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Py <br /> APPLICATION FOR PAYMENT <br /> PAYMENT NO.4 <br /> Project: 2005 Pavement Management Program <br /> Owner: City of Arden Hills <br /> Owner No.: <br /> Contractor: ARNT CONSTRUCTION COMPANY, INC. <br /> URS Job No.: 31809691.00301 <br /> Application Date: 11/14/2005 <br /> For Period Ending: 11/3/2005 <br /> Original Contract Amount: $1,375,247.66 <br /> Contract Amendments: $0.00 <br /> Contract Amount To Date: $1,375,247.66 <br /> Total Amount of Work Complete To Date: $962,050.06 <br /> Material Suitably Stored On-Site but not <br /> Incorporated Into Work: $0.00 <br /> Gross Amount Due To Date: $962,050.06 <br /> Less 5.00%Retainage: $48,102.50 <br /> Amount Due To Date: $913,947.56 <br /> Less Previous Payments: $575,055.71 <br /> Total Due This Application: $338,891.85 <br /> I hereby certify that/items d amounts shown are correct for the work completed <br /> to date. <br /> Contracto nstru o Co , nc. f <br /> By: Date: <br /> The work shown on this project and the application for payment have been reviewed <br /> and the amount shown is recommended for payment. <br /> URS Corp ation <br /> By: Date: //-3�o S <br /> APPROVED FOR PAYMENT <br /> Owner: City of Arden Hills <br /> By: Date: <br /> Page 1 of 5 <br />