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<br />I........ <br />i.1I1 <br />Hnnn....n.. <br />l~J..~~sAfi~!~s <br />Engi6lie:is&Aichiie<lS <br /> <br />Owner: City of Centerville, 1880 Main Street, Centerville, MN 55038 Date: July 18, 2006 <br />For Period: 6/1/2006 to 7/18/2006 Request No: 1 <br />Contractor: Burschville Construction, Inc., 11440 8th Street NE, P. O. Box 65, Hanover, MN 55341 <br /> <br />CONTRACTOR'S REQUEST FOR PAYMENT <br />BACKAGE ROAD AND 21ST AVENUE UTILITY AND STREET IMPROVEMENTS <br />BRA FILE NO. 000616-05143-0 <br /> <br />SUMMARY <br /> Original Contract Amount $ 1,118,251.90 <br />2 Change Order - Addition $ 0.00 <br />3 Change Order - Deduction $ 0.00 <br />4 Revised Contract Amount $ 1,118,251.90 <br />5 Value Completed to Date $ 110,246.95 <br />6 Material on Hand $ 0.00 <br />7 Amount Earned $ 110,246.95 <br />8 Less Retainage 5% $ 5,512.35 <br />9 Subtotal $ 104,734.60 <br />10 Less Amount Paid Previously $ 0.00 <br />11 Liquidated damages - $ 0.00 <br />12 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. $ 104,734.60 <br /> <br />Recommended for Approval by: <br />BONESTROO, ROSENE, ANDERLlK & ASSOCIATES, INC. <br /> <br />~~ <br /> <br />Approved by Contractor: <br />BU CHVILLE CONSTRUCTION, INC. <br /> <br />Approved by Owner: <br />CITY OF CENTERVILLE <br /> <br /> <br />J <br /> <br />Specified Contract Completion Date: <br /> <br />Date: <br /> <br />61605143REQ1x1s <br /> <br />~I <br />