CONTRACTOR'S REQUEST FOR PAYMENT CHASKA VETERANS PARK IMPROVEMENTS STANTEC PROJECT NO

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1 Owner: City of Chaska, 1 City Hall Plz., Chaska, mn Date: December 12, 2017 For Period: 12/1/2017 to 1/31/2018 Request No: 1 Contractor: Blackstone Contractors, LLC, 9520 County Rd. 19, Ste. D, Loretto, MN CONTRACTOR'S REQUEST FOR PAYMENT CHASKA VETERANS PARK IMPROVEMENTS STANTEC PROJECT NO SUMMARY 1 Original Contract Amount $ 1,758, Change Order - Addition $ 467, Change Order - Deduction $ 434, Revised Contract Amount $ 1,792, Value Completed to Date $ Material on Hand $ Amount Earned $ Less Retainage 5% $ Subtotal $ Less Amount Paid Previously $ Liquidated damages - $ AMOUNT DUE THIS REQUEST FOR PAYMENT NO. 1 $ 0.00 Recommended for Approval by: STANTEC Approved by Contractor: BLACKSTONE CONTRACTORS, LLC Approved by Owner: CITY OF CHASKA Specified Contract Completion Date: Date:

2 PART 1 - SITE, WALKS, TRAILS: 1 MOBILIZATION LS $ TRAFFIC CONTROL LS $ REMOVE BITUMINOUS TRAIL PAVEMENT SY $ REMOVE CONCRETE SIDEWALK SF $ CLEAR AND GRUB TREE EA $ TRANSPLANT TREE EA $ REMOVE BUSHES LS $ SAWCUT BITUMINOUS (FULL DEPTH) LF $ SAWCUT CONCRETE (FULL DEPTH) LF $ COMMON EXCAVATION (EV) - SITE GRADING (INCLUDES PLANTING EXCESS) CY $ AGGREGATE BASE; CLASS 5, 100% CRUSHED TN $ TYPE SP 9.5 WEARING COURSE MIXTURE (2,B) TN $ BITUMINOUS PATCHING SY $ " CONCRETE WALK SF $ " CONCRETE WALK SPECIAL SF $ CONCRETE PLAYGROUND EDGER LF $ CONCRETE PAVER EDGE - AT LOWER FLAG CIRCLE SF $ CONCRETE STAIRS LS $ CONCRETE FINISH 1 - SAND BLAST SF $ CONCRETE FINISH 2 - WASHED AGGREGATE SF $ TRUNCATED DOMES SF $ CONCRETE PEDESTRIAN CURB RAMP SF $ DECOMPOSED GRANITE WALK SF $ ARCHITECTURAL PAVER -TYPE 1 (BUFF MIX ) SF $ GRANITE PAVER- TYPE 1 SF $ GRANITE PAVER- TYPE 2 SF $ GRANITE PAVER - TYPE 3 SF $ LIMESTONE CLADDING AT PERGOLA LS $ LIMESTONE CAPS AT PERGOLA SEATWALL EA $ STONE BENCH TYPE 1 EA $ STONE BENCH TYPE 2 EA $ STONE BENCH TYPE 3 EA $ ENGRAVING ON BENCH TYPE 1 EA $ ENGRAVING ON LIMESTONE AT SERVICE WALL EA $ ENGRAVING ON SERVICE WALL GRANITE PANELS EA $ GRANITE CLADDING - MILITARY MONUMENT EA $ GRANITE CLADDING - SERVICE WALL EA $ F&I SIGN TYPE C SF $ TIMBER RETAINING WALL SF $ GROUND REINFORCEMENT MESH SY $ STORM DRAIN INLET PROTECTION EA $ ROCK CONSTRUTION ENTRANCE EA $ ROCK DITCH CHECK EA $ SEDIMENT CONTROL LOG TYPE WOOD FIBER LF $ LOAM TOPSOIL BORROW (LV) CY $ ROOTING TOPSOIL BORROW (LV) CY $ MNDOT SEED MIXTURE AC $ SODDING TYPE LAWN SY $ BONDED FIBER MATRIX SY $ HYDRAULIC SOIL STABILIZER TYPE 6 SY $ FERTILIZER LB $ EROSION CONTROL BLANKET, CATEGORY 3 SY $ WATER FOR TURF ESTABLISHMENT MGAL $ SILT FENCE, MACHINE SLICE LF $ SILT FENCE, FLOATING LF $ MILITARY MONUMENT FOOTING AND CONCRETE CORE EA $ PERGOLA WALL FOOTING AND CONCRETE CORE LS $ ARCHERY STAND FOOTING EA $0.00

3 59 FLAGPOLE TYPE 1, 50' EA $ FLAGPOLE TYPE 2, 40' EA $ FLAGPOLE TYPE 3, 30' EA $ HAND RAIL LF $ PERGOLA - METAL WORK AND INSTALL LS $ RP - RECEPTACLE PEDESTAL EA $ RPL - RECEPTACLE PEDESTAL WITH LIGHT EA $ HANDHOLES EA $ HANDHOLES AV EA $ RELOCATE SERVICE CABINET EA $ LUMINAIRE TYPE TLC - MILITARY BRANCH INTERPRITIVE MONUMENT LIGHTS LF $ LUMINAIRE TYPE TLD - LIMESTONE BENCH LIGHTS LF $ LUMINAIRE TYPE TLE - SERVICE WALL LF $ LUMINAIRE TYPE FLA - LIGHTING AT FLAGS EA $ RELOCATE LIGHTING UNIT EA $ LUMINAIRE TYPE OMA - MILITARY BRANCH INTERPRITIVE MONUMENT LIGHTS EA $ ELECTRICAL CONNECTION - PERGOLA SIGN EA $ ELECTRICAL CONNECTION - COIN LIGHT BOX SIGN EA $ ELECTRICAL CONNECTION - COIN INTERPRETIVE SIGN LS $ ELECTRICAL CONNECTION - COIN PODIUM SIGN LS $ ELECTRICAL CONNECTION - LIGHTING UNITS PLA EA $ " PLASTIC PIPE LF $ " PVC SCHEDULE 40 CONDUIT LF $ " PVC SCHEDULE 40 CONDUIT LF $ " PVC SCHEDULE 40 CONDUIT LF $ ONE CONDUCTOR #4 AWG WIRE LF $ ONE CONDUCTOR #6 AWG WIRE LF $ ONE CONDUCTOR #8 AWG WIRE LF $ ONE CONDUCTOR #10 AWG WIRE LF $ ONE CONDUCTOR #12 AWG WIRE LF $ FIVE CONDUCTOR CABLE (2#12,1#12G,2/C#16 SHLD) LF $ TWO CONDUCTOR #16 SHIELDED CABLE LF $ LED LETTERS - PERGOLA EA $ COIN LIGHT BOX SIGN EA $ COIN INTERPRETIVE SIGN LS $ COIN PODIUM SIGN LS $ BRONZE MEDALION EA $0.00 TOTAL PART 1 - SITE, WALKS, TRAILS: $0.00 PART 2 - PARKING LOT: 96 REMOVE BITUMINOUS PAVEMENT SY $ REMOVE CONCRETE CURB AND GUTTER LF $ REMOVE STORM PIPE LF $ PAVEMENT MARKING REMOVAL LF $ SELECT GRANULAR BORROW (CV) CY $ COMMON EXCAVATION (EV) - PARKING LOT CY $ GEOTEXTILE FABRIC TYPE V SY $ AGGREGATE BASE; CLASS 5, 100% CRUSHED - PARKING LOT TN $ STREET SWEEPER (WITH PICK UP BROOM) HR $ " THICK BITUMINOUS PAVEMENT, TYPE SP 9.5 (2,C) SY $ BITUMINOUS TACK COAT GAL $ CONCRETE PAVEMENT: 7" THICKNESS - DUMPSTER ENCLOSURE SF $ CONCRETE CURB AND GUTTER DESIGN B612 LF $ CONCRETE VALLEY GUTTER LF $ " CONCRETE WALK SF $ PLANTING MEDIA CY $0.00

4 112 4" PE PERFORATED DRAIN TILE LF $ " PERFORATED PVC DRAINTILE, SDR 26 LF $ CONNECT TO EXISTING STORM SEWER PIPE EA $ " DIA STORM SEWER MH, INC CASTING AND ADJ RINGS EA $ " RCP STORM SEWER, CLASS 5 LF $ " SOLID LINE, PAINT LF $ CROSSWALK MARKING EPOXY SF $ PAVEMENT MARKING SYMBOL EA $ DECORATIVE TRASH RECEPTICAL ENCLOSURE LS $0.00 TOTAL PART 2 - PARKING LOT: $0.00 PART 3 - BUILDING IMPROVEMENTS: 121 NORTH ADDITION LS $ SOUTH ADDITION LS $ " SDR 26 DRAIN TILE LF $ " CLEAN OUT EA $ " SUMP DRAIN BOX EA $ " CONCRETE HEADWALL W/RODENT GUARD EA $ CABLE RAILING LF $ RANDOM RIPRAP CL II CY $ PANELBOARD EA $ CONNECTION CABINET EA $ LIGHTING CONTROL PANEL EA $ RECEPTALCE - BUILDING MOUNTED EA $ LUMINAIRE TYPE TLA - RAILING LIGHTING AT DECK BASE BID LF $ LUMINAIRE TYPE HB6 - BUILDING MOUNTED DOWN LIGHTS EA $ LUMINAIRE TYPE OKA - BUILDING MOUNTED WALL LIGHT EA $ " PVC SCHEDULE 40 CONDUIT LF $ " EMT CONDUIT LF $ " EMT CONDUIT LF $ ONE CONDUCTOR #3/0 AWG WIRE LF $ ONE CONDUCTOR #1 AWG WIRE LF $ ONE CONDUCTOR #4 AWG WIRE LF $ ONE CONDUCTOR #6 AWG WIRE LF $ ONE CONDUCTOR #8 AWG WIRE LF $ ONE CONDUCTOR #10 AWG WIRE LF $ ONE CONDUCTOR #12 AWG WIRE LF $ TWO CONDUCTOR #16 SHIELDED CABLE LF $0.00 TOTAL PART 3 - BUILDING IMPROVEMENTS: $0.00 ALTERNATE 1 - BUILDING DECK (ADD): 147 DECK 1 - NORTHEAST SF $ DECK 2 - SOUTHEAST SF $ DECK 3 - SOUTH SF $ CABLE RAILING LF $ LUMINAIRE TYPE TLA - RAILING LIGHTING AT DECK ALTERNATE LF $ " PVC SCHEDULE 40 CONDUIT LF $ ONE CONDUCTOR #12 AWG WIRE LF $0.00 TOTAL ALTERNATE 1 - BUILDING DECK (ADD): $0.00

5 ALTERNATE 2- PARKING LOT TURN AROUND PAVEMENT (PRICE DIFFERENCE FROM BITUMINOUS PAVEMENT - ITEM 95): 154 CONCRETE PAVEMENT; 7" THICKNESS SY $0.00 TOTAL ALTERNATE 2- PARKING LOT TURN AROUND PAVEMENT (PRICE DIFFERENCE FROM BITUMINOUS PAVEMENT - ITEM 95): $0.00 ALTERNATE 3 - ARCHERY RANGE (ADD): 155 ARCHERY STAND LS $ ARCHERY FENCING/NETTING LF $0.00 TOTAL ALTERNATE 3 - ARCHERY RANGE (ADD): $0.00 ALTERNATE 5 - PAVILION AREA (ADD): 176 REMOVE CONCRETE WALK SF $ " CONCRETE WALK SF $ CONCRETE SPECIAL FINISHING - STAR EA $ ORNAMENTAL FENCE LF $ TRELLIS EA $ TRELLIS FOOTINGS LS $ " CONCRETE WALK SF $0.00 TOTAL ALTERNATE 5 - PAVILION AREA (ADD): $0.00 CHANGE ORDER NO. 1 1 ARCHITECTURAL PAVER -TYPE 1 (BUFF MIX ) SF 1460 (31.25) $ INCH GRANITE PAVER - TYPE 4 SF $ GRANITE PAVER - TYPE 1 SF 650 (115.00) $ GRANITE PAVER - TYPE 1, 2" THICKNESS SF $ GRANITE PAVER - TYPE 2 SF 120 (115.00) $ GRANITE PAVER - TYPE 2, 2" THICKNESS SF $ GRANITE PAVER - TYPE 3 SF 300 (115.00) $ GRANITE PAVER - TYPE 3, 2" THICKNESS SF $ ENGRAVING ON BENCH TYPE 1 EA 6 ( ) $ ONSITE SANDBLASTING BENCH TYPE 1 EA $ GROUND REINFORCEMENT MESH SY 450 (29.50) $ COIN INTERPRETIVE SIGN LS 2 ( ) $ REMOVE STORM PIPE LF 125 (70.00) $ CONNECT TO EXISTING STORM SEWER PIPE EA 2 ( ) $ " DIA STORM SEWER MH, INC CASTING AND ADJ RINGS EA 3 ( ) $ " RCP STORM SEWER, CLASS 5 LF 132 (85.00) $ HANDHOLES EA 4 (365.00) $ ELECTRICAL CONNECTION - COIN INTERPRETIVE SIGN LS 2 (85.00) $ " PVC SCHEDULE 40 CONDUIT LF 725 (3.68) $ " PVC SCHEDULE 40 CONDUIT LF 123 (4.20) $ ONE CONDUCTOR #8 AWG WIRE LF 2240 (2.10) $ TWO CONDUCTOR #16 SHIELDED CABLE LF 405 (4.20) $ CONCRETE PAVEMENT: 7" THICKNESS - DUMPSTER ENCLOSURE SF $ DECORATIVE TRASH RECEPTICAL ENCLOSURE LS 1 ( ) $ DECORATIVE TRASH RECEPTICAL ENCLOSURE, MODIFIED LS $ NORTH ADDITION LS 1 ( ) $ NORTH ADDITION - MODIFIED LS $ SOUTH ADDITION LS 1 ( ) $ SOUTH ADDITION - MODIFIED LS $ LUMINAIRE TYPE HB6 - BUILDING MOUNTED DOWN LIGHTS EA $ " EMT CONDUIT LF $ ONE CONDUCTOR #4 AWG WIRE LF $0.00

6 33 ONE CONDUCTOR #6 AWG WIRE LF $ ONE CONDUCTOR #8 AWG WIRE LF $ DECK 1 - NORTHEAST, ADDITIONAL SF SF $ DECK 3 - SOUTH SF 176 (33.00) $ CABLE RAILING - ADDITIONAL LF LF $ LUMINAIRE TYPE TLA - RAILING LIGHTING AT DECK ALTERNATE LF $ " CONCRETE WALK SF 250 (14.00) $ CONCRETE SPECIAL FINISHING - STAR EA 1 ( ) $ ORNAMENTAL FENCE LF 66 (78.75) $0.00 TOTAL CHANGE ORDER NO. 1 $0.00 TOTAL PART 1 - SITE, WALKS, TRAILS: $0.00 TOTAL PART 2 - PARKING LOT: $0.00 TOTAL PART 3 - BUILDING IMPROVEMENTS: $0.00 TOTAL ALTERNATE 1 - BUILDING DECK (ADD): $0.00 TOTAL ALTERNATE 2- PARKING LOT TURN AROUND PAVEMENT (PRICE DIFFERENCE FROM BITUMINOUS PAVEMENT - ITEM 95): $0.00 TOTAL ALTERNATE 3 - ARCHERY RANGE (ADD): $0.00 TOTAL ALTERNATE 5 - PAVILION AREA (ADD): $0.00 TOTAL CHANGE ORDER NO. 1 $0.00 WORK COMPLETED TO DATE: $0.00

7 PROJECT PAYMENT STATUS OWNER CITY OF CHASKA STANTEC PROJECT NO CONTRACTOR BLACKSTONE CONTRACTORS, LLC CHANGE ORDERS No. Date Description Amount 1 12/4/2017 This Change Order provides for additional work on $33, this project. See Change Order Total Change Orders $33, PAYMENT SUMMARY No. From To Payment Retainage Completed 1 12/01/ /31/2018 Material on Hand Total Payment to Date Original Contract $1,758, Retainage Pay No. 1 Change Orders $33, Total Amount Earned Revised Contract $1,792, Contract Summary Base Bid Alt 1 Alt 2 $1,613, $47, $12, Alt 3 $43, Alt 5 $42, Change Order No. 1 Deducts ($434,455.10) Change Order No. 1 Add $467, Total $1,792,153.17