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<br />. <br /> <br />. <br /> <br />. <br /> <br />APPLICATION FOR PAYMENT <br />PAYMENT NO.1 <br /> <br />OOS CfJP1 <br />X Clly Copy <br />Cooeraclor Cq:y <br />Inspector Copy <br /> <br />Project: <br />Owner: <br />Owner No.: <br />Contractor: <br />URS Job No.: <br />Application Date: <br />For Period Ending: <br /> <br />2006 Pavement Management Program / Ridgewood Neighborhood <br />City of Arden Hills <br /> <br />Amt Construction <br />31809837 <br />8/22/2006 <br />8/17/2006 <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 />$1,808,584.32 <br />-$105,270.16 <br />$1,703,314.16 <br />$513,486.94 <br /> <br />$0.00 <br />$513,486.94 <br />$25,674.35 <br />$487,812.59 <br />$0.00 <br />$487,812.59 <br /> <br />I hereby certify that all items an amounts shown are correcl for the work completed <br />to date. <br /> <br /> <br />Date: 9 - ;),). - {Xc.:> I <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 /> /J ! <br />URS CorpQJ.<ttion /2Jz <br /> // <br /> ,/ <br /> L) /c'///.. ~--t/~ 8,/;:'>'0/ <br />By: /r-;::;,(CA1/./'Vc Date: <br />/. ~ I / / <br /> , ,/ <br /> J/ <br />APPROVED FOR PAYMENT <br />Owner: City of Arden Hills <br />By: Date: <br /> <br />1 of 10 <br />