staff report memo · K-6
Discussion and Consideration of Approval of State Revolving Fund (SRF) Reimbursement Request #3 – Water Treatment Facility Upgrade Project – Motion to Approve — K.6
Page 3 of 15
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: 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.: 7
Application Date: 3/27/2026
Application Period: From 2/21/2026 to 3/27/2026
<table>
<tr>
<th> </th>
<th> </th>
<th> </th>
</tr>
<tr>
<td>1. Original Contract Price</td>
<td>$ 12,182,553.00</td>
<td></td>
</tr>
<tr>
<td>2. Net change by Change Orders</td>
<td>$ 12,420.34</td>
<td></td>
</tr>
<tr>
<td>3. Current Contract Price (Line 1 + Line 2)</td>
<td>$ 12,194,973.34</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>$ 2,861,085.19</td>
<td></td>
</tr>
<tr>
<td>5. Retainage<br>a. 5% x $ 2,577,764.99 Work Completed<br>b. 5% x $ 283,320.20 Stored Materials<br>c. Total Retainage (Line 5.a + Line 5.b)</td>
<td>$ 128,888.25<br>$ 14,166.01<br>$ 143,054.26</td>
<td></td>
</tr>
<tr>
<td>6. Amount eligible to date (Line 4 - Line 5.c)</td>
<td>$ 2,718,030.93</td>
<td></td>
</tr>
<tr>
<td>7. Less previous payments (Line 6 from prior application)</td>
<td>$ 2,380,846.68</td>
<td></td>
</tr>
<tr>
<td>8. Amount due this application</td>
<td>$ 337,184.25</td>
<td></td>
</tr>
<tr>
<td>9. Balance to finish, including retainage (Line 3 - Line 4, plus 5c)</td>
<td>$ 9,476,942.41</td>
<td></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: 3/27/26
PAYMENT OF: $ 337,184.25
(line 8 or other - attach explanation of the other amount)
Recommended by Engineer
By: [signature]
Title: Senior Project Engineer
Date: April 2, 2026
Approved by Funding Agency
By: __________________________
Title: __________________________
Date: _________________________
Approved by Owner
By: __________________________
Title: __________________________
Date: _________________________
Date: _________________________ Date: _________________________
Sources
- revize: K.6 (9xvwpqTcLqtJYXREIb0a0RiyGeR5wC.pdf) — where it was found ↗ first seen Oct 12, 2026
Attached to agenda item: K-6 Discussion and Consideration of Approval of State Revolving Fund (SRF) Reimbursement...
Data last updated October 15, 2026. Built from the archive's documents; see how the data is built.