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<br />------------------ - <br /> <br />. " <br /> <br />/' <br /> <br />.- <br /> <br />Bonestroo <br /> <br /> <br />Date: <br />Re uest No: <br /> <br />. <br />of Centerville, 1889 MainSt, Centerville, MN 55038 <br />6/1/2007 to 7/17/2007 <br />Veit & Com n. Inc., 14000 Veit Place, R ers, MN 55374 <br /> <br />For Period: <br />Contractor. <br /> <br />CONTRACTOR'S REQUEST FOR PAYMENT <br />2007 HIDDEN SPRING PARK IMPROVEMENTS <br />BONESTROO FILE NO. 000616-07155-0 <br /> <br />'~ <br /> <br />SUMMARY <br />1 o.riQ.inal Contract Amount <br />2 Change Order - Addition <br />3 Change Order - Deduction <br />4 Revised Contract Amount <br />5 Value Completed to Date <br />6 Material on Hand <br />7 Amount Earned <br />8 Less Retainage 5% <br />9 Subtotal <br />10 Less Amount Paid Previously <br />I_~_ _u~__llm_ Liquidated damages~___ <br />12 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. <br /> <br />$ <br /> <br />$ <br />$. <br /> <br />0.00 <br />0.00 <br /> <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />-$ <br />$ <br /> <br />Recommended for Approval by. <br />BONESTROO <br /> <br /> <br />~, <br /> <br />VEIT ,It COMPANY,. INC. <br /> <br />Approved by Owner. <br />CTY OF CENTERVILLE <br /> <br />~......... ..A~ <br /> <br />Ju 17,2007 <br />1 <br /> <br />218;281.00 <br /> <br />218,281.00 <br />126,283.00 <br />0.00 <br />126,283.00 <br />6,314.15 <br />119,968.85 <br />0.00 <br />000 <br />119,968.85 <br /> <br />Specified Contract Completion Date: <br /> <br />Date: <br /> <br />61607155REQ1.x18 <br /> <br />// <br />