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<br />. <br /> <br />e <br /> <br />e <br /> <br />APPLICATION FOR PAYMENT <br /> <br />BRW eo~y~ <br />O~,her Cot'ji <br />Contractor . (!~ <br />~topY <br /> <br />NO. 5 <br /> <br />Project WEST ROUND LAKE ROAD IMPROVEMENTS PHASE I <br />CITY OF ARDEN HILLS <br />Owner CITY OF ARDEN HILLS <br />Owner's Project No. Engineer's File No. 37951-005-2301 <br />Contractor FOREST LAKE CONTRACTING <br />Application Date 9/13/99 For Period Ending 8/31/99 <br /> <br />-------------------------------------------------------------------- <br /> <br />STATEMENT OF WORK <br /> <br />Original Contract Amount <br /> <br />$ 794,725.05 <br />$ 11,970.00 <br />$ 806,695.05 <br />$ 737,420.19 <br />$ 0.00 <br />$ 737,420.19 <br />$ 36,871.01 <br />$ 700,549.18 <br />$ 529,665.23 <br />$ 170,883.95 <br /> <br />Net Change By Contract Amendment <br /> <br />Contract Amount to Date <br /> <br />Total Amount of Work Completed to Date <br /> <br />Material Suitably Stored on Site but not <br />Incorporated into Work <br /> <br />Gross Amount Due to Date <br /> <br />Less 5.00% Retainage <br /> <br />Amount Due to Date <br /> <br />Less Previous Payments <br /> <br />Payment Due this Application <br />