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<br />. <br /> <br />. <br /> <br />. <br /> <br />APPLICATION FOR PAYMENT <br />PAYMENT NO.2 <br /> <br />/ URS Copy <br />" City Copy <br />Contractor Copy <br />Inspector Copy <br /> <br />Project: <br /> <br />Arden Hills Park Department <br />Perry Park Ballfield Improvements <br />City of Arden Hills <br /> <br />Owner: <br />Owner No.: <br />Contractor: <br /> <br />FINAL PAYMENT <br /> <br />THOMAS & SONS <br />CONSTRUCTION <br />37951-005-8001 <br /> <br />BRW Job No.: <br /> <br />Application Date: <br />For Period Ending: <br /> <br />12/13/2004 <br />12/6/2004 <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 0.00% Retainage: <br />Amount Due To-Date: <br />Less Previous Payments: <br /> <br />Total Due This Application: <br /> <br />$42,698.75 <br />$0.00 <br />$42,698.75 <br />$41,959.22 <br /> <br />$0.00 <br />$41,959,22 <br />$0.00 <br />$41,959.22 <br />$35,243.57 <br /> <br />$6,715.65 <br /> <br /> <br />I hereby certify that all items and amounts shown are correct for the work completed to- <br />date. d <br /> <br />Contractor: . H~ <br /> <br />By: " <br /> <br />Date: <br /> <br />/j)- tf-o V <br />r <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 />APPROVED FOR PAYMENT <br />Owner: City of Arden Hills <br /> <br />By: <br /> <br />Date: / ?- - ff'- t? '-r <br /> <br />Date: <br /> <br />Page 1 of 4 <br />