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Art3_AppleValley_FY19_Transit_ThunderbirdRevisedToBearValley_Inv TDA Article 3: Claims/Change Request Type of Request TDA Article 3:Claims Project Title Bear Valley&Navajo Rd Turnout Project Type Transit Project Contact Name Julie Ryan Agency Apple Valley Contact Phone 7602407000 Contact Email jryan@applevalley.org Type of Claim Reimbursement Request Reimbursement Request Reimbursement Reimbursement Request Form.pdf 225.75KB Request Form Backup Back up Documents.pdf 563.8KB Documentation Completion Verification(if applicable) Minute Action Item(if applicable) Photos(for Bus stop photo.JPEG 3.34MB completed projects) Other Reimbursement Request Cost Breakdown.pdf 69.73KB -a. 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OWNERS NAME:Town of Apple Valley JOB DESCRIPTION:Bear Valley Intersection Improvement TOWN PROJECT NUMBER:2019-03 CROSSTOWN JOB NUMBER:5243 BID UNIT TOTAL TOTAL TOTAL QTY AMOUNT ITEM BID OF UNIT CONTRACT QTY AMOUNT PREV PREV THIS THIS # DESCRIPTION QUANTITY MEAS. PRICE PRICE TO DATE TO DATE QUANTITY AMOUNT ESTIMATE ESTIMATE 1 Mobilization 1 LS $ 30,000.00 30,000.00$ 50% 15,000.00$ -$ 0.50 15,000.00$ 2 Public Convenience, Safety, Traffic Control and Detours 1 LS $ 100,000.00 100,000.00$ 25% 25,000.00$ -$ 0.25 25,000.00$ 3 Erosion Control 1 LS $ 15,000.00 15,000.00$ 25% 3,750.00$ -$ 0.25 3,750.00$ 4 Clearing and Grubbing 1 LS $ 16,845.00 16,845.00$ -$ -$ -$ 5 Unclassified Excavation 428 CY $ 125.00 53,500.00$ 309 38,625.00$ -$ 309 38,625.00$ 6 Landscaping and Irrigation Restoration 1 LS $ 5,500.00 5,500.00$ -$ -$ -$ 7 Asphalt Concrete Pavement 260 TN $ 312.00 81,120.00$ -$ -$ -$ 8 8 Inch Portland Cement Concrete Pavement (Road Conc 3627 SF $ 20.00 72,540.00$ 2880.00 57,600.00$ -$ 2880 57,600.00$ 9 6 Inch Crushed Aggregate Base 313 CY $ 50.00 15,650.00$ 117.00 5,850.00$ -$ 117 5,850.00$ 10 9 Inch Thick Portland Cement Concrete Pavement (Bus Pad) 1933 SF $ 36.00 69,588.00$ -$ -$ -$ 11 4 Inch Thick PCC Sidewalk 6210 SF $ 18.00 111,780.00$ -$ -$ -$ 12 Curb and Gutter 1134 LF 50.00$ 56,700.00$ 607.00 30,350.00$ -$ 607 30,350.00$ 13 Curb Ramp 18 EA 10,345.00$ 186,210.00$ 1.00 10,345.00$ -$ 1 10,345.00$ 14 Adjust Utility Cover to Grade 12 EA 850.00$ 10,200.00$ -$ -$ -$ 15 AC Berm 15 LF 500.00$ 7,500.00$ -$ -$ -$ 16 High Visibility Crosswalk (Thermoplastic) 2360 SF 5.65$ 13,334.00$ -$ -$ -$ 17 Limit Lines (Thermoplastic) 182 SF 5.65$ 1,028.30$ -$ -$ -$ 18 White Traffic Striping (4 Inch) (Thermoplastic) 290 LF 4.00$ 1,160.00$ -$ -$ -$ 19 White Traffic Striping (8 Inch) (Thermoplastic) 453 LF 5.00$ 2,265.00$ -$ -$ -$ 20 Yellow Traffic Striping (4 Inch) (Thermoplastic) 245 LF 4.00$ 980.00$ -$ -$ -$ 21 Legends & Symbols (Thermoplastic) 556 SF 9.00$ 5,004.00$ -$ -$ -$ 22 Rised Pavement Markers (Reflective) 40 EA 12.50$ 500.00$ -$ -$ -$ 23 Signage 16 EA 345.00$ 5,520.00$ -$ -$ -$ 24 Bear Valley Road and Kiowa Road Signal Modification 1 LS 382,600.00$ 382,600.00$ 37.90% 145,005.40$ -$ 0.379 145,005.40$ 25 Bear Valley Road and Navajo Road Signal Modification 1 LS 382,435.70$ 382,435.70$ 37.90% 144,943.13$ -$ 0.379 144,943.13$ 1,626,960.00$ 476,468.53$ -$ 476,468.53$ 1 Credit Service Pedestals 1 LS ($9,291.00)(9,291.00)$ 100% (9,291.00)$ 100% (9,291.00)$ -$ -$ -$ (9,291.00)$ (9,291.00)$ -$ (9,291.00)$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ 1,617,669.00$ 467,177.53$ -$ 467,177.53$ RETENTION THIS ESTIMATE: 5% Total Subject to Retention :467,177.53$ -$ 467,177.53$ RETENTION PREV ESTIMATE: Less Retention :(23,358.88)$ -$ (23,358.88)$ CONTRACT AMOUNT AMOUNT DUE:443,818.65$ -$ 443,818.65$ 1,626,960.00$ CHANGE ORDERS & EXTRA WORK Complete 29% (9,291.00)$ APPROVED BY: REVISED CONTRACT AMOUNT 1,617,669.00$ DATE: TOTAL LUMP SUM CHANGE ORDERS TOTAL AMOUNT EXTRA WORK CHANGE ORDERS TOTAL CONTRACT =>> EXTRA WORK AT FORCE ACCOUNT Total Contract Bid Items LUMP SUM CHANGE ORDERS 1/2/2025 12/31/2024 5243-001Field Qty's Verification # PAY PERIOD: DATE: Crosstown Electrical & Data, Inc. 5454 Diaz St. Irwindale, CA. 91706 (626) 608-7779 QTY VERIFICATON & APPROVAL INVOICE TO FOLLOW. OWNERS NAME:Town of Apple Valley JOB DESCRIPTION:Bear Valley Intersection Improvement TOWN PROJECT NUMBER:2019-03 CROSSTOWN JOB NUMBER:5243 BID UNIT TOTAL TOTAL TOTAL QTY AMOUNT ITEM BID OF UNIT CONTRACT QTY AMOUNT PREV PREV THIS THIS # DESCRIPTION QUANTITY MEAS. PRICE PRICE TO DATE TO DATE QUANTITY AMOUNT ESTIMATE ESTIMATE 1 Mobilization 1 LS $ 30,000.00 30,000.00$ 75% 22,500.00$ 50% 15,000.00$ 25% 7,500.00$ 2 Public Convenience, Safety, Traffic Control and Detours 1 LS $ 100,000.00 100,000.00$ 50% 50,000.00$ 25% 25,000.00$ 25% 25,000.00$ 3 Erosion Control 1 LS $ 15,000.00 15,000.00$ 50% 7,500.00$ 25% 3,750.00$ 25% 3,750.00$ 4 Clearing and Grubbing 1 LS $ 16,845.00 16,845.00$ 100% 16,845.00$ -$ 100% 16,845.00$ 5 Unclassified Excavation 428 CY $ 125.00 53,500.00$ 409 51,125.00$ 309 38,625.00$ 100 12,500.00$ 6 Landscaping and Irrigation Restoration 1 LS $ 5,500.00 5,500.00$ -$ -$ -$ 7 Asphalt Concrete Pavement 260 TN $ 312.00 81,120.00$ 190 59,280.00$ -$ 190 59,280.00$ 8 8 Inch Portland Cement Concrete Pavement (Road Conc 3627 SF $ 20.00 72,540.00$ 2880 57,600.00$ 2880.00 57,600.00$ -$ 9 6 Inch Crushed Aggregate Base 313 CY $ 50.00 15,650.00$ 117 5,850.00$ 117.00 5,850.00$ -$ 10 9 Inch Thick Portland Cement Concrete Pavement (Bus Pad) 1933 SF $ 36.00 69,588.00$ -$ -$ -$ 11 4 Inch Thick PCC Sidewalk 6210 SF $ 18.00 111,780.00$ 1028 18,504.00$ -$ 1028 18,504.00$ 12 Curb and Gutter 1134 LF 50.00$ 56,700.00$ 607 30,350.00$ 607.00 30,350.00$ -$ 13 Curb Ramp 18 EA 10,345.00$ 186,210.00$ 4 41,380.00$ 1 10,345.00$ 3 31,035.00$ 14 Adjust Utility Cover to Grade 12 EA 850.00$ 10,200.00$ -$ -$ -$ 15 AC Berm 15 LF 500.00$ 7,500.00$ -$ -$ -$ 16 High Visibility Crosswalk (Thermoplastic) 2360 SF 5.65$ 13,334.00$ -$ -$ -$ 17 Limit Lines (Thermoplastic) 182 SF 5.65$ 1,028.30$ -$ -$ -$ 18 White Traffic Striping (4 Inch) (Thermoplastic) 290 LF 4.00$ 1,160.00$ -$ -$ -$ 19 White Traffic Striping (8 Inch) (Thermoplastic) 453 LF 5.00$ 2,265.00$ -$ -$ -$ 20 Yellow Traffic Striping (4 Inch) (Thermoplastic) 245 LF 4.00$ 980.00$ -$ -$ -$ 21 Legends & Symbols (Thermoplastic) 556 SF 9.00$ 5,004.00$ -$ -$ -$ 22 Rised Pavement Markers (Reflective) 40 EA 12.50$ 500.00$ -$ -$ -$ 23 Signage 16 EA 345.00$ 5,520.00$ -$ -$ -$ 24 Bear Valley Road and Kiowa Road Signal Modification 1 LS 382,600.00$ 382,600.00$ 68.90% 263,611.40$ 37.90% 145,005.40$ 31% 118,606.00$ 25 Bear Valley Road and Navajo Road Signal Modification 1 LS 382,435.70$ 382,435.70$ 68.90% 263,498.20$ 37.90% 144,943.13$ 31% 118,555.07$ 1,626,960.00$ 888,043.60$ 476,468.53$ 411,575.07$ 1 Credit Service Pedestals 1 LS ($9,291.00)(9,291.00)$ 100% (9,291.00)$ 100%($9,291.00)-$ -$ -$ -$ (9,291.00)$ (9,291.00)$ (9,291.00)$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ 1,617,669.00$ 878,752.60$ 467,177.53$ 411,575.07$ RETENTION THIS ESTIMATE: 5% Total Subject to Retention :878,752.60$ 467,177.53$ 411,575.07$ RETENTION PREV ESTIMATE: 5%Less Retention :(43,937.63)$ (23,358.88)$ (20,578.75)$ CONTRACT AMOUNT AMOUNT DUE:834,814.97$ 443,818.65$ 390,996.32$ 1,626,960.00$ CHANGE ORDERS & EXTRA WORK Complete 54% (9,291.00)$ APPROVED BY: REVISED CONTRACT AMOUNT 1,617,669.00$ DATE: TOTAL CONTRACT =>> Total Contract Bid Items LUMP SUM CHANGE ORDERS TOTAL LUMP SUM CHANGE ORDERS EXTRA WORK AT FORCE ACCOUNT TOTAL AMOUNT EXTRA WORK CHANGE ORDERS DATE:1/30/2025 PAY PERIOD:1/31/2025 Field Qty's Verification #5243-002 Crosstown Electrical & Data, Inc. 5454 Diaz St. Irwindale, CA. 91706 (626) 608-7779 QTY VERIFICATON & APPROVAL INVOICE TO FOLLOW. OWNERS NAME:Town of Apple Valley JOB DESCRIPTION:Bear Valley Intersection Improvement TOWN PROJECT NUMBER:2019-03 CROSSTOWN JOB NUMBER:5243 BID UNIT TOTAL TOTAL TOTAL QTY AMOUNT ITEM BID OF UNIT CONTRACT QTY AMOUNT PREV PREV THIS THIS # DESCRIPTION QUANTITY MEAS. PRICE PRICE TO DATE TO DATE QUANTITY AMOUNT ESTIMATE ESTIMATE 1 Mobilization 1 LS $ 30,000.00 30,000.00$ 85% 25,500.00$ 75% 22,500.00$ 10% 3,000.00$ 2 Public Convenience, Safety, Traffic Control and Detours 1 LS $ 100,000.00 100,000.00$ 75% 75,000.00$ 50% 50,000.00$ 25% 25,000.00$ 3 Erosion Control 1 LS $ 15,000.00 15,000.00$ 75% 11,250.00$ 50% 7,500.00$ 25% 3,750.00$ 4 Clearing and Grubbing 1 LS $ 16,845.00 16,845.00$ 100% 16,845.00$ 100% 16,845.00$ -$ 5 Unclassified Excavation 428 CY $ 125.00 53,500.00$ 1060 132,500.00$ 409 51,125.00$ 651 81,375.00$ 6 Landscaping and Irrigation Restoration 1 LS $ 5,500.00 5,500.00$ -$ -$ -$ 7 Asphalt Concrete Pavement 260 TN $ 312.00 81,120.00$ 217 67,704.00$ 190.00 59,280.00$ 27 8,424.00$ 8 8 Inch Portland Cement Concrete Pavement (Road Conc 3627 SF $ 20.00 72,540.00$ 3446 68,920.00$ 2880 57,600.00$ 566 11,320.00$ 9 6 Inch Crushed Aggregate Base 313 CY $ 50.00 15,650.00$ 176 8,800.00$ 117.00 5,850.00$ 59 2,950.00$ 10 9 Inch Thick Portland Cement Concrete Pavement (Bus Pad)1933 SF $ 36.00 69,588.00$ -$ -$ -$ 11 4 Inch Thick PCC Sidewalk 6210 SF $ 18.00 111,780.00$ 2753 49,554.00$ 1028 18,504.00$ 1725 31,050.00$ 12 Curb and Gutter 1134 LF 50.00$ 56,700.00$ 714 35,700.00$ 607.00 30,350.00$ 107 5,350.00$ 13 Curb Ramp 18 EA 10,345.00$ 186,210.00$ 10 103,450.00$ 4 41,380.00$ 6 62,070.00$ 14 Adjust Utility Cover to Grade 12 EA 850.00$ 10,200.00$ -$ -$ -$ 15 AC Berm 15 LF 500.00$ 7,500.00$ -$ -$ -$ 16 High Visibility Crosswalk (Thermoplastic) 2360 SF 5.65$ 13,334.00$ -$ -$ -$ 17 Limit Lines (Thermoplastic) 182 SF 5.65$ 1,028.30$ -$ -$ -$ 18 White Traffic Striping (4 Inch) (Thermoplastic) 290 LF 4.00$ 1,160.00$ -$ -$ -$ 19 White Traffic Striping (8 Inch) (Thermoplastic) 453 LF 5.00$ 2,265.00$ -$ -$ -$ 20 Yellow Traffic Striping (4 Inch) (Thermoplastic) 245 LF 4.00$ 980.00$ -$ -$ -$ 21 Legends & Symbols (Thermoplastic) 556 SF 9.00$ 5,004.00$ -$ -$ -$ 22 Rised Pavement Markers (Reflective) 40 EA 12.50$ 500.00$ -$ -$ -$ 23 Signage 16 EA 345.00$ 5,520.00$ -$ -$ -$ 24 Bear Valley Road and Kiowa Road Signal Modification 1 LS 382,600.00$ 382,600.00$ 68.90% 263,611.40$ 68.90% 263,611.40$ -$ 25 Bear Valley Road and Navajo Road Signal Modification 1 LS 382,435.70$ 382,435.70$ 90.95% 347,825.27$ 68.90% 263,498.20$ 22% 84,327.07$ 1,626,960.00$ 1,206,659.67$ 888,043.60$ 318,616.07$ 1 Credit Service Pedestals 1 LS ($9,291.00)(9,291.00)$ 100% (9,291.00)$ 100%($9,291.00)-$ 2 Additional Survey for Turn-Out Redesign -$ -$ -$ (9,291.00)$ (9,291.00)$ (9,291.00)$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ 1,617,669.00$ 1,197,368.67$ 878,752.60$ 318,616.07$ RETENTION THIS ESTIMATE: 5% Total Subject to Retention : 1,197,368.67$ 878,752.60$ 318,616.07$ RETENTION PREV ESTIMATE: 5%Less Retention :(59,868.43)$ (43,937.63)$ (15,930.80)$ CONTRACT AMOUNT AMOUNT DUE:1,137,500.24$ 834,814.97$ 302,685.27$ 1,626,960.00$ CHANGE ORDERS & EXTRA WORK Complete 74% (9,291.00)$ APPROVED BY: REVISED CONTRACT AMOUNT 1,617,669.00$ DATE: DATE:3/4/2025 PAY PERIOD:2/28/2025 Field Qty's Verification #5243-003 TOTAL CONTRACT =>> Total Contract Bid Items LUMP SUM CHANGE ORDERS TOTAL LUMP SUM CHANGE ORDERS EXTRA WORK AT FORCE ACCOUNT TOTAL AMOUNT EXTRA WORK CHANGE ORDERS Account #: 158300181100 MICR Acct. #: 158300181100 Check No.: 172746 Transaction Type: Check Amount: $443,818.65 Date: 02/12/2025 Sequence Number: 8613737253 Front: Back: 5/2/25, 12:35 PM Print Images https://singlepoint.usbank.com/cs70_banking/sbb/app/smallbiz/image/printImagesFromViewer?singleImage=true&includeHeader=true&ImageNo=1 1/1 Account #: 158300181100 MICR Acct. #: 158300181100 Check No.: 173280 Transaction Type: Check Amount: $390,996.32 Date: 03/18/2025 Sequence Number: 8315063582 Front: Back: 5/2/25, 12:34 PM Print Images https://singlepoint.usbank.com/cs70_banking/sbb/app/smallbiz/image/printImagesFromViewer?singleImage=true&includeHeader=true&ImageNo=1 1/1 Account #: 158300181100 MICR Acct. #: 158300181100 Check No.: 173345 Transaction Type: Check Amount: $302,685.27 Date: 03/26/2025 Sequence Number: 8613830411 Front: Back: 5/2/25, 12:33 PM Print Images https://singlepoint.usbank.com/cs70_banking/sbb/app/smallbiz/image/printImagesFromViewer?singleImage=true&includeHeader=true&ImageNo=1 1/1 San Bernardino Associated Governments Reimbursement Request Article 3 Grant Program Claimant: Town of Apple Valley Allocation #:L20‐TAV‐07 Total Project Cost Article 3 Award Amount Percent Article 3*Local Match ATP Funds $128,940.19 $53,897.00 41.80% $75,043.19 *Note: Actual share is forumal based. Instructions: Please complete 1 through 5 below. Amount $53,897.00 $75,043.19 $128,940.19 $53,897.00 $0.00 $95,839.53 ‐$20,796.34 $0.00 $0.00 $149,736.53 ‐$20,796.34 I certify that the information on this Financial Reporting form is true and accurate to the best of my knowledge. (Authorized Agent specified in Authorizing Resolution) Signed:Date: 6/28/2025 Bear Valley & Navajo Rd. Turnout (previously Thunderbird Road Bus Turnout) Field will change to red if local share is not met (not allowed). Field will change to green if local share exceed requirement (allowed). ATP Funds (if applicable)5) ATP (if applicable) Grant Information (completed by SBCTA) Total Amount Remaining Project Name 3) Article 3 4) Local Match Total Total Project Costs to Date (include amount requested above) 1) Article 3 Cost (amount being requested for reimbursement) 2) Local Match/ATP Funds Cost Local Match Article 3 Balance Remaining Art3_AppleValley_FY19_Transit_ThunderbirdRevisedToBearValley_Claim (1) Reimbursement Request Page 1 Bear Valley & Navajo Turnout (Previously Thunderbird) Bus Stop Cost No. Item 1 Mobilization/Demobilization 6,375.00$ 2 Public Convenience, Safety, Traffic Control and Detours 18,750.00$ 3 Erosion Control 2,812.50$ 4 Clearing and Grubbing 8,422.50$ 5 Unclassified Excavation 39,125.00$ 6 Landscaping and Irrigation Restoration -$ 7 Asphalt Concrete Pavement 6,770.40$ 8 8 Inch Portland Cement Concrete Pavement (Road Conc 6,892.00$ 9 6 Inch Crushed Aggregate Base 880.00$ 10 9 Inch Thick Portland Cement Concrete Pavement (Bus P -$ 11 4 Inch Thick PCC Sidewalk 30,000.00$ 12 Curb and Gutter 16,900.00$ 13 Curb Ramp 20,690.00$ 14 Adjust Utility Cover to grade -$ 15 AC Berm -$ 16 High Visibility Crosswalk (Thermoplastic) -$ 17 Limit Lines (Thermoplastic) -$ 18 White Traffic Striping (4 inch) (Thermoplastic) -$ 19 White Traffic Striping (8 Inch) (Thermoplastic) -$ 20 Yellow Traffic Striping (4 inch) (Thermoplastic) -$ 21 Legends & Symbols (Thermoplastic) -$ 22 Raised Pavement Markers (Reflective) -$ 23 Signage -$ 24 Bear Valley Road and Kiowa Road Signal Modification -$ 25 Bear Valley Road and Navajo Road Signal Modification -$ CR1 Service Pedestals -$ T&M Additional Survey -$ -$ -$ -$ Total Billed 157,617.40$ Held Retention 7,880.87$ Total Paid Out 149,736.53$ 12