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Owner: City of Centerville 1880 Main St. , Centerville MN 55038 Date: October 16 2013 <br /> 0 sta For Period: 8/23/2013 to 10/16/2013 Re uest No 4 <br /> Contractor: Northdale Construction Co. Inc. 9760 71st St. NE Albertville MN 55301 <br /> CONTRACTOR'S REQUEST FOR PAYMENT <br /> 2013 STREET AND UTILITY IMPROVEMENTS <br /> STANTEC PROJECT NO. 193801520 <br /> SUMMARY <br /> 1 Original Contract Amount $ 1,533,650.86 <br /> 2 Change Order - Addition $ 12,545.39 <br /> 3 Change Order - Deduction $ 0.00 <br /> 4 Revised Contract Amount $ 1,546,196.25 <br /> 5 Value Completed to Date $ 1,312,828.54 <br /> 6 Material on Hand $ 0.00 <br /> 7 Amount Earned $ 1,312,828.54 <br /> 8 Less Retainage 5% $ 65,641.43 <br /> 9 Subtotal $ 1,247,187.11 <br /> 10 Less Amount Paid Previously $ 1,110,469.62 <br /> 11 Liquidated damages - $ 0.00 <br /> 12 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. 4 $ 136,717.49 <br /> Recommended for Approval by: <br /> STANTEC <br /> Approved by Contractor: Approved by Owner: <br /> NORTHDALE CONSTRUCTION CO., CITY OF CENTERVILLE <br /> Specified Contract Completion Date: Date: <br /> 193801520RE04.)dsm <br /> 11 <br />