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<br />\ <br /> <br />APPLICATION FOR PAYMENT <br />PAYMENT NO.6 <br /> <br />URS Copy <br />vt." <br />,:v l..,-'/,'i,! <br />..., '-. .(-',; <br />Gcnir8ctcit' Copy <br /> <br />. <br /> <br />Project: <br /> <br />2005 Pavement Management Program <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 />ARNT CONSTRUCTION COMPANY, INC. <br />31809691.00301 <br />1/17/2006 <br />12/31/2005 <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 />$1,375,247.66 <br />$0.00 <br />$1,375,247.66 <br />$1,344,458,31 <br /> <br />$0.00 <br />$1,344,458.31 <br />$67,222.92 <br />$1,277,235.39 <br />$1,042,904.22 <br />$234,331.17 <br /> <br />I hereby certify that all items and amounts shown are correct for the work completed <br /> <br />to date. II I(L <br />C'""'''''''71f c,'"",,4 em,,", <br /> <br />By: L L--..-/ Date: J -) 9 - 6& <br />'-.---) <br /> <br /> <br />. <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 />Date: )-/8.06 <br /> <br />APPROVED FOR PAYMENT <br /> <br />Owner: City of Arden Hills <br /> <br />By: <br /> <br />Date: <br /> <br />. <br /> <br />Page 1 of 5 <br />