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<br />::. Rosene
<br />U Anderlik &
<br />'11' Associates
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<br />Ownur: CIl of Cenlervilie, 18 0 Main St., Centervilie, /, iN 55038
<br />
<br />For Period: 12/10/99 to 6/2; 00
<br />
<br />Date:
<br />Reauest No:
<br />
<br />June 27,2000
<br />3 AND FINAL
<br />
<br />Enginw'&Architectl Contractor: IN B Miller Inc., 101 Norris Lake Rd NW, Elk River, MN 55330
<br />
<br />REQUEST FOR PA'{MENT
<br />WATER INTERCmlNECT
<br />BRA FILE NO, 616-9[J-809
<br />
<br />SUMMARY
<br /> Original Contract Amount $ 57,894.50
<br />2 Change Order - Addition $ 0.00
<br />3 Change Order - Deduction $ 0.00
<br />4 Revised Contract Amount $ 57,894.50
<br />5 Value Completed to Date $ 59,876.75
<br />6 Material on Hand $ 0.00
<br />7 Amount Earned $ 59,876.75
<br />8 Less Retainage 0% $ 0.00
<br />9 Subtotal $ 59,876.75
<br />10 Less Amount Paid Previously $ 56,716.66
<br />11 Liquidated damages - $ 0.00
<br />12 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. 3 ANC, FINAL $ 3,160.09
<br />
<br />Recommended for Approval by:
<br />BONESTROO, ROSENE, ANDERLII( & ASSOCIHES, INC.
<br />
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<br />Approved by Contractor:
<br />W 8 MILj...5R INC
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<br />Approved by Owner:
<br />CITY OF CENTERVILLE
<br />
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<br />
<br />Specified Contract Completion Date:
<br />October 29, 1999
<br />
<br />Date:
<br />
<br />.
<br />
<br />request3Final
<br />
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