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<br />. <br /> <br />APPLICATION FOR PAYMENT <br />PAYMENT NO.2 <br /> <br />Project: <br /> <br />Booster Station Rehabilitation Project <br />Addendum No.1 <br />City of Arden Hills <br /> <br />URS Copy <br />~City Copy <br />Contraclor Copy <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 />Contra~r: _ , EN:?~~ tyll~v.vT~' INC. <br /> <br />By: (Jd1lF~[;~ <br /> <br />. <br /> <br />Owner: <br />Owner No,: <br />Contractor: <br />BRW Job No.: <br /> <br />ENCOMM MIDWEST, INC. <br />37951-026-0201 <br /> <br />Application Date: <br />For Period Ending: <br /> <br />3/9/04 <br />3/6/04 <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 5.00% Retainage: <br />Amount Due To-Date: <br />Less Previous Payments: <br />Total Due This Application: <br /> <br />$175,420.00 <br />$0.00 <br />$175,420,00 <br />$14,300,00 <br /> <br />$0.00 <br /> <br />$14,300.00 <br />$715.00 <br />$13.585.00 <br />$2,137,50 <br />$11,447.50 <br /> <br />Date: 3-~!J--N <br /> <br />The work on this project and the application for payment have been reviewed and the <br />amount shown i ecommended for payment. <br /> <br />By: <br />/ <br /> <br /> <br />Date: <br /> <br />:'31.?2::< /0 t.r <br /> <br />URS Cor <br /> <br />, <br /> <br />APPROVED FOR PAYMENT <br />Owner: City of Arden Hills <br /> <br />By: <br /> <br />Date: <br /> <br />Page 1 of 4 <br />