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

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: Water Treatment Plant Upgrades Application No.: 11 Application Date: 7/29/2026 Application Period: From 6/27/2026 to 7/31/2026 1. Original Contract Price $ 12,182,553.00 2. Net change by Change Orders $ 20,148.91 3. Current Contract Price (Line 1 + Line 2) $ 12,202,701.91 4. Total Work completed and materials stored to date $ 7,512,523.41 (Sum of Column G Lump Sum Total and Column G Unit Price Total) $ 7,512,523.41 5. Retainage a. 5% X $ 6,640,315.19 Work Completed $ 332,015.76 b. 5% X $ 872,208.22 Stored Materials $ 43,610.41 c. Total Retainage (Line 5.a + Line 5.b) $ 375,626.17 6. Amount eligible to date (Line 4 - Line 5.c) $ 7,136,897.24 7. Less previous payments (Line 6 from prior application) $ 5,849,541.80 8. Amount due this application $ 1,287,355.44 9. Balance to finish, including retainage (Line 3 - Line 4, plus 5c) $ 5,065,804.67 Contractor's Certification The undersigned Contractor certifies, to the best of its knowledge, the following: Contractor: Signature: Date: PAYMENT OF: $ 1,287,355.44 (line 8 or other - attach explanation of the other amount) Recommended by Engineer Approved by Owner By: By: Title: Title: Date: Date: Approved by Funding Agency By: By: Title: Title: Date: Date: EJCDC® C-620 Contractor's Application for Payment © National Society of Professional Engineers for EJCDC. All rights reserved. 00 62 76 - 1 of 11 G:\13\13603\13603021\Pay Apps\Pay App #11\13603021_Tiffin WTP Pay App #1 (IFA)