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<br />. A' Bonestroo <br />~ Rosene <br />n Anderlik & <br />1 ~ 1 Associates <br />Engineers & Architects <br /> <br />Owner: City of Centerville, 1880 Main St., Centerville, MN 55038 Date: AUQust 4, 2005 <br />For Period: 7/21/2005 to 8/4/2005 Request No: 3 <br />Contractor: American Tank Services Inc., DBA Holte ContractinQ, 3174 Ryan Ln., S1. Paul, MN 55117 <br /> <br />CONTRACTOR'S REQUEST FOR PAYMENT <br />POND AND DITCH IMPROVEMENTS <br />BRA FILE NO. 000616-04140-0 <br /> <br />SUMMARY <br />1 Original Contract Amount $ 77,725.00 <br />2 Change Order - Addition $ 5,107.96 <br />3 Change Order - Deduction $ 0.00 <br />4 Revised Contract Amount $ 82,832.96 <br />5 Value Completed to Date $ 73,497.26 <br />6 Material on Hand $ 0.00 <br />7 Amount Earned $ 73,497.26 <br />8 Less Retainage 2,000.00 $ 2,000.00 <br />9 Subtotal $ 71,497.26 <br />10 Less Amount Paid Previously $ 60,386.70 <br />11 Liquidated damages - $ 0.00 <br />12 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. 3 $ 11,110.56 <br /> <br />Recommended for Approval by: <br />BONESTROO, ROSENE, ANDERLlK & ASSOCIATES, INC. <br /> <br />I~"? .tJ~ <br /> <br />Approved by Contractor: <br />AMERICAN TANK SERVICES INC DBA HOLTE <br />CONTRACTING <br /> <br />Approved by Owner: <br /> <br />CITY OF CENTERVlllE <br /> <br />Specified Contract Completion Date: <br />May 27, 2005 <br /> <br />Date: <br /> <br />61604140REQ3.xls <br /> <br />27- <br />