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CONTRACTOR'S PARTIAL PAY REQUEST <br />DISTRIBUTION: <br />2009 PAVEMENT MANAGEMENT PROGRAM <br />CONTRACTOR (1) <br />CITY OF ARDEN HILLS, MINNESOTA <br />OWNER (1) <br />BM I PROJECT NO.. T16.100326 <br />ENGINEER 1 <br />BONDING CO. (1) <br />TOTAL AMOUNT BID PLUS APPROVED CHANGE ORDERS <br />$11195,405.98 <br />TOTAL, COMPLETED WORK TO DATE <br />$5592213.26 <br />TOTAL, STORED MATERIALS TO DATE <br />$0.00 <br />DEDUCTION FOR STORED MATERIALS USED IN WORK COMPLETED <br />$0.09 <br />TOTAL, COMPLETED WORK & STORED MATERIALS <br />$659,213.25 <br />RETAINED PERCENTAGE 5% <br />$33,450.65 <br />TOTAL AMOUNT OF OTHER PAYMENTS OR DEDUCTIONS <br />$0.00 <br />NET AMOUNT DUE TO CONTRACTOR TO DATE <br />$635,752.50 <br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES <br />$530, 551.70 <br />PAY CONTRACTOR AS ESTIMATE NO. 5 <br />$105,190.99 <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 />Contractor: Erattalone Companies, Inc. <br />3205 Spruce Street <br />St. Paul, MN 55117 <br />By <br />Name Title <br />Date <br />CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT: <br />ENGINEER: BOLTON & MENK, INC., ENGINEERS, 12224 NICOLLET AVENUE, BURNSVILLE, MN. <br />By ....� , PROJECT ENGINEER <br />Travis Winter, P.E. <br />Date <br />APPROVED FOR PAYMENT: <br />OWNER: City of Arden dills <br />By <br />Name Title Date <br />And <br />Name Title bate <br />