.07 3,018.07 87% 436.03 243 COR-004+-Xfmr Pad relocate & bollards 1,804.21 - - 0% 1,804.21 244 COR -006 - Chem Containment Curbs 1,022.01 - 1,022.01 1,022.01 100% - 245 COR -007 - Bldg 10 Load Brg Wall Chngs 2,556.62 442.75 442.75 17% 2,113.87 246 COR-008R-12" Valve Add,6" Valve Deducts (1,619.74) (1,619.74) (1,619.74) 100% - 247 COR-010-MCC Rm Intake Duct Addition 3,402.31 - - 0% 3,402.31 248 COR-012-Low Lift Pump Efficiency Credit (2,890.94) (2,890.94) (2,890.94) 100% - - - - - - - - - - - - - - - - - - - Change Order Totals $ 20,148.91 $ (4,067.93) $ 4,040.08 $ - $ (27.85) 0% $ 20,176.76 Original Contract and Change Orders Project Totals $ 12,202,701.91 $ 5,400,495.59 $ 1,239,819.60 $ 872,208.22 $ 7,512,523.41 62% $ 4,690,178.50 EJCDC® C-620 Contractor's Application for Payment © National Society of Professional Engineers for EJCDC. All rights reserved. 00 62 76 - 10 of 11 G:\13\13603\13603021\Pay Apps\Pay App #11\13603021_Tiffin WTP Pay App #1 (IFA)