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<br />r <br /> <br />I Bonestroo <br />l1:li Rosene <br />'II Anderlik& <br />.u. Assodates <br />Engineer$.& Architects <br /> <br />Owner: City of Centerville, 1880 Main Street, Centerville, MN 55038-9794 Date: October 28, 2004 <br />For Period: September 30,2004 to October 31,2004 Reauest No: 4 <br />Contractor: Maauire Iron, Inc., PO Box 1446, Sioux Falls, SD 57101 <br /> <br />CONTRACTOR'S REQUEST FOR PAYMENT <br />500 MG SPHEROID ELEVATED STORAGE TANK <br />BRA FILE NO. 616-03-130 <br /> <br />SUMMARY <br />1 Original Contract Amount $ 943,115.35 <br />2 Change Order - Addrtion $ <br />3 Change Order - Deduction $ <br />4 Revised Contract Amount $ 943,115.35 <br />5 Vaiue Compieted to Date $ 621,966.10 <br />6 Material on Hand $ 0.00 <br />7 Amount Earned $ 621,966,10 <br />8 Less Retainage 5% $ 31,098.31 <br />9 Subtotal $ 590,867.79 <br />10 Less Amount Paid Previously $ 466,783.83 <br />11 Liquidated Damages $ 0.00 <br />12 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. 4 $ 104,083.96 <br /> <br /> <br />Specified Con1ract Completion Date: <br /> <br />Approved by Owner: <br />CITY OF C h'~ <br /> <br /> <br /> <br />~h <br />Date N(jV, ~I 2cJo i <br /> <br /> <br />61603130 Req 4.x1s <br />