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<br />. CONTRACTOR1S PARTIAL PAY REQUEST <br />2009 PAVEMENT MANAGEMENT PROGRAM <br />CITY OF ARDEN HillS, MINNESOTA <br />BMI PROJECT NO.: T16.100326 <br /> <br />TOTAL AMOUNT BID PLUS APPROVED CHANGE ORDERS <br />TOTAL, COMPLETED WORK TO DATE <br />TOTAL, STORED MATERIALS TO DATE <br />DEDUCTION FOR STORED MATERIALS USED IN WORK COMPLETED <br />TOTAL, COMPLETED WORK & STORED MATERIALS <br />RETAINED PERCENTAGE ( 50/0 ) <br />TOTAL AMOUNT OF OTHER PAYMENTS OR (DEDUCTIONS) <br />NET AMOUNT DUE TO CONTRACTOR TO DATE <br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES <br />PAY CONTRACTOR AS ESTIMATE NO. 2 <br />Certificate for Partial Payment <br />I hereby certify that, to the best of my knowledge and belief, all items quantities and prices <br />of work and material shown on this Estimate are correct and that all work has been <br />performed in full accordance with the terms and conditions of the Contract for this project <br />between the Owner and the undersigned Contractor, and as amended by any <br />authorized changes, and that the foregoing is a true and correct statement of the <br />contract amount for the period covered by this Estimate. <br /> <br />DISTRIBUTION: <br />CONTRACTOR (1) <br />OWNER (1) <br />ENGINEER (1) <br />BONDING CO. (1) <br />$1,196,405.98 <br />$221,653.52 <br />$0.00 <br />$0.00 <br />$221 ,653.52 <br />$11,082.68 <br />$0.00 <br />$210,570.85 <br />$56,409.09 <br />$154,161.76 <br /> <br />Contractor: Frattalone Companies, Inc. <br />.3205 e Street <br />'r"---....J st. ~ ul, M )5117 <br /> <br />By \.~ -7 <br /> <br />v \J Name <br /> <br />Date ) -' J ,. CI OJ <br /> <br />p . Iv'L <br />Title <br /> <br />CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT: <br />ENGINEER: BOLTON & MENK, INC., ENGINEERS, 12224 NICOLLET AVENUE, BURNSVILLE. MN. <br /> <br />By L_~ ~ 241*- <br />Travis Winter, P. E. - <br /> <br />Date 0/ ~? <br /> <br />, PROJECT ENGINEER <br /> <br />APPROVED FOR PAYMENT: <br />. OWNER: City of Arden Hills <br /> <br />By <br /> <br />Name <br /> <br />TitJe <br /> <br />Date <br /> <br />And <br /> <br />Name <br /> <br />Title <br /> <br />Date <br />