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<br />. <br /> <br />1 <br /> <br />~ <br /> <br />. <br /> <br />JnJ Bonestroo <br />e Rosene <br />n Anderlik & <br />1U1 Associates <br />Engineers &. Architetts <br /> <br />Owner: City of Centerville, 1880 Main St., Centerville, MN 55038 Dale: December 9, 2002 <br />For Period: 10/4/2002 to 1219/2002 Reouest No: 4 AND FINAL <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 $ 158.803,00 <br />2 Change Order - Addition $ 8,750,00 <br />3 Change Order - Deduction $ 0.00 <br />4 Revised Contract Amount $ 167,553,00 <br />5 Value Completed to Date $ 164,710,00 <br />6 Material on Hand $ 0,00 <br />7 Amount Eamed $ 164.710,00 <br />8 Less Retainage 0% $ 0,00 <br />9 Sublotal $ 164,710,00 <br />10 Less Amount Paid Previously $ 163.062,90 <br />11 Liquidated damages - $ 0,00 <br />12 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. 4 AND FINAL $ 1.647,10 <br /> <br />Recommended for Approval by: <br />BONESTROO, ROSENE, ANDERLlK & ASSOCIATES, INC. <br /> <br /> <br />iAA!h1if/1 tjL:1~,C1,L..----~ <br />" <br /> <br />Approved by Contractor: <br /> <br /> <br />.'F"l'hJ4<<v.o <br /> <br />ApprOved by Owner: <br />CITY OF CENTERVILLE <br /> <br />Specified Contract Completion Date: <br />September 13, 2002 <br /> <br />Date: <br /> <br />61601123REQ4Fil13l <br />