Packet: Tiffin Regular City Council Meeting (07/07/2026)

Contractor's Application for Payment Owner: City of Tiffin Engineer: MSA Professional Services Contractor: Tricon Construction Group Project: Water Treatment Plant Upgrades - City of Tiffin Contract: Water Treatment Plant Upgrades Owner's Project No.: Engineer's Project No.: 13603016 Contractor's Project No.: Application No.: 10 Application Date: 6/26/2026 Application Period: From 5/21/2026 to 6/26/2026 <table> <tr> <th> </th> <th> </th> <th> </th> </tr> <tr> <td>1. Original Contract Price</td> <td>$</td> <td>12,182,553.00</td> </tr> <tr> <td>2. Net change by Change Orders</td> <td>$</td> <td>12,420.34</td> </tr> <tr> <td>3. Current Contract Price (Line 1 + Line 2)</td> <td>$</td> <td>12,194,973.34</td> </tr> <tr> <td>4. Total Work completed and materials stored to date<br>(Sum of Column G Lump Sum Total and Column G Unit Price Total)</td> <td>$</td> <td>6,157,412.42</td> </tr> <tr> <td>5. Retainage<br>a. 5% X $ 5,500,495.59 Work Completed<br>b. 5% X $ 656,916.83 Stored Materials<br>c. Total Retainage (Line 5.a + Line 5.b)</td> <td>$</td> <td>275,024.78<br>32,845.84<br>307,870.62</td> </tr> <tr> <td>6. Amount eligible to date (Line 4 - Line 5.c)</td> <td>$</td> <td>5,849,541.80</td> </tr> <tr> <td>7. Less previous payments (Line 6 from prior application)</td> <td>$</td> <td>4,796,094.74</td> </tr> <tr> <td>8. Amount due this application</td> <td>$</td> <td>1,053,447.06</td> </tr> <tr> <td>9. Balance to finish, including retainage (Line 3 - Line 4, plus 5c)</td> <td>$</td> <td>6,345,431.54</td> </tr> </table> Contractor's Certification The undersigned Contractor certifies, to the best of its knowledge, the following: Contractor: Tricon Construction Group Signature: Mary K. Stone Date: 6/26/2026 PAYMENT OF: $1,053,447.06 (line 8 or other - attach explanation of the other amount) Recommended by Engineer By: [signature] Title: Senior Project Engineer Date: 6/30/2026 Approved by Funding Agency By: [signature] Title: [title] Approved by Owner By: [signature] Title: [title] Date: [date]