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<br />. <br /> <br />. <br /> <br />. <br /> <br />APPLICATION FOR PAYMENT <br />PAYMENT NO.5 <br /> <br />Project: <br /> <br />2001 Sanitary Sewer Rehabilitation Project <br />Lift Station #8 Reconstruction <br />City of Arden Hills <br /> <br />V SR''''J COpy <br />City Copy <br />Contractor Cot't' <br />inspector COpy' <br /> <br />I hereby certify that all items and amounts shown are correct for the work completed to- <br />date. <br /> <br />Contractor: GRIDOR CONSTRUCTION, INC. <br /> <br />By: Date: <br /> <br />Owner: <br />Owner No.: <br />Contractor: <br /> <br />GRIDOR CONSTRUCTION, <br />INC. <br />37951-016-0101 <br /> <br />The work on this project and the application for payment have been reviewed and the <br />amount sho is recommended for payment. <br /> <br /> <br />By: <br /> <br />BRW Job No.: <br /> <br />Application Date: <br />For Period Ending: <br /> <br />8/13/01 <br />7/21/01 <br /> <br />Original Contract Amount: <br />Contract Amendments: <br />Contract Amount To Date: <br />Total Amount of Work Complete To Date: <br />Material Suitably Stored On-Site but not <br />Incorporated into Work: <br />Gross Amount Due To-Date: <br />Less 2.00% Retainage: <br />Amount Due To-Date: <br />Less Previous Payments: <br /> <br />Total Due This Application: <br /> <br />$302,484.00 <br />$0.00 <br />$302,484.00 <br />$277,562.05 <br /> <br />$0.00 <br />$277,562.05 <br />$5,551.24 <br />$272.010.81 <br />$254,820.45 <br /> <br />$17,190.36 <br /> <br />Date: <br /> <br />c;/rs/o/ <br /> <br />APPROVED FOR PAYMENT <br />Owner: City of Arden Hills <br /> <br />By: <br /> <br />Date: <br /> <br />Page 1 of 5 <br />