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<br />e <br /> <br />e <br /> <br />- <br /> <br />I hereby certify that all items and amounts shown are correct for the work completed to date, <br /> <br />By <br /> <br /> <br />Contractor <br /> <br />Date <br /> <br />ID'l.Q'1 <br /> <br />The work on this project and the application for payment have been reviewed and the amount <br />shown is recommended for payment. <br /> <br /> <br />By <br /> <br />APPROVED FOR PAYMENT <br /> <br />Owner <br /> <br />City of A rrlen Hills <br /> <br />By <br /> <br />(Name and Title) <br /> <br />Date <br /> <br />/o/6A? <br /> <br />Date <br />