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� <br />�. <br />� a � :�yn����� �F �����x��,� �iF' b � �}�r <br />Owner: City of Arden Hills <br />1245 West H i g hway 96 <br />Arden Hills, MN 55112 <br />For Period: 5/24/2010 to 6/20/2010 <br />Contractor: T. A. Schifsky & Sons, inc. <br />2370 East Hwy. 36 <br />North St. Paul, MN 55109 <br />Pay Voucher <br />ARDH - 2010 Pavement Management Project <br />Client Contract No.: <br />Project No.: 01771-02 <br />Client Project No.: <br />Date: 6/23/2010 <br />Request No.: <br />Proiect Summary <br />1 Original Contract Amount $779,799.67 <br />2 Contract Changes - Addition $0.00 <br />3 Contract Changes - Deduction ($48,169.08) <br />4 Revised Contract Amount $731,630.59 <br />5 Value Completed to Date $107,937.86 <br />6 Material on Hand $0.00 <br />7 Amount Earned $107,937.86 <br />8 Less Retainage 5% $5,396.89 <br />9 Subtotal $102,540.97 <br />10 Less Amount Paid Previously $0.00 <br />11 Liquidated Damages $0.00 <br />12 AMOUNT DUE THIS PAY VOUCHER NO. 1 $102,540.97 <br />THIS IS TO CERTIFY THAT THE ITEMS OF WORK SHOWN IN THIS CERTIFICATE OF PARTIAL PAYMENT HAVE <br />BEEN ACTUALLY FINISHED FOR THE WORK COMPRISING THE ABOVE MENTIONED PROJECTS IN <br />ACCORDANCE WITH THE PLANS AND SPECIFICATIONS HERETOFORE APPROVED. <br />Recommended for Approval by: <br />WSB & Associates, Inc. <br />Approved by Contractor: <br />7'. A. Schifsky & Sons, Inc. <br />Specified Contract Completion Date: <br />5/31 /2011 <br />Comment: <br />Construction Observer: <br />Approved by Owner: <br />City of Arden Hills <br />Date: <br />Page 1 <br />