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<br />, <br /> <br />, <br /> <br />'A' Bonestroo <br />R Rosene <br />n Anderlik & <br />.~. Associates <br />Engineers &. Archlteas <br /> <br />Ow~er: Citv of Centerville, 1880 Main St, Centerville, MN 55038 Date: Auoust 6, 2002 <br />Far Period: 6/13/2002 to 8/6/2002 Reouest No: 1 <br /> , <br />Contractor: Earth Burners Inc., 5910 Fremont St., Duluth, MN 55807 <br /> <br />CONTRACTOR'S REQUEST FOR PAYMENT <br />CSAH 14 WATER MAIN EXTENSION <br />BRA FILE NO. 616-01-123 <br /> <br />SUMMARY <br /> Original Contract Amount $ 168,803.00 <br />2 Change Order - Addition $ 0.00 <br />3 Change Order - Deduction $ 0.00 <br />4 Revised Contract Amount $ 158,80300 <br />5 Value Completed to Date $ 122,323.00 <br />6 Material on Hand $ 0.00 <br />7 Amount Earned $ 122,323.00 <br />8 Less Retainage 5% $ 6,116.15 <br />9 Subtotal $ 116,206.85 <br />10 Less Amount Paid Previously $ 0.00 <br />11 Liquidated damages - $ 0.00 <br />12 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. $ 116,206.85 <br /> <br />Recommended for Approvai by: <br />BONESTROO, ROSENE, ANDERLIK & ASSOCIATES, INC. <br /> <br />'-1~ W!~. <br /> <br />~ <br /> <br />Approved by Contractor. <br />EARTH BURNERS INC <br /> <br />~p <br /> <br />---- <br /> <br />Approved by Owner. <br />CITY OF CE~..~ '''RVI'LLU'E ~ <br />~I'~ <br />eihr Ad~~'{,lrc<.kll <br /> <br />Specified Contract Completion Date: <br />September 13, 2002 <br /> <br />Date:~ <br /> <br />I~ Za;z- <br />, <br /> <br />4 ?/1-Lf1q~S- 3DO <br /> <br />a1601123REQhls <br />