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<br />.. <br /> <br />;I <br /> <br />~:=roo <br />-=- AnderIik & <br />UAssodates <br />EngIneers & Arddtects <br /> <br />Owner: City of Centervllle, 1880 Main St., Centervllle, MN 55038 Date: Auaust 8, 2003 <br />For Period: 612/2003 to 8/812003 Reauest No: 1 <br />Contractor: Dave Perkins Contractlna Inc., 14230 Basalt Sl NW, Anoka, MN 55303 <br /> <br />CONTRACTOR'S REQUEST FOR PAYMENT <br />PELTIER PRESERVE UTILITY & STREET IMPROVEMENTS <br />BRA FILE NO. 616-03-129 <br /> <br />SUMMARY <br />1 Original Contract Amount $ 503,307.00 <br />2 Change Order - Addition $ 0.00 <br />3 Change Order - Deduction $ 0.00 <br />4 Revised Contract Amount $ 503,307.00 <br />5 Value Completed to Date $ 148,946.00 <br />6 Material on Hand $ 0.00 <br />7 Amount Eamed $ 148,946.00 <br />8 Less Retainage 5% $ 7,447.30 <br />9 Subtotal $ 141,498.70 <br />10 Less Amount Paid Previously $ 0.00 <br />11 Liquidated damages - $ 0.00 <br />12 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. 1 ':",,, $ 141.498.70 <br /> <br />Recommended for Approval by: <br />BONESTROO, ROSENE, ANDERUK & ASSOCIATES, INC. <br /> <br />Approved by Contractor: <br /> <br />~~NC <br />~ tZ <br /> <br />Approved by Owner: <br />CITY OF CENTERVlLLE <br /> <br />- <br /> <br />Specified Contract Completion Date: <br />May 15, 2004 <br /> <br />-4~~- <br />Date: /J I <br />(.,tbLe; Z, bt:7r13 <br /> <br />61603129REQ1 <br />