Text · page 3 of 27
This document was a scan. Its text was produced by character recognition and may contain errors; check the original for exact wording.
TOWN OF ORCHARD PARK
4295 SOUTH BUFFALO STREET, ORCHARD PARK, NEW YORK 14127
PROJECT PAYMENT REQUEST Final CO and Release of Retention
PROJECT : Multi-Use Maintenance Salt & Topsoil Building Storage Project - Electrical
JOB NO. : 2022.021
DATE : 4/6/2026
BY : JUK
PAYMENT NO. : Final CO and Release of Retention
ITEM NO. DESCRIPTION QUANTITY UNIT PRICE TOTAL
Credit - for two, two tier fiberglass cable
racks for the handlhole and one, 2” conduit 1 ($161.85) 161.85
clap.
Credit - Unused contingency allowance 1 ($10,000.00) 10,000.00
FINAL CO Release of Retention 1 -10,161.85 -10,161.85
TOTAL CHANGE : ($10,161.85)
Original Contract AMOUNE...o..ecccccccccccecccsscccecssensceetssecstseceseceens $43,975.00
CHANGES OFUOL8 oie eececetetetteesssecsseseesesevassecsecsstssseneseseesesseecess $0.00
Approved Contract Amount to [email protected] $43,975.00
Final Change Order Amount to Date ....c.cccccccceccccccccsesesecerseeses $33,813.15
Cost of Work Completed as of Previous Payment.....0......0.00.. $33,813.15
Cost of Work Completed During Current Payment Period......... $0.00
Total Work Completed to [email protected] $33,813.15
Less: 5% Contract [email protected] - $0.00
S517]
6) (6) =| Sens $33,813.15
LeSS: PreVIOUS PAYMENES.......cccccccccccsctsetscseessecssevecscevssesenseeees - $32,276.25
AMOUNT DUE THIS PAYMENT .....1:ssessecvesecsscecsecncnscsessusnsecsscsestenereeenseees $1,536.90
APPROVALS:
CONTRACTOR: CIR Electrical Construction Corp. TOWN ENGINEER:
BY: Dominic D'Alba
=
DATE: 4/10/2026 DATE: 4 AO {CE
/
S:\Town Projects\Multi-Use Maintenance Facility 2022.022\Salt & Topsoil Storage\Construction\EC Construction\Payments\Cover Sht Final Chang Order- release of retention