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�. <br /> �-�� Owner; Ci of Centerville 1880 Main Street Centerviile P1N 5503B-9794 Date: December 8 2010 <br /> �` � y For Period: 12/1/2010 to 12/8/2010 Re uesk Nc 1 <br /> ��������� Contractor: GM Contra�ting Inc. 19810 - 515th Avenue p.0. B�x 736 Lake C stal MN 56055 <br /> C�F� FY�t�f1E�' ��1�. f�kl`i�iEh'T � <br /> CDBG WAT�R S�RVICES <br /> BONESTR00 FiLE N0. QQ0616-10171-Q <br /> SUMMARY <br /> 1 Originaf Contract Amount $ 162,207.68 <br /> 2 Change Order - Addition $ p.p0 <br /> 3 Change Order - Deduction $ 0.00 <br /> 4 Revised Contract Amount $ 162,207.68 <br /> 5 Value Completed to Date $ 108,002.88 <br /> 6 Material on Nand $ 0.00 � <br /> 7 Amount Earned $ 108,002.88 <br /> 8 Less ltetainage 5% $_ 5 400.14 I <br /> 9 Subtotal $ 102�602J4 I <br /> 10 Less Arnount Paid Previously $ 0.00 'I <br /> il Liquidated damages - $ 0.00 I <br /> 12 AMOUIVT DUE THIS REQUEST FOR PAYMENT N0. 1 � 102,602.74 <br /> I <br /> I <br /> Recommended for Approval by: I <br /> 80NESTR00 , <br /> I <br /> I <br /> Approved by Contractor: Approved by Owner: <br /> 6N6 COf�TRAC�"IhG, IPlC. C F CENTER Il E <br /> \ .��/�����---a/�.� � <br /> Specified Contract Compietion Date: Date: ,,,, <br /> lZ �j-Z��o <br /> '�'`le �i���— ��4� <br /> 81810t 71 REQ t,dem <br /> 9 <br />