WORK PERFORMED TO DATE In support of Application for Payment No. For the period from , through inclusive. Project No. Name and location of Project Design-Builder's Name and Address WORK INCLUDED IN ORIGINAL CONTRACT ACTUAL COSTS WORK PERFORMED TO DATE CSI Category and Description Item No. and Designation (1) Number & Kind of Units (2) Unit Price (3) Actual Cost (4) No. of (5) Amount Earned to Date (6) Value of Incomplete Work (7) Percent Complete (8) A. Contracting Requirements: * a. b. c, 1. Division 1 – General Requirements: * a. b. c. 2. Division 2 – Site Construction: ** (i) Building a. b. c. (ii) Infrastructure a. b. c. 3. Division 3 – Concrete: * a. b. c. 4. Division 4 – Masonry: ** (i) Building a. b. c. (ii) Infrastructure a. b. c. 5. Division 5 – Metals: * a. b. c.
6. Division 6 – Wood and Plastics: * a. b. c. 7. Division 7 – Thermal & Moisture: ***** a. b. c. Roof: 8. Division 8 – Doors & Windows: * a. b. c. 9. Division 9 – Finishes: * a. b. c. 10. Division 10 – Specialties: * a. b. c. 11. Division 11 – Equipment: *** (i) Fixed or Built-in: a. b. c. (ii) Moveable: a. b. c. 12. Division 12 – Furnishings: *** (i) or Built-in: a. b. c. (ii) Moveable: a. b. c. 13. Division 13 – Special Construction: * a. b. c. 14. Division 14 – Conveying Systems: * a. b. c. 15. Division 15 – Mechanical: **** (i) Building a. b. c. (ii) Infrastructure a. b. c. 16. Division 16 – Electrical: ** (i) Building a. b. c. (ii) Infrastructure
A Structural steel columns and beams, fireproofed with masonry, concrete, plaster, or other noncombustible material Concrete or concrete on steel deck, fireproofed Formed concrete, precast slabs, concrete or gypsum on steel deck, fireproofed Nonbearing curtain walls, masonry, concrete, metal and glass panels, stone “Fire Resistive” NFPA 220 Type I or II SBC Type I or II IBC , IB or IIA None B Reinforced concrete columns and beams; construction Concrete or concrete on steel deck, fireproofed Formed concrete, precast slabs, concrete or gypsum on steel deck, fireproofed Nonbearing curtain walls, masonry, concrete, metal and glass panels, stone “Fire Resistive” NFPA 220 Type I or II SBC Type I or II IBC , IB or IIA Type 4 or Type 6 C Masonry or concrete walls with or without pilasters; masonry or concrete walls with steel, fire retardant treated wood (FRTW) or concrete frame Wood or concrete plank on steel floor joists, or concrete slab on grade Wood or steel joists with wood or steel deck; concrete plank concrete block, or tile masonry tilt-up, formed concrete, curtain walls “Ordinary” NFPA 220 Type III SBC Type V IBC Type IIIA or IIIB Type 2 D Wood or steel studs in bearing wall, wood frame, primarily combustible construction Wood or steel floor joists or concrete slab on grade Wood or steel joists with wood or steel deck Almost any material, generally combustible construction “Frame” and “Heavy Timber’ NFPA 220 Type V & Type IV (Timbers) SBC Type III or VI IBC Type IV, VA, VB Type 1 Or Type 7 S Metal bents, columns, girders, purlins, and girts; noncombustible construction deck on steel floor joists, or concrete slab on grade Steel deck on steel joists skin or sandwich panels; generally noncombustible “Non-Combustible” NFPA 220 Type II SBC Type IV IBC Type IIB Type 3
Good barns and stables – – 35 30 30 Average barns, hog barns, stables and silos – – 30 25 25 Low-cost barns and stables – – 20 15 15 Excellent poultry houses – – 30 25 25 Good poultry houses, equipment, and utility sheds – – 25 20 20 Average poultry, equipment, and utility buildings – – 20 15 15 Low-cost poultry houses – – 15 15 15 Tobacco barns – – 20 20 15 Miscellaneous sheds and outbuildings 10 to 15 yrs Good greenhouses – – – 30 40 Average lath and greenhouses – – – 20 25 Low-cost lath greenhouses – – – 10 15 Elementary and Secondary Schools A B C D S Good school plants 50 50 45 40 – Average school plants 45 45 45 40 – Low-cost school plants – – 40 35 – Good and excellent classrooms 50 50 45 40 40 Low-cost and average classrooms 45 45 40 35 35 Cheap classrooms – – 35 30 30 Good and average gymnasiums 45 45 40 35 35 Good and average multipurpose, manual arts 45 45 40 35 35 Low-cost multipurpose, manual arts – – 35 30 30 Average shower building – – 30 25 25 Good and excellent day care centers – – 45 40 – Average day care centers – – 40 35 35 Low-cost day care centers – – 40 35 – Re-locatable classrooms – – – 10 –
Commissioning Checklist (Items checked must be commissioned if this Project is Subject to the Georgia Energy Efficiency and Sustainable Construction Act of 2008) COMMISSIONING CHECKLIST PROJECT NAME: MECHANICAL SYSTEMS - Heating, Ventilating, and Air Conditioning (HVAC) Main Items Included in Scope Required Thermometers and gauges Vibration isolation Steam condensate system Hot water heating systems Computer room HVAC systems Chemical water treatment systems Chillers Cooling towers Condenser water system Air terminal unit systems, VAV, PIU, etc. Humidifiers Duct silencers Dampers Variable frequency drives and motors Air distribution systems Exhaust air systems Trend logs Network communication Test and Balance verification Refrigeration equipment and controls Chilled Water System BUILDING ENVELOPE Main Items Included in Scope Required Options Selected Roofing system – insulation, roof membrane, rain and ice shield, pitch, coping, flashing, curbs for mechanical equipment, downspouts, drains, scuppers Exterior skin – curtainwall, storefront, masonry, brick / stone veneers, precast panels, metal panels, stucco / EIFS, siding Walls – vapor barriers, insulation, mortar nets, weeps, joints, sealants, masonry ties Slab on grade – vapor barriers, water-proofing, drainage, foundation drains and windows – sealants, mechanical operation, sills, flashing, end dams, hardware Water tests, mockups, wind loads, thermal infiltration Special design features – dome, cornice, canopy, skylight, etc. NOTES: COMMISSIONING CHECKLIST - 2 ELECTRICAL SYSTEMS Main Included in Scope Required Options