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<br />.- <br /> <br />Bonestroo <br /> <br />Owner: City of Centerville, 1880 Main Street, Centerville, MN 55038 Date: January 7, 2008 <br />For Period: . 9/6/2007 to 117/2008 Request No: 4 <br />Contractor: Veit.& Company, Inc., 14000 Veit Place, Roqers, MN 55374 <br /> <br />CONTRACTOR'S REQUEST FOR PAYMENT <br />2007 HIDDEN SPRING PARK IMPROVEMENTS <br />BONESTROO FILE NO. 000616-07155-0 <br /> <br />SUMMARY <br />1 Original 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 />11 Uquidated damages - <br />12 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. <br /> <br /> $ <br />$ 0.00 <br />$ 0.00 <br /> $ <br /> $ <br /> $ <br /> $ <br /> $ <br /> $ <br /> $ <br /> $ <br />4 $ <br /> <br />218,281.00 <br /> <br />218,281.00 <br />219,473.40 <br />0.00 <br />219,473.40 <br />10,973.67 <br />208,499.73 <br />202,456.73 <br />0.00 <br />6,043.00 <br /> <br />Recommended for Approval by: <br />BONESTROO <br /> <br />&-;5- <br /> <br /> <br />Approved by Owner: <br />CITY OF CENTERVILLE <br /> <br />Specified Contract Completion Date: <br /> <br />Date: <br /> <br />'I <br /> <br />61607155REQ4.xJs <br />