IAC/PSCP FORM 302.4 COST ESTIMATE SUMMARY PAGE 1 of 12, LEA: DATE: PROJECT TITLE: PSC NO: Cost Estimate for: Planned Bid Date Design Capacity Building Gross Area New/Add Renovation Total I Design Development General building description number of stores, type of construction, eto: Construction Document Existing wall perimeter Acres of Site Developed Undeveloped Total [ee [carson | ee | wasone 1 arin a erasIAC/PSCP FORM 302.4 COST ESTIMATE SUMMARY PAGE 2 of 12 LEA: PROJECT TITLE: AREAS AT STAGES NEW 80. FT, RENOVATED SQ. FT. FINAL SQ. FT. EDUCATIONAL SPECIFICATIONS ‘SCHEMATIC DESIGN DESIGN DOCUMENTS ‘CONSTRUCTION DOCUMENTS COST PER SQ. FT. Percent Inflation and percent Contingency of costs reported on page 1. Ineligible areas included (square feet: Energy Index (BTU's/Sa. Ft./Yeat Local construction funds to be available: and cover costs of items identified below: (monthiyear| Ineligible Areas: fo Off-Site Work: Alternates: See Indicate and list costs of the following: Permits s Water Connections $ Insurance 8 Sewer Connections 8 Cost estimated or confirmed by project architect and accepted by Board of Education. “Signature of ArchitectEnaineer ‘Sanature of LEA representativeIACIPSCP FORM 302.4 COST ESTIMATE WORKSHEET PAGE 3 of 12 LEA: PROJECT TITLE: ESTIMATED esTiMATED a csi. CATEGORY cost OF NeW Cost oF on CONSTRUCTION RENOVATION ow1 | GeneRat conomons ow 2 | sitework 22050 | Dematon 02110 | Clearing 02140 | dewatering 02210 | ste Gradina 02220 | excavation & Backing 02270 | Erosion Convo! 02360 | rings 02370. | caissons o2aaa | Fences 02450 | Roads & Walks cute outers Parking 02400 | Play Fields & Equipment 02461 | Payground Equipment 02405 | Lawne 02491 | trees 02492 | shape 02619 | Aspnatt Pavine 02616 | concrete Paving 02600 | sit Unies to 10’ of buna Water Sewer Storm oss 102800 | site Improvements\AC/PSCP FORM 302.4 COST ESTIMATE WORKSHEET PAGE 4 of 12 LEA: DATE: PROJECT TITLE: PSC NO: cs CATEGORY te a ora ae Total Site Work piva_| concrete 03100 | Formwork 03200 | Reinforcement 03250 | Accessories 03300 | castinolace 03310 | Structural Concrete Piers Grade Beams Footings Slab on Grade Woter Stops Concrete Staits 03400 | Pre-cast Structural 03450 | pre-cast Architectural 03800 | Cementitious Decks other Total Conerete piv | masonry oat00 | Mortar (04210. | Brick Masonry (04213 | Structural Glazed Tile Masonry (04220 | Concrete Unit Macony 04270. | Giaes Unit Masonry 04800 | stone OtherIAC/PSCP FORM 302.4 COST ESTIMATE WORKSHEET PAGE 5 of 12, Le, DATE: PROJECT TITLE: PSC NO: ESTIMATED ESTIMATED. TOTAL cs. CATEGORY COST OF NEW cost oF cost CONSTRUCTION RENOVATION Total Masonry pis | meraLs : 05120 | Structural Stee! 05210 | Steel Joists 05311 | Steel Deck 05400 | Cold-formed Metal Framing 05510 | Metal Stairs 05520 | Handrails & Railings 05530 | Gratings 05700. | Ornamental Metal other a Total Metals pve | woop & PLASTICS 06100 | Rough Carpentry 06200] Finish Carpentry 6400 | Architectural Woodwork 06600 | Piestic Fabrications Other Total Wood & Plastics Div 7 | THERMAL & MOISTURE PROTECTION 07100, | Waterproofing walls Slabs 07150. | Dempprooting 07210} Building insuation o7240 | BLES. 07260. | FireproofingIAC/PSCP FORM 302.4 COST ESTIMATE WORKSHEET PAGE 6 of 12 LEA: PROJECT TITLE: ESTIMATED ESTIMATED aon csi. CATEGORY OST OF NEW COST OF coer CONSTRUCTION RENOVATION. 07300 | Shingles & Rooting Ties 07400. | Preformed Roofing & Siding 07412 | Metal Roofing 07500 | Membrane Roofing 07810 | Builtup Rooting 07600 | Flashing & Sheet Metal 07810 | Skylights 07900 | Sealants Other Total Thermal & Moisture Protection piv8 | Doors & WINDOWS 08100 | Metal Doors & Frames (08210 | Wood Doors 06331 | Overhead Doors 08350. | Folding Doors 08400 | Entrancos & Storefronts 08500. | Metal Windows 08700 | Haraware 08800 | Glazing 08900 | Glazed Curtain Walls omer Total Doors & Windows pve | rNisHes 09100 | Metal Support Systems 09200, | Lath & Plaster 09250 | Gypsum Board 09310 | Ceramic Tie 09330 | Quarry TieIAC/PSCP FORM 302.4 COST ESTIMATE WORKSHEET PAGE 7 of 12 LEA: DATE: PROJECT TITLE: PSC NO: ESTIMATED. ESTIMATED TOTAL cs. CATEGORY COST OF NEW cost oF cost CONSTRUCTION RENOVATION 09400 | Terrazzo 09510 | Acoustical Cellings 09511 | Acoustical Pancis 09550 | Wood Flooring 09650 | Resilient Flooring 03680 | Carpet 09800 | Special Coatings 09900 | Painting 09950 | Wall Coverings Other [ Tota rises piv 10 | SPECIALTIES 10100 | Chalkboards, Tackboards 10160 | Toilet Partitions & Accessories 10200. | Louvers & Vents 10270} Access Flooring 10350 | Flagpoles 10420 | Plaques 10440 | Sians 10500 | Lockers 10521 | Fire Extinguishers 10522 | Fire Extinguisher Cabinets 10523 | Fire Blankets 19610 | Demountable Partitions 10620 | Folding Partitions 10624 | Folding Gates 10871 | Metal Sheiving Wire Shelving || 1997\ACIPSCP FORM 302.4 COST ESTIMATE WORKSHEET PAGE 8 of 12 LEA: DATE: PROJECT TITLE: PSC NO: csi caTeGoRY cere lew Sere oral 10800 | Toilet & Bath Accessories other par | cquement 11050 | Book Theft Protection 11081 |} Stage Rigging 11062 | Stage Curtains 11065 | Portable Stages, Risers 11132 | Projection Screens 11172. | Waste Compactors 11400. | Food Service Equipment 11450. | Residential Equipment 11460. | Unie Kitchens 11481 | Scoreboards 11486 | Gymnasium Equipment 11501 | Paint Spray Booths Total Equipment ult — | 12301 | Metal Casework Other piv 12_| FURNISHINGS 12302 | Wood Casework 12510 | Binds & Shades 12710 | Auditorium Seating 12760 | Teleecoping Bleachers other | Total FurnishingsIAC/PSCP FORM 302.4 COST ESTIMATE WORKSHEET PAGE 9 of 12 LEA: DATE: PROJECT TITLE: PSC NO: [ ESTIMATED ESTIMATED a csi. CATEGORY cost OF NEW cost OF cer | CONSTRUCTION RENOVATION SPECIAL CONSTRUCTION Le 13123 | Greenhouses 13125 | Grandstands & Bleachers 13151 | Swimming Poo! 13410 | Liquid & Gas Storage Tanks 13940 | aulding Automation Systems 13970 | Fire Supp./Supervisory System L ote “Total Special Construction pwv 14 | convevine systems 14200 | Elevotors 14415 | Whostchair Lifts other piv 1s | MECHANICAL Total Conveying Systems 15250. | Mechanical insulation 15200} Fire Protection 16210 | Fire Protection Ping 15220 | Fire Pumps 115330 | Wer Piped Sprinkler Systems Other Fire Protection 15400, | Plumbing 18408 15410. | Plumbing Piping 15424 | Domestic Water Heaters 15450 | Plumbing Equipment Water Dietibution Pumps [osCOST ESTIMATE WORKSHEET IAC/PSCP FORM 302.4 PAGE 10 of 12 LEA: DATE: PROJECT TITLE: PSC NO: ESTIMATED ESTIMATED ee cS. CATEGORY COST OF NEW cost OF cost CONSTRUCTION RENOVATION 15475. | Fool & Fountain Equipment | is120 | soncia systems 15491 | Compressed Air Systems 16488 | Gas Piping System Other Plumbing 15550. | Heat Generation 15555 | Boilers 18575 | Breechings/Chimneys/Stacks 19590 | Fuel Handling Systems ther Heat Generation 15660 | Refrigeration 19658 | Compressors 16620 | Water Chillers 18710 | Cooling Towers 15730 | Liquid Coolers 15740. | Condensers oxner Coating 15760. | Heat Transfer 16758. | Heat Exchangers 16770 | Heat Pumps 15780 | Packaged Air Conditioning Units 19790 | Air Cols 15830. | Tecminol Heat Transfer Units 15845, | Energy Recovery Units (Other Heat Transfer 15860 | Air Handling 19255 | Units and CosCOST ESTIMATE WORKSHEET \AC/PSCP FORM 302.4 PAGE 11 of 12 LEA: DATE: PROJECT TITLE: PSC NO: ESTIMATED. ESTIMATED a GtAl cs. CATEGORY COST OF NEW cost oF pe CONSTRUCTION RENOVATION 16870 | Power Ventilators (Other Air Handing 1680 | Ai Distrbution 15885 | Air Clesning Devices 16890} Ductwork 15930 | Air Terminal Units 15940. | Air Outlets & inlets (other Air Distribution 15950. | Controls 15955. | Building Systems Controls 18860 | EM, &C. Systeme 15970 | Control Systems Other Controle 15990 | TestingiAcjusting/Balencing Total Mecharical = piv 16 | ELECTRICAL 16050 | Bacie Materials & Methods yer10 | Raceways 16120. | wires & Cables 1610 | Bows 16140. | Wiring Devices 16160 | Cabinets & Enclosures ‘Other Basic Electrical 16400 | Service & Distribution 16420. | Service Entrance 16425. | Switchboards 16465 | Bus Duct 16470 | PanetboardsCOST ESTIMATE WORKSHEET 1AC/PSCP FORM 302.4 PAGE 12 of 12, LE DATE: PROJECT TITLE: PSC NO: T estwaren ESTIMATED ree cs. CATEGORY COST OF NEW cost oF tee CONSTRUCTION RENOVATION, ther Service & Distribution 16500 | Ushting 16501 | Lamps 16510 | Interior Luminaries 16520. | Exterior Luminaries 16595 | Emergency Litto 16500 | Theatrical Lighting Other Lighting 16600. | Special Systems 16820 | Packaged Engine Gen. System 16870 | Lightning Protection System other Special Systems 16700 | Communications 16720. | Alarm & Detection Syatoms 16730. | clock & Prosram Systems 16740. | Voice & Dato Systoms 16741 | Telephone Distribution System 16760 | intercom System 16770 | P.A. & Music System 10780. | TV. System 16765 | Satelite Systems ‘other Communications 16900 | Controts Total Electrical TOTAL AILIAC/PSCP FORM 303.1 CONSTRUCTION DOCUMENT SUBMISSION LEA: DATE: PROJECT TITLE: PSC NO: Previous titles used for this project: ete Architect/Engineer: Ce Date of approval of D.D.’s by the Interagency Committee: Do the construction documents submitted follow the concept of the design development documents? YES No If "NO", list changes: cdot ies oe ee ee ee ‘The following items ere included with this submission: [Submit thro copies as directed) Specifications Drawings Updated Electrical Calculations Updated Electrical Power Requirements Updated Mechanical Calculations Construction Document Analysis (Form 303.2) Updated Cost Estimate Summary & Worksheet Form 302.4) Other (describe) _| NOTE: EACH ITEM MUST REFLECT DATE OF ISSUE. \ hereby request that these construction documents be reviewed and approved as submitted Signature of LEA ReprasentativeIACIPSCP FORM 303.2 CONSTRUCTION DOCUMENT ANALYSIS LEA: DATE: PROJECT TITLE: PSC NO: ‘SCHEDULE DATE D.D.’s approved by IAC Design Capacity: €.D.'s approved by LEA Site Developed: Advertise for Bid Total Site: Contract Award Air Conditioned: % Completion Sprinklered: ___ ves = __ NO GROSS SQUARE FEET SN ene ‘CODES STATE LOCAL, TOTAL 4 Existing Building = : Building New/Add Electrical Renovation Mechanical | Demoiton Plumbing Proposed Total Energy ‘MAXIMUM CONSTRUCTION ALLOCATION STATE LOCAL TOTAL AE EST. Building 3 Site Development 3 Total 3 ALTERNATES ‘STATE LOCAL a 2. 3. 4. 5. 6. Gignature of LEA RepresentativeIACIPSCP FORM 303.3 APPROVAL OF CONSTRUCTION CONTRACT AWARD LEA: DATE: PROJECT TITLE: PSC NO: FUNDS AVAILABLE CONTRACT SCOPE Total State Allocation _$ New Sq. Ft. Local Funds 8 Reno Sq. Ft. Other™ 8 Demo Sq. Ft. TOTAL a PROPOSED CONTRACT AWARD Date of bid opening STATE LOCAL TOTAL Building/Site Other* Total Contract Contingency (i) Total Project +Source of Other Funds: Recommendation is for the acceptance of the BASE BID and alternates list alternates in BOXES) as submitted by SF ag ee cocce2 ose ee eae ee | for the total amount of _$ REQUIRED ATTACHMENTS: if Copy of bid package submitted by low bidder Minority Business Enterprise information Brief description of alternates: Copy of bid tabulation Signature of LEA RepresentativeOWNER/CONTRACTOR AGREEMENT LEA: PROJECT TITLE: —_— ——— IAC/PSCP FORM 303.4 DATE: PSC NO: ‘Complete this form in single copy and use as transmittal Jotter for agreement between owner and contractor, al Date of Interagency Committee approval of contract award: State funds approved: = Local funds approved: 2 Total amount of approved contra z Indicate material submitted: Signed Contract Performance Bond Labor & Material Bond Other Wdentity) Other ddentity) Other ddentiy) = I hereby submit to the Interagency Committee the enclosed agreement for filing to substantiate junre each payments when requested on this local education agency's Monthly Financial Report, JACIPSCP Form 306.3. er SignatureIAC/PSCP FORM 305.1 CHANGE ORDERS LEA: DAT! PROJECT TITLE: PSC NO: Original State contingency allocation: Change Orders previously submitted: 1 thy Change Order No. Brief Description Amount (8) [hereby request approval of the change order es described herein. “Architects Signature | Date Signature of LEA Representative / Date@ INSTRUCTIONS FOR COMPLETION OF FORM 305. ‘All amounts shall be rounded to the nearest whole dollar. One copy of all change orders issued for a project must be submitted to PSCP at the same time of issue to the contractor. Use a separate form for each project. Do not enter change orders for more than oft project on any single form. However, more than one change order for any one project may be submitted on a single form. Include with the change order submission a letter from the architect recommending his approval of all change orders listed. Include sufficient documentation to allow determination of State funding. NOTE: Copy on WHITE paper.INSTRUCTIONS FOR COMPLETION OF FORM 306.1 1. Amount entered shall not be rounded up or down. 2, PSC Allocation: The allocation to be entered is the current amount allocated for the project including formal adjustments approved in the Interagency Committee minutes. ‘Total State Approved Contracts: Show only the cumulative amount of contracts approved By ihe Interagency Committee. This includes construction contracts and change orders. Refer to the "Approved Contracts" column on the monthly printout. 4, Invoices; The following documentation must be attached to process this request: «Construction: The most recent "Standard Contractor’s Requisition for Payment" including a listing of all change orders issued to date with original signatures. « Systemic/Relocatables: The most recent Contractor's invoice including all billings to Gate and a listing of all change orders issued to date with original signatures, 5, Signature: This form must be signed by the LEA Superintendent or an authorized representative.TAC/PSCP FORM 306.1 LEA REQUEST FOR PAYMENT TO CONTRACTOR LEA: DATE: ‘SCHOOL NAME; PSC #: (CONSTRUCTION PROJECT TYPE: ‘SYSTEMICRENOVATION LEA VOUCHER # TT RELOCATABLE TOTAL STATE PSC ALLOCATION: APPROVED CONTRACTS: PRIOR STATE PAYMENTS/REIMBURSEMENTS: PAYEE NAME AND ADDRESS: _ joa foie rasta Soe ii ie ee TAX IDE | INVOICE TRVOKE NUMBER DATE AMOUNT TOTAL, LOCAL COSTS _- TOTAL REQUEST ‘hereby certify thatthe invoices reflected on tis isting have been approved for payment by ll local responsible persons, are fo a project previously approved bythe State Board of Public Works for funding tea the Pablie School Construction Program, ae applicable to contractual agreements approved by the tmeragency Coramitee on School Consiruction, and have not been previously submited for payment Tignature oF LEA Representative Revised 7/1/00INSTRUCTIONS FOR COMPLETION OF FORM 306.2 Amount entered shall not be rounded up or down. PSC Allocation: The allocation to be entered is the current amount allocated for the project including formal adjustments approved in the Interagency Committee minutes. Total State Approved Contracts: Show only the cumulative amount of contracts approved by the Interagency Committee. This includes construction contracts and change orders. Refer to the "Approved Contracts" column on the monthly printout. Cancelled Checks: Copies of cancelled checks or IAC/PSCP Form 306.2a, "Contractor's Certification of Receipt of Payment" must be attached to this request. Invoices: The following documentation must be attached to process this request: © Construction: The most recent "Standard Contractor's Requisition for Payment” including a listing of all change orders issued to date with original signatures. « Systemic/Relocatables: The most recent Contractor's invoice including all billings to date and a listing of all change orders issued to date with original signatures. Signature: ‘This form must be signed by the LEA Superintendent or an authorized representative.IACIPSCP FORM 306.2 REQUEST FOR REIMBURSEMENT TO LEA LEA: DATE: ‘SCHOOL NAME: PSC #: ‘CONSTRUCTION PROJECT TYPE: ‘SYSTEMIC RENOVATION LEA VOUCHER # RELOCATABLE, TOTAL STATE PSC ALLOCATION: APPROVED CONTRACTS: MAIL PAYMENT TO THE FOLLOWING ADADDRESS: A se ee eh ee SN SS ay oo TAX ID # | REQUEST REIMBURSEMENT FOR THE FOLLOWING PROJECTS: INVOICE | INVOICE] DATE CONTRACTOR, NUMBER| DATE | PAID AMOUNT TOTAL. LOCAL COSTS_- ‘TOTAL REQUEST, hereby cry that this reimbursement request represen invoices that have been approved fr Payment PY 1A nea sexponsible persons, i for aproieet previously approved bythe State Board of Public Works for funding unr the Pulie School Constroction Progra, is applicable to contractual aprerens proved PY Interagency Comittee on School Construction, has not been previously submited for payment aarrrrsement and payment ofthis amount has been made by this Board of Eucation to the applicable ‘contractor from funds other than tax exempt bond proceeds. Signature of LEA Represeniaive Revised 7/4/00IAC/PSCP FORM 306.3 MONTHLY FINANCIAL REPORT White LEA: DATE: PROJECT TITLE: PSC NO: CASH SUMMARY for the Month/Year of PSC Allocation Total State Appv'd Contracts _§ Prior State Payments/Reimbursements __® EXPENDITURES PRIOR REPORTS THIS REPORT TOTAL TO DATE Construction AIE Fees Related Total PSC Costs Local & Other Grand Total NOTE: ATTACH COPIES OF THE APPROVED CONSTRUCTION REQUISITIONS AND RELATED INVOICES. \ hereby certify that expenses shown on this report are correct, have not been previously submitted, have been approved for payment by all local responsible persons, are for @ project previously approved by the State Board of Pubic Works for funding under :he cui School Construction Program, and are applicable to contractual agreements approved by the Interagency Committee on School Construction. STATE USE ome | tts ‘Signature of LEA Representative eccoce al INSTRUCTIONS FOR COMPLETION OF FORM 306.3 ‘All amounts shall be rounded to the nearest whole dollar. PSC Allocation A separate monthly financial report should be prepared for each project by funding year. The Public School Construction allocation to be entered on the form is the current amount allocated for the project including formal adjustments approved in Interagency Committee minutes. Total State Aporoved Contracts Show only the cumulative amount of contracts approved by the Interagency Committee. This includes construction contracts, change corere. architect fees, and related contracts. Refer to the “Approved Contracts column on the monthly printout. Expenditures ‘A. Construction Expenditures made on the general contract (including site development and transportables). Include a copy of all current requisitions. B. Ale Fees Expenditures made to the architect for services. Include @ copy of all current requisitions. ©. Related Expenditures for systemic renovation costs. Include a copy of all current requisitions. D. Local & Other An amount of any invoice or requisition that does not fit in the above categories. Signature This form must be signed by the LEA superintendent or his or her authorized representative. NOTE: Copy on WHITE paper.IAC/PSCP FORM 306.4 STANDARD MONTHLY CONTRACTOR'S PAGE 1 of 16 REQUISITION FOR PAYMENT LEA: DATE: PROJECT TITLE: PSC NO LOCATION: REQ N fe COMPLETED TO DATE CURRENT esi. TOTAL prion _| PAYMENT ov CATEGORY cost * i. REauisiTNs | DUE 7_| ceneRat conomrions 2_| se work 3 _[ concnere |_+__| masonny | 5 __[ metas © _| wooo a Puastics THERMAL & MOIST. PROTECTION ‘DOORS & WINDOWS FINISHES 10 SPECIALTIES u EQUIPMENT, BUILT-IN 2 FURNISHINGS, BUILTIN 13 ‘SPECIAL CONSTRUCTION CONVEYING SYSTEMS 18 MECHANICAL 16 ELECTRICAL TOTAL CHANGE ORDERS MATERIAL STORED TOTAL ADJUSTED LESS: RETAINAGE TOTAL | certify the above estimates and that timely pa} ‘tod will be, made to suppliers and subcontractors on this project, as requisitioned payments syments have been (except initial submission), are received, and in accordance with our contracts. ‘Name of Contractor Firm ‘Authorized Signature\AC/PSCP FORM 308.4 ead a Mea eee STANDARD MONTHLY CONTRACTOR'S PAGE 2 of 16 REQUISITION FOR PAYMENT LEA: PROJECT TITLE: PSC NO: LOCATION: REQ NO: NOTARIZATION County , to wit: I hereby certity that on this day of In the year of : before me, a Notary Public for said County, personally appeared (name), and made oath in due form of law that he/she is (title) of (name of firm}, and on behalf of said firm stated that the matters and facts set forth in the foregoing verification are true to the best of his/her knowledge, information and belief. He/she acknowledged that he/she executed the same purposes herein contained and that they had full authority to execute same. ‘As witness my hand and official seal: NOTARY PUBLIC, Reviewed and agreed justified to the best of my knowledge: ‘Architect SignaturelDate Signature of LEA RepresentatvelDate Remarks: Li.IAC/PSCP FORM 306.4 STANDARD MONTHLY CONTRACTOR'S HS REQUISITION FOR PAYMENT MINORITY BUSINESS ENTERPRISE PARTICIPATION LEA: + DATE: PROJECT TITLE: PSC NO: LOCATION: REQ NO: AMOUNT PAD TOTAL ose ram | vuLyt, TOTAL ones MBE THIS to PAID ADD NAME OF MBE contract | REQUISITION | JuNe30,__ | TODATE 2 3 4 6 8 TOTAL | certify that the figures and information presented above represent ments, that timely payments have been and will be, made to suppliers and subcontractors ton the project, 2s requisitioned payments are received, and in accordance with o accurate and true state- wur contracts. ‘Name of Contractor Firm ‘Authorized Signature/DateIAC/PSCP FORM 306.4 STANDARD MONTHLY CONTRACTOR'S PAGE 4 of 16 REQUISITION FOR PAYMENT LEA: DATE: PROJECT TITLE: PSC NO: LOCATION: REQ NO: ‘COMPLETED ‘TO DATE ‘CURRENT TOTAL PRIOR, PAYMENT cS. CATEGORY cost % 3 REQUISITIONS DUE piv | GENERAL CONDITIONS: pw2_ | SITE WORK : - + (02050 | demotion ‘2110 | Clearing 02140. | Dewatering 02210 | Ske Grading (02220. | Excavation & Backing 02270 | Erosion Control 02360 | Pings (02370 | Calssons ‘o2eea | Fences (02450. | Roads & Walks Curbs Gutters Parking 02460. | Play Fields & Equipment (02461 | Playground Equipment 2485 | Lawns 241 | Trees ‘2492 | shrubs (02513. | Asphalt Paving ‘02615 | Concrete Paving (02600 | Site Utttes to 10° of bids Water SeworIAC/PSCP FORM 306.4 STANDARD MONTHLY CONTRACTOR'S PAGE 5 of 16 REQUISITION FOR PAYMENT LEA: DATE: PROJECT TITLE: PSC NO: LOCATION: REQ NO: COMPLETED Toate cunnenr TOTAL enon | PAYMENT csi. | CATEGORY cost | % ¢ | eecusions | “ove om cw (02800. | Site improvements (02900. | Landscape Total Site Work Other — Hal piv3_ | concrete 103100. | Formwork (03200. | Reinforcement 03260 | Accessories 03300 | Castin-place [ cssio_[ Sear cone are | rade Seams Footings Slab on Grade Wate Stops Concrete See o2400 | Precast Smuctrl 92050 | Preces Archtecural J) ca500. | cements Oocke otter [recone pw | masonay #100 | MonaIAC/PSCP FORM 306.4 STANDARD MONTHLY CONTRACTOR'S PAGEIG o(16 REQUISITION FOR PAYMENT LEA: DATE: PROJECT TITLE: PSC NO: LOCATION: REQ NO: cr COMPLETED TOTAL 7 mon | PAYMENT cau | careconr | cor 7 | vetons | SRE ae [eae es merle! 1 owns [ eae = ee | pws | metas ie a cree | cone re oe C Tea Sale sae "I pivé | WOOD & PLASTICS S cee [Rach eom cen [cn nc oemIAC/PSCP FORM 306.4 STANDARD MONTHLY CONTRACTOR'S PAGE 7 of 16 REQUISITION FOR PAYMENT LEA: PROJECT TITLE: LOCATION: [ COMPLETED Toate coment TOTAL enon | armen csi. | caTeconY cost |x «| secusmons | “ove ov7 | Rattteoresnon || 4 7100 | Waterproofing Walls Slabs 07150. | Dampprocting (07210 | Building insuation o7240 | ELFS. (07250 | Fireprooting (07300 | Shingles & Roofing Tiles (07400. | Pre-formed Roofing & Siging (7412 | Metal Rooting (07500. | Membrane Roofing 07810 | Buiteup Roofing (07600 | Flashing & Sheet Metal ‘o7e10 | Skyiiahts (07900 | Sealants Other | “Total Thermal & Moist. Prot. pive | Doors & windows (08100 | Metal Doors & Frames 08210 | Wood Doors (08331 | Overhead Doors (08950 | Folding Doors (06400 | Entrances & Storefronts (08500 | Metal WindowsIAC/PSCP FORM 306.4 STANDARD MONTHLY CONTRACTOR’S PAGE 8 of 16 REQUISITION FOR PAYMENT LEA: DATE: PROJECT TITLE: PSC NO: LOCATION: REQ NO: aon | camera = Fras pwv9 | FINISHES 7 rial | oct a [aoa aa | ar sel sae | SEs ae [i arines = eee | iia | aeSTANDARD MONTHLY CONTRACTOR'S REQUISITION FOR PAYMENT IAC/PSCP FORM 308.4 PAGE 9 of 16 LEA: DATE: PROJECT TITLE: PSC NO: LOCATION: REQ NO: ra ae 5 To DATE ccunnent TOTAL PRIOR PAYMENT csi. CATEGORY cost $ aequisirions | DUE 10200 | Lowers & Vers 10270. | Access Roorina 10950 | Aagpoles 10420 | Plaques = ‘Signs 10500. | Lockers 10521 | Fe Exinguishers 10522 | Fre Extinguisher Cabinets 10523. | Fie Btonkets 0610 | demountable Partitions 70820. | Folding aritions 10624. | Folding Gatos 10671 | Metal Shing 10673. | Wire Shelving 10900 | Toilet & Bath Accessories otner otal Species pw it | cOUPMENT 11050. | Book Theft Protection v106t_ | Stage Riana 11062 | stoge Curtains 71065 | Portable Stages, Risers r 11132 | Projection Sereens 11172 | waste Compactors 11400 | Food Service EauipmentSTANDARD MONTHLY CONTRACTOR'S REQUISITION FOR PAYMENT IACIPSCP FORM 306.4 PAGE 10 of 16 LEA: DATE: PROJECT TITLE: PSC NO: LOCATION: REQ NO: ‘COMPLETED TO DATE ccunrent TOTAL Rion PAYMENT cs CATEGORY cost % $ nequismons | DUE 71460. | Resident! Equipment 11460. | Une Kitchens 11481 | Scoreboards 71486 | Gymnesim Eaubment 11601 _| Paine Spray Boothe othe r Team oral iB piv 2 | FURNISHINGS : 12201 | Metal Casework 12302 | wood Casework 12510 | Blinds & Shades 12710 | Austodum Seatna 12760. | Telescoping Bleachers over _| “Total Furishings al piv 13. | speciat consraucrion | 19123. | Greenhouses 13128 | Granceands & Bleachers 13151 | Swimming Poot 4 yas10 | uid & Gas Storage Tanks 12940 | Balding Automation System 13070 | Fre Supp /Superisory Sys other Total Special Construction |STANDARD MONTHLY CONTRACTOR'S REQUISITION FOR PAYMENT IAC/PSCP FORM 308.4 PAGE 11 of 16 LEA: DATE: PROJECT TITLE: PSC NO: LOCATION: REQ NO: co cconpuereo TO DATE conse TOTAL puon | PAYMENT csi CATEGORY cost : aeauismons | "DUE piv 14 | CONVEYING SYSTEMS 14200. | Elevators 14415 | Wheelchair Lifts other piv 15. | MECHANICAL 15250. | Mechanical Insulation 16300 | Fire Protection 15310 | Fre Protection Piping 16320. | Fire Pumps 16330 | Wet Piped Sprinkler System 15375. | standpipe and Hose System Other Fire Protection 48400. | Plumbing 15406 | Roof Drainage Systems 15410 | Plumbing Piping 15424 | Domestic Wator Heaters 15450. | Plumbing Equipment 15453. | Water Distrbution Pumps 75475. | Poot & Fountain Equipment 16480. | Special Systems 16431 | Compressed Air Systems 15488 | Gas ining System other Plumbing 15560 | Heat GenerationSTANDARD MONTHLY CONTRACTOR'S REQUISITION FOR PAYMENT IAC/PSCP FORM 306.4 PAGE 12 of 16 LEA: DATE: PROJECT TITLE: PSC NO: LOCATION: REQ NO: COMPLETED TO DATE ‘CURRENT TOTAL PRIOR PAYMENT cs. CATEGORY cost $ REQUISITIONS. DUE 15565 | Boilers 15575 | Breechings/Chimneys/Stacks 15580. | Fue! Handing Systems ‘Other Heat Generation 18650 | Rotrigeration 15655 | Compressors 16670 | Condensing Units 1680 | Water Chillers 18710 | Cooling Towers 18730 | Liquid Coolers 18740 | Condensers Other Cooting 18750. | Heat Transter 15755. | Heat Exchangers 15770 | Heat Pumps: 18780. | Pkad Air Concitioning Units 18790 | AirCoils 15830. | Terminal Heat Transfer Units 15045 | Energy Recovery Units z other Heat Transfer 16250. | Air Handling 1055 | Units and Coits 15870. | Power Ventistors Other Air Handling 1280 | Air Distribution 15885. | Air Cleening DevicesSTANDARD MONTHLY CONTRACTOR'S REQUISITION FOR PAYMENT IAC/PSCP FORM 306.4 PAGE 13 of 16 LEA: DATE: PROJECT TITLE: PSC NO: LOCATION: REQ NO: = ame aoe =a _ Fa a 1STANDARD MONTHLY CONTRACTOR’S REQUISITION FOR PAYMENT IACIPSCP FORM 306.4 PAGE 14 of 16 LEA: DATE: PROJECT TITLE: PSC NO: LOCATION: REQ NO: ws 40 aa See — Fao te alle 1 as Se alae alles liarslexee = ‘controls Racor poomemnnSTANDARD MONTHLY CONTRACTOR'S REQUISITION FOR PAYMENT LEA: IACIPSCP FORM 306.4 PAGE 15 of 16 DATE: PROUECTENIME Gy 2 ee ete eee pay SCINO] ROGATIONSHG oti dace it coc Se ee EONS CHANGE ORDERS comPLeTeD TO DATE current co Tort No. BRIEF DESCRIPTION cost , scone | our TOTAL (Enter on Page 1)STANDARD MONTHLY CONTRACTOR'S REQUISITION FOR PAYMENT Page 16 of 16 LEA: PROJECT TITLE MATERIAL ‘Stored on Site ‘CURRENT Tew DESCRIPTION cost PRIOR PAYMENT REQUISITIONS DUE i TOTAL (Enter on Page 1) ‘Additional information to be filed with initial and Final Submissions Only cost Foundations and Slab on Grade Structural System Exterior Walls Interior Partitions Ceilings Floor Finishes onmmooe Pp Lighting Site size in acres: Portion of site being developed in acres: Size of school in gross square feet: Construction start date: