2006-10-25 CC Packet - Laserfiche WebLink

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APPLICATION AND CERTIFICATION FOR PAYMENT PROJECT: Pheasant Marsh 3rd Addition CONTRACTOR: Soil-Con, Inc. PO Box 217 East Bethel, MN 55011 OWNER: Ground Development, Inc. CONTRACT FOR: Site Grading & Erosion Control 7575 Golden Valley Road, Suite 250 Golden Valley, MN 55427 VOUCHER NO.: 2 PERIOD ENDING: July 20, 2006 VOUCHER DATE: August 2,2006 The present status of the account for this Contract is as follows: ORIGINAL CONTRACT SUM ............ ........................... ............................... Net change by Change Orders ....... .......................... ............................... CONTRACT SUM TO DATE ............. ........................... ............................... VALUE OF WORK COMPLETED TO DATE ................ ............................... LESS CHARGES AND DEDUCTIONS ....................... ............................... LESS RETAINAGE 2% ........................................................0. LESS PREVIOUS VOUCHERS.......... ........................... ............................... CURRENT PAYMENT DUE............... ........................... ............................... The undersigned Contractor certifies that the Work covered by this Application for Payment has been completed in accordance with the Contract documents, that all amounts have been paid by them for Work for which previous Certificates for Payments were issued and payments received from the Owner, and that the current payment shown herein is now due. Contractor. By: Date: ~ -/0 - In accordance with the Contract and this Application for Payment the Contractor is entitled to payment in the amount shown above. Engineer: JAMES R. HILL, INC. 1523 94th Lane NE, Suite B Blaine, MN 55449 By~O-A7 DATE: rh~ rJ;::\'i( r'i~ ~-,_: t'\1' ~ '. " " . ::$'1l~ _. . ~-:;.~.-- $ $ $ $ $ $ $ $ 119,495.00 51,146.85 170,641.85 166,838.35 3,336.77 58,084.42 105,417.16 3D