4-Application for Payment.pdf

This is an Application for Payment form issued by Kane County Forest Preserve District, located at 1996 South Kirk Road, Suite 320, Geneva, Illinois 60134, in connection with contract opportunity SB-FP-07-2526 for teasel management services. The form serves as a standardized payment request document for contractors performing work on preservation and restoration projects. The application captures work completion data across multiple line items, including the original contract amount, any extras or change orders, materials stored, work completed percentages and dollar amounts, retained funds, previously paid amounts, and net amounts currently due. Contractors complete the form by documenting the contract details, adjusted total contract values, percentage and dollar amounts of work completed, retention amounts, and cumulative payment history to determine the current payment request.

The payment application form includes designated fields for contractor sworn statements and signatures, along with contact information for Kane County Forest Preserve District leadership, including Bill Lenert as President and Benjamin Haberthur as Executive Director, with phone and fax numbers provided for inquiries. The form is designed to track financial progress on teasel control projects across multiple preserves in Illinois through targeted herbicide applications, with each project awarded individually. The standardized format enables systematic documentation of contractor performance and payment authorization throughout the project duration.