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<br />4- <br /> <br />Bonestroo <br /> <br />Owner: City 01 Centerville, 1880 Main St., Centerville, MN 55038 Date: November 10,2008 <br />For Period: 1/812008 to 11/10/2008 Request No: 5 AND FINAL <br />Contractor: Veit & Company, Inc, 14000 Veit Place. Roqers, MN 55374 <br /> <br />CONTRAOOR'S REQUEST fOR PAYMENl <br />2007 HIDDEN SPRING PARK IMPROVEMENTS <br />BONESTROO FilE NO 000616.07155-0 <br /> <br />SUMMARY <br />1 Original Contrad Amount <br />2 Change Order - Addition <br />3 Change Order. Deduction <br />4 Revised Contrad Amount <br />5 Value Completed to Date <br />6 Material on Hand <br />7 Amount Earned <br />8 Less Retainage 0% <br />9 Subtotal <br />10 Less Amount Paid Previously <br />11 Liquidated damages - <br />12 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. <br /> <br />$ <br /> <br />$ <br />$ <br /> <br />7,852.40 <br />0.00 <br /> <br />5 AND FINAL <br /> <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br /> <br />Recommended for Approval by: <br />BONESTROO <br /> <br />~~ .P- <br /> <br />Approved by Contractor: <br />VEIT Br COMPANY, INC. <br /> <br />Approved by OWner: <br />CITY OF CENTERVILLE <br /> <br />218,281.00 <br /> <br />226,133.40 <br />226,133.40 <br />0.00 <br />226,133.40 <br />0.00 <br />226, t 33.40 <br />208,499.13 <br />0.00 <br />17,633.67 <br /> <br />Specified (on tract Completion Date: <br /> <br />Date. <br /> <br />61607155REQSFINALlds <br /> <br />/tJ <br />