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<br /> " <br /> . . lIRS Copy <br /> 1" City Copy <br /> . APPLICATION FOR PAYMENT Contractor Copy <br /> PAYMENT NO.4 Inspector Co:)y <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: 10/24/2006 <br /> For Period Ending: 1 0/20/2006 <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: $1,381,216.14 <br /> Material Suitably Stored On-Site but not <br /> Incorporated Into Work: $0.00 <br /> Gross Amount Due To Date: $1,381,216.14 <br /> Less 5.00':'0 Retainage: $69,060.81 <br /> Amount Due To Date: $1,312,155.33 <br /> Less Previous Payments: $919,493.49 <br /> Total Due This Application: $392,661.84 <br /> I hereby certify that all items and amounts shown are correct for the work completed <br /> . to date. contra~NSTRl ION r:. <br /> I By: ;; ~:/ ( ~ X / Date: /{; - Jo- 0 (...,. <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 /> By: L~ Date: /0- ;lo-o(' <br /> APPROVED FOR PAYMENT <br /> Owner: City of Arden Hills <br /> By: Date: <br /> . <br />