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<br /> , <br /> l'?~:1 (~(":oy <br /> I< C;'y ~c'::'/ <br /> APPLICATION FOR PAYMENT (~,';".~;:':v ,'>:JY <br /> inS:;.,.:"- . <br /> PAYMENT NO.5 <br />Project: 2006 Pavement Management Program / Ridgewood Neighborhood <br />Owner: City of Arden Hills <br />Owner No.: <br />Contractor: Amt Construction <br />URS Job No.: 31809837 <br />Application Date: 11/21/2006 <br />For Period Ending: 11/17/2006 <br />Original Contract Amount: $1.808.584.32 <br />Contract Amendments: -$105,270.16 <br />Contract Amount To Date: $1,703,314.16 <br />Total Amount of Work Complete To Date: $1,630,885.99 <br />Material Suitably Stored On-Site but not <br />Incorporated Into Work: $0.00 <br />Gross Amount Due To Date: $1,630,885.99 <br />Less 5.00~';' Retainage: $81,544.30 <br />Amount Due To Date: $1,549,341.69 <br />Less Previous Payments: $1,312,155.33 <br />Total Due This Application: $237,186.36 <br />I hereby certify that all items and amounts shown are correct for the work completed . <br />to date. <br />con~;f!(/rfo11 <br /> Date: //-)..0- O<..P <br />By: (/ L,_~ J '--------- \,..- <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 /> Date: //;;</-oC <br />APPROVED FOR PAYMENT <br />Owner: City of Arden Hills <br />By: Date: <br /> . <br />