My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
CCP 01-12-2004
ArdenHills
>
Administration
>
City Council
>
City Council Packets
>
2000-2009
>
2004
>
CCP 01-12-2004
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
5/8/2007 1:19:18 PM
Creation date
11/14/2006 3:33:31 PM
Metadata
Fields
Template:
General (2)
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
145
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
<br />. <br /> <br />. <br /> <br />. <br /> <br />APPLICATION FOR PAYMENT <br />PAYMENT NO, 1 <br /> <br />Project: <br /> <br />Lift Station #7 Rehabilitation / <br />Karth Lake Pumping Station <br />City of Arden Hills <br /> <br />'f., URS Copy <br />C~y Copy <br />Contractor Copy <br />Inspector Copy <br /> <br />Owner: <br />Owner No.: <br />Contractor: <br />BRW Job No.: <br /> <br />JAY BROS., INC. <br />37951.028.0101 <br /> <br />Application Date: <br />For Period Ending: <br /> <br />1/6/04 <br />12/12/03 <br /> <br />Original Contract Amount: <br /> <br />Contract Amendments: <br /> <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 /> <br />Gross Amount Due To-Date: <br />Less 5.00% Retainage: <br />Amount Due To-Date: <br /> <br />Less Previous Payments: <br /> <br />Total Due This Application: <br /> <br />$232,772.50 <br />$0.00 <br />$232,772.50 <br />$51,852.00 <br /> <br />$0.00 <br />$51,852.00 <br />$2,592.60 <br />$49,259.40 <br />$0.00 <br />$49,259.40 <br /> <br />I hereby certify that all items and amounts shown are correct for the work completed to- <br />date. <br /> <br />Contractor: JAY BROS., INC. <br /> <br />By: 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 />By: <br /> <br />Date: / /7 ~ '! <br /> <br />APPROVED FOR PAYMENT <br />Owner: City of Arden Hills <br /> <br />By: <br /> <br />Date: <br /> <br />Page 1 of5 <br />
The URL can be used to link to this page
Your browser does not support the video tag.