APPLICATION AND CERTIFICATE FOR PAYMENT AlA DOCUMENT G702 Page 1 of 1 TO OWNER: City of Fontana - Parks APPLICATION NO.: 17-RET City of Fontana PERIOD TO: 4/6/2022
8353 Sierra Ave PROJECT NOS.: MS-209-PW-20
Fontana, CA 92335 PO#: 22000885
CONTRACT DATE: 1/28/2020
FROM CONTRACTOR:
Alliance Building Solutions, Inc. RETENTION INVOICE
12520 High Bluff Drive Ste. 345
San Diego, CA 92130
CONTRACT FOR: Parks Lighting
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractors knowledge, information Application is made for payment, as shown below, in connection with the Contract. and belief the Work covered by this Application for Payment has been completed in Continuation Sheet, AIA Document G703, is attached. accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received $3,697.716.00 from the Owner, and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM
2. Net Change by Change Orders $0.00
3. CONTRACT SUM TO DATE (Line 1 + 2) $ $3,697,716.00 ALLIANCE BUILDING SOLUTIONS, INC. $3,697.716.00 Date: 45.22
4. TOTAL COMPLETED & STORED TO DATE
(Column G on G703) Kelly Svensen, Controller
5. RETAINAGE:
% of Completed Work $0.00
(Columns D + E on G703)
b. % of Stored Material $0.00
(Column F on G703)
Total Retainage (Line 5a + 5b or
Total in Column I of G703) $0.00
6. TOTAL EARNED LESS RETAINAGE $3,697,716.00
(Line 4 less Line 5 Total)
7. LESS PREVIOUS CERTIFICATES FOR PAYMENT $3,514,679.05 (Line 6 from prior Certificate)
8. CURRENT PAYMENT DUE $183,036.95
9. BALANCE TO FINISH, INCLUDING RETAINAGE
(Line 3 less Line 6) $ $0.00
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS
Total changes approved in previous
months by Owner $0.00 $0.00
Total approved this Month $0.00 $0.00
TOTALS $0.00 $0.00
NET CHANGES by Change Order $0.00
Project: City of Fontana - Parks
ALLIANCE Application No.: 17-RET
Application Date: 4/6/2022
Period To: 4/6/2022
WORK COMPLETED
FROM MATERIALS TOTAL COMPLETED BALANCE TO RETAINAGE
SCHEDULED PREVIOUS THIS PERIOD PRESENTLY AND STORED TO % (G/C) FINISH (IF VARIABLE
DESCRIPTION OF WORK STORED DATE
VALUE APPLICATION (C - G) RATE)
(D + E) (NOT IN D OR E) (D +E+ F)
Project Bond, Engineering, Mobilization
Bond / Insurance 36,977.00 $ 36,977.00 $ 36,977.00 100%$ APME Engineering 277,329.00 $ 263,462.55 13,866.45 277,329.00 100% 5 Mobilization 438,179.00 $ 416,270.05 21,908.95 438,179.00 100% 5 City of Fontana Parks
Bill Martin Park - Exterior Lighting 95,814.82 S 91,024.08 S 4,790.74 95,814.82 100% S Bill Martin Park - Sports Field Lighting 14,372.22 287,444.42 100% 5 Chaparelle Park - Exterior Lighting 13,609.44 12. 928.97 680.47 13,609.44 100% S Chaparelle Park - Sports Field Lighting 71,449.59 67,877.11 3,572.48 71,449.59 100% Condor Park - Exterior Lighting 4.046.22 3,843.91 202.31 4,046.22 100% Coyote Canyon Park - Exterior Lighting 44,481.25 42,257.19 2,224.06 44,481.25 100% Coyote Canyon Park - Sports Field Lighting 140.011.26 133,010.70 7,000.56 140,011.26 100% 8,837.96 8,396.06 441.90 8,837.96 100%
Fernandez Park - Exterior Lighting
Heritage Circle Park - Exterior Lighting 1,452.01 1,379.41 72.60 1,452.01 100% Hunter Ridge Park - Exterior Lighting 7,148.30 6,790.89 357.42 7,148.30 100% Hunter Ridge Park - Sports Lighting 66,699.20 63,364.24 3,334.96 66,699.20 100% Jack Bulik Park - Exterior Lighting 24,970.00 23,721.50 1,248.50 24,970.00 100% 416,784.06 395,944.86 20,839.20 416,784.06 100%
Jack Bulik Park - Sports Lighting
Koehler Park - Exterior Lighting 21.779.00 20,690.05 1,088.95 21,779.00 100% Koehler Park - Sports Lighting asses es es es es es es en es es en en es es en es es en es es es 156,726.22 148 889 91 7,836.31 156,726.22 100% Martin Tutor Park - Exterior Lighting 9,416.00 8,945.20 470.80 9,416.00 100% Martin Tutor Park - Sports Lighting 25,542.38 24,265.26 1,277.12 25,542.38 100% McDermott Sports Complex - Exterior Lighting 4,020.00 3,819.00 201.00 4,020.00 100% McDermott Sports Complex - Sports Field Lighting 42,107.70 40.002.32 2,105.39 42,107.70 100% es North Gate Park - Sports Field Lighting 4,815.63 4,574.85 240.78 4,815.63 100% North Heritage Park - Exterior Lighting 2,125.85 2,019.56 106.29 2,125.85 100% North Tamarind Park - Exterior Lighting 264.43 251.21 13.22 264.43 100% Oak Park - Exterior Lighting 1,932.49 1,835.87 96.62 1,932.49 100% 1,005.00 954.75 50.25 1,005.00 100%
Oak Park - Sports Field Lighting
Pacific Electric Trail - Exterior Lighting 140.841.12 133,799.06 7,042.06 140.841.12 Patricia Marrujo Park - Exterior Lighting 23,034.78 21,883.04 1,151.74 23,034.78 100% Patricia Murray Park - Exterior Lighting 2,211.88 2,101.29 110.59 2,211.88 100% Ralph M. Lewis Park - Exterior Lighting 63,936.00 60,739.20 3,196.80 63,936.00 100%
Project: City of Fontana - Parks
• ALLIANCE Application No.: 17-RET
Application Date: 4/6/2022
Period To: 4/6/2022
WORK COMPLETED
FROM MATERIALS TOTAL COMPLETED BALANCE TO RETAINAGE
SCHEDULED PREVIOUS PRESENTLY AND STORED TO (IF VARIABLE DESCRIPTION OF WORK VALUE THIS PERIOD % (G/C) FINISH
APPLICATION STORED DATE (C - G) RATE)
(D + E) (NOT IN D OR E) (D+E+ F)
Ralph M. Lewis Park - Sports Fleld Lighting 386,050.68 $ 366,748.15 19,302.53 386,050.68 100% $ Rosena Park East - Exterior Lighting 16,434.98 S 15,613.23 821.75 16,434.98 100% S Rosena Park West - Exterior Lighting 3,274.41 S 3,110.69 5 163.72 3,274.41 100% S San Sevaine Park - Exterior Lighting 17,507.43 5 16,632.06 5 875.37 17,507.43 100% S San Sevaine Park - Sports Field Lighting 21,400.00 S 20,330.00 S 1,070.00 21,400.00 100% $ Sante Fe Park - Exterior Lighting 4,495.44 5 4,270.67 224.77 4,495.44 100% S Seveille Park - Exterior Lighting 4,962.19 4,714.08 $ 248.11 4,962.19 100% $ Shadow Park - Exterior Lighting 1,785.75 5 1,696.46 $ 89.29 1,785.75 100% S es es Sierra Crest Park - Exterior Lighting 4,495.44 S 4,270.67 S 224.77 4,495.44 100%S South Ridge Park - Exterior Lighting 13,778.00 13,089.10 688.90 13,778.00 100% South Ridge Park - Sports Field Lighting 159,933.08 151,936.43 7,996.65 159,933.08 100% $ Sycamore Park - Exterior Lighting 17,069.00 16,215.55 853.45 17,069.00 100% $ Sycamore Park - Sports Field Lighting 27,185.33 25,826.06 1,359.27 27,185.33 100% Veterans Park - Exterior Lighting 73,433.50 69.761.83 3,671.68 73,433.50 100% Veterans Park - Sports Field Lighting 293,612.04 278,931.44 14,680.60 293,612.04 100%5 10,820.26 S 569.49 100%S uner
Village Park - Exterior Lighting 11,389.75$ 11,389.75
Village Park - Sports Field Lighting 205,916.97 S 195,621.12 us 10,295.85 205,916.97 100% S SUB-TOTAL $ 3,697,716.00 $ 3,514,679.05 $ 183,036.95 $ 3,697,716.00 100% s Change Order Work
Change Order No. 1 0% $
Change Order No. 2 0% S
on s
Change Order No. 4 0% $
Change Order No. 4 0% S
TOTAL $ 3,697,716.00 $ 3,514,679.05 S 183,036.95 $ 3,697,716.00 100% s $ 183,036.95
ALLIANCE INVOICE
Alliance Building Solutions, Inc.
12520 High Bluff Drive #345 INVOICE NO. 17-RET
San Diego, CA 92130
858-333-4771 DATE 4/6/2022
[email protected]
TO
City of Fontana
16489 Orange Way
Fontana, CA 92335
JOB PO#: 22000885_2020
City of Fontana - Parks Lighting
DESCRIPTION TOTAL
2. Bond / Insurance $0.00
3. APME Engineering $13,866.45
4. Mobilization $21,908.95
7. Bill Martin Park - Exterior Lighting $4,790.74
8. Bill Martin Park - Sports Field Lighting $14,372.22
9. Chaparelle Park - Exterior Lighting $680.47
10. Chaparelle Park - Sports Field Lighting $3,572.48
11. Condor Park - Exterior Lighting $202.31
12. Coyote Canyon Park - Exterior Lighting $2.224.06
13. Coyote Canyon Park - Sports Field Lighting $7,000.56
14. Fernandez Park - Exterior Lighting $441.90
15. Heritage Circle Park - Exterior Lighting $72.60
16. Hunter Ridge Park - Exterior Lighting $357.42
17. Hunter Ridge Park - Sports Lighting $3,334.96
18. Jack Bulik Park - Exterior Lighting $1,248.50
19. Jack Bulik Park - Sports Lighting $20,839.20
20. Koehler Park - Exterior Lighting $1,088.95
21. Koehler Park - Sports Lighting $7,836.31
22. Martin Tutor Park - Exterior Lighting $470.80
23. Martin Tutor Park - Sports Lighting $1,277.12
ALLIANCE INVOICE
Alliance Building Solutions, Inc.
12520 High Bluff Drive #345 INVOICE NO. 17-RET
San Diego, CA 92130
858-333-4771 DATE 4/6/2022
[email protected]
TO
City of Fontana
16489 Orange Way
Fontana, CA 92335
JOB PO#: 22000885_2020
City of Fontana - Parks Lighting
DESCRIPTION TOTAL
24. McDermott Sports Complex - Exterior Lighting $201.00
25. McDermott Sports Complex - Sports Field Lighting $2,105.39
26. North Gate Park - Sports Field Lighting $240.78
27. North Heritage Park - Exterior Lighting $106.29
28. North Tamarind Park - Exterior Lighting $13.22
29. Oak Park - Exterior Lighting $96.62
30. Oak Park - Sports Field Lighting $50.25
31. Pacific Electric Trail - Exterior Lighting $7,042.06
32. Patricia Marrujo Park - Exterior Lighting $1,151.74
33. Patricia Murray Park - Exterior Lighting $110.59
34. Ralph M. Lewis Park - Exterior Lighting $3,196.80
35. Ralph M. Lewis Park - Sports Fleld Lighting $19.302.53
36. Rosena Park East - Exterior Lighting $821.75
37. Rosena Park West - Exterior Lighting $163.72
38. San Sevaine Park - Exterior Lighting $875.37
39. San Sevaine Park - Sports Field Lighting $1,070.00
40. Sante Fe Park - Exterior Lighting $224.77
41. Seveille Park - Exterior Lighting $248.11
42. Shadow Park - Exterior Lighting $89.29
43. Sierra Crest Park - Exterior Lighting $224.77
ALLIANCE INVOICE
Alliance Building Solutions, Inc.
12520 High Bluff Drive #345 INVOICE NO. 17- RET
San Diego, CA 92130
858-333-4771 DATE 4/6/2022
[email protected]
TO
City of Fontana
16489 Orange Way
Fontana, CA 92335
JOB PO#: 22000885_2020
City of Fontana - Parks Lighting
DESCRIPTION TOTAL
44. South Ridge Park - Exterior Lighting $688.90
45. South Ridge Park - Sports Field Lighting $7.996.65
46. Sycamore Park - Exterior Lighting $853.45
47. Sycamore Park - Sports Field Lighting $1,359.27
48. Veterans Park - Exterior Lighting $3,671.68
49. Veterans Park - Sports Field Lighting $14,680.60
50. Village Park - Exterior Lighting $569.49
51. Village Park - Sports Field Lighting $10,295.85
$183,036.95
CONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
NOTICE: THIS DOCUMENT WAIVES THE CLAIMANT'S LIEN, STOP PAYMENT NOTICE, AND PAYMENT BOND RIGHTS EFFECTIVE ON RECEIPT OF PAYMENT.
A PERSON SHOULD NOT RELY ON THIS DOCUMENT UNLESS SATISFIED THAT THE CLAIMANT HAS RECEIVED PAYMENT.
Identifying Information
Name of Claimant: Alliance Building Solutions, Inc
Name of Customer: City of Fontana
Job Location: City of Fontana, Parks Lighting
Owner: City of Fontana
Conditional Waiver and Release
This document waives and releases lien, stop payment notice, and payment bond rights the claimant has for labor and service provided, and equipment and material delivered, to the customer on this job. Rights based upon labor or service provided, or equipment or material delivered, pursuant to a written change order that has been fully executed by the parties prior to the date that this document is signed by the claimant, are waived and released by this document, unless listed as an Exception below. This document is effective only on the claimant's receipt of payment from the financial institution on which the following check is drawn:
Maker of Check: City of Fontana
Amount of Check: $ 183,036.95
Check Payable to: Alliance Building Solutions, Inc.
Exceptions
This document does not affect any of the following:
Disputed claims for extras in the amount of: $
Signature
Claimant's Signature: Y quensen
Claimant's Title: Kelly Svensen, Controller
Date of Signature: 04/06/2022
7/1/12