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<br />. <br /> <br />j(]j Bonestroo <br />Rosene <br />-=- AnderIik & <br />1\11 Associates <br />Engineers & ArchitectS' <br /> <br />Owner. Citv of Centerville, 1880 Main Street, Centerville, MN 55038-9794 Date: Auaust30, 2004 <br />For Period: Mav 31, 2004 to AUQust31, 2004 R""uesl No: 2 <br />Contraelor. Maauire Iron, Inc., PO Box 1446, Sioux Falls, SO 57101 <br /> <br />CONTRACTOR'S REQUEST FOR PAYMENT <br />500 MG SPHEROID ELEVATED STORAGE TANK <br />BRA FILE NO. 616-03-130 <br /> <br />PAID <br />SEP 2 2 2004 <br /> <br />CK.# <br /> <br />SUMMARY <br />1 Original Contrael Amount <br />2 Change Order - Add~ion <br />3 Change Order - Deduction <br />4 Revised Contrael Amount <br />5 Value Completed to Date <br />6 Material on Hand <br />7 Amounl Earned <br />8 Less Relainage 5% <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 />943,115.35 <br /> <br />$ <br />$ <br /> <br />2 <br /> <br />943,115.35 <br />147,237.00 <br />22,851.03 <br />170,088.03 <br />8,504.40 <br />161,583.63 <br /> <br />64,825.15 <br />0.00 <br /> <br />~) <br />~Oc7 <br />loot ..-~ qiif()- <br /> <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br /> <br />Recommended for Approval by: <br />BONESTROO, ROSENE, ANDERUK & ASSOCIATES, INC. <br /> <br /> <br />Approved by Owner. <br /> <br />~~ #4) <br />&Iq A~~ff-~V <br /> <br />SpecWied Contrael Completion Date: <br /> <br />Date: <br /> <br />~. <br /> <br />(~ 'Uf)4 <br />, <br /> <br />61603130 Req 2.X1s <br />