contract agreement · E-4
Approval of Pay Application #14 - Tricon Construction - Water Treatment Facility Upgrade Project — E-4
Page 2 of 12
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.: 14R
Application Date: 10/23/2026
Application Period: From 9/25/2026 to 10/23/2026
<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>57,799.31</td>
</tr>
<tr>
<td>3. Current Contract Price (Line 1 + Line 2)</td>
<td>$</td>
<td>12,240,352.31</td>
</tr>
<tr>
<td>4. Total Work completed and materials stored to date<br>(Sum of Column G Lump Sum Total and Column G Unit Price Total)</td>
<td>$</td>
<td>10,772,645.47</td>
</tr>
<tr>
<td>5. Retainage<br>a. 5% X $ 10,440,899.11 Work Completed<br>b. 5% X $ 331,746.36 Stored Materials<br>c. Total Retainage (Line 5.a + Line 5.b)</td>
<td>$</td>
<td>522,044.96<br>16,587.32<br>538,632.28</td>
</tr>
<tr>
<td>6. Amount eligible to date (Line 4 - Line 5.c)</td>
<td>$</td>
<td>10,234,013.19</td>
</tr>
<tr>
<td>7. Less previous payments (Line 6 from prior application)</td>
<td>$</td>
<td>9,699,565.50</td>
</tr>
<tr>
<td>8. Amount due this application</td>
<td>$</td>
<td>534,447.69</td>
</tr>
<tr>
<td>9. Balance to finish, including retainage (Line 3 - Line 4, plus 5c)</td>
<td>$</td>
<td>2,006,339.12</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: 10-29-2026
PAYMENT OF: $534,447.69
(line 8 or other - attach explanation of the other amount)
Recommended by Engineer
By: Clint White
Title: Senior Project Engineer
Date: 10/29/2026
Approved by Funding Agency
By: ____________________________
Title: ____________________________
Approved by Owner
By: ____________________________
Title: ____________________________
Date: ____________________________ Date: ____________________________
Sources
- revize: E-4 (00L6VnYDu28uGYFo8S1NM0AY3BAEzH.pdf) — where it was found ↗ first seen Oct 31, 2026
Attached to agenda item: E-4 Approval of Pay Application #14 - Tricon Construction - Water Treatment Facility...
Data last updated November 1, 2026. Built from the archive's documents; see how the data is built.