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CCP 01-14-2002
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CCP 01-14-2002
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<br />JAN-09-2002 12:10 <br /> <br />BRW <br /> <br />512 373 5525 P.02/05 <br /> <br />APPLICATION FOR PAYMENT <br />PAYMENT NO, 4 <br /> <br />l' <br /> <br />Project: <br /> <br />Water Main Improvements Project, <br />Old Highway 10 <br />Arden Manor Park Improvements <br />City of Arden Hills <br /> <br />e <br /> <br />Owner: <br />Owner No.: <br />Contractor: <br /> <br />DAVE PERKINS <br />CONTRACTING INC. <br />3795J.018-0101 <br /> <br />FINAL PAYMENT <br /> <br />BRW Job No.: <br /> <br />Application Date: <br />For Period Ending: <br /> <br />1(14(02 <br />1/4/02 <br /> <br />Original Contract Amount <br />Contract Amendments: <br />Contract Amount To Date: <br />Total Amount of Work Complete To Dare: <br />Material Suitably Stored On-Site but not <br />Incorporated into Work; <br />Gross Amount Due To-Date: <br />Less 0.00% Retainage: <br />Amount Due To-Date: <br />Less Previous Payments: <br />Total Due This Application: <br /> <br />$227,828.00 <br />$0.00 <br />$227,828.00 <br />$227,155.45 <br /> <br />$0.00 <br /> <br />$227,155.45 <br />$0.00 <br />$227,155.45 <br />$206,787.45 <br /> <br />$20,368.00 <br /> <br />I hereby certify that all items and amounts shown are correct for the work completed to- <br />date. <br /> <br />Contractor: DAVE PERKINS CONTRACTING INC. <br /> <br />By: Date: <br /> <br />e <br /> <br />The work on this project and the application for payment have been reviewed and the <br />amount shown is recommended for payment. <br /> <br /> <br />BRW, Inc. <br />By: <br /> <br />Date: //C:>'?/6~ <br /> <br />APPROVED FOR PAYMENT <br />Owner: City of Arden Hills <br /> <br />By: <br /> <br />Date: <br /> <br />. <br /> <br />Page 1 of 5" <br />
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