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09-12-05
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09-12-05
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9/17/2012 10:46:46 AM
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11/14/2006 4:22:50 PM
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<br />APPLICATION FOR PAYMENT <br />PAYMENT NO. 2/ FINAL PAYMENT <br /> <br />Project: <br /> <br />Street Sign Program <br /> <br />. <br /> <br />Owner: <br />Owner No.: <br />Contractor: <br />URS Job No.: <br />Application Date: <br />For Period Ending: <br /> <br />City of Arden Hills <br /> <br />Northern Traffic Supply <br />37951-005-0101 <br />9/6/2005 <br />8/26/2005 <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 />$51,620.00 <br />$0.00 <br />$51,620.00 <br />$55,514.02 <br /> <br />$0.00 <br />$55,514.02 <br />$0.00 <br />$55,514.02 <br />$44,860.90 <br />$10,653.12 <br /> <br />I hereby certify that all items and amounts shown are correct for the work completed <br />to date_ <br /> <br />Contractor: Northern Traffic Supply. <br /> <br />P~u.~ <br /> <br />. <br /> <br />By: <br /> <br />Date: <br /> <br />1'- 2 ~CJS <br /> <br />The work shown on this project and the application for payment have been reviewed <br />and the amount shown is recommended for payment. <br /> <br />By: <br /> <br /> <br />/) <br />~</ <br /> <br />Date: 7- b'O~ <br /> <br />APPROVED FOR PAYMENT <br /> <br />Owner: City of Arden Hills <br /> <br />By: Date: <br /> <br />. <br />
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