Laserfiche WebLink
<br />. <br /> <br />. <br /> <br />. <br /> <br />OCT-09-2002 13:42 <br /> <br />8RW <br /> <br />612 373 6526 P.02/14 <br /> <br />APPLICATION FOR PAYMENT <br />PAYMENT NO.1 <br /> <br />Project: <br />Owner: <br />Owner No.: <br />Contractor: <br /> <br />2002 Pavement Management Program for Hunters Court and Waldon Place <br />City of Arden Hills <br /> <br />SAW Job No.: <br /> <br />T. A, SCHIFSKY AND SONS <br />INC. <br />37951-020-0101 <br /> <br />Application Date: <br />For Period Ending: <br /> <br />10/15/02 <br />9/30/02 <br /> <br />Original Contract Amount: <br />Contract Amendments: <br />Contract Amount To Date: <br />Total Amount of Work Complete To Dale: <br />Material Suitably Stored On-Site but not <br />Incorporated into Work: <br />Gross Amount Due To-Date: <br />Less 5.00% Aetainage: <br />Amount Due To-Date: <br />Less Previous Payments: <br />Total Due This Applicalion: <br /> <br />$160,416_50 <br />$0.00 <br />$160,416_50 <br />$87,708.00 <br /> <br />$0.00 <br />$87,708.00 <br />S4,385.40 <br />$83,322.60 <br />SO.OO <br /> <br />$83,322.60 <br /> <br />I hereby certify that all items and amounts shown are correct for the work completed to- <br />date. <br /> <br />Contractor: T. A. SCHIFSKY AND SONS INC. <br /> <br />By: <br /> <br />Date: <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 />Date: }pA/t'J'?- <br /> <br />By: <br /> <br />APPROVED FOR PAYMENT <br />Owner: City of Arden Hills <br /> <br />By: <br /> <br />Date: <br /> <br />Page 1 of 5 <br />