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<br />(%c"''t~It.,n:~RfS ;f'ionn\lP <br />~~:~~~~~~~ . . ~. -\Ji <br /> <br />. ~. Bonestroo <br />9 Rosene <br />'iii Anderlik& <br />'U, Associates <br />Engineers & Architects <br /> <br />Owner: Citv of Centerville, 1880 Main Street, Centerville, MN 55038-9794 Date: December 23 2004 <br />For Period: 7/27/2004 to 12/23/2004 Request No: 5 <br />Contractor: Northdale Construction Comnanv Inc., 14450 Northdale Blvd., Roaers, MN 55374 <br /> <br />CONTRACTOR'S REQUEST FOR PAYMENT <br />HUNTERS CROSSING 2ND ADDITION PHASE 1 UTILITY AND STREET IMPROVEMENTS <br />BRA FILE NO. 616-03-132 <br /> <br />SUMMARY <br />1 Original Contract Amount $ 598,749.66 <br />2 Change Order - Addition $ 0.00 <br />3 Change Order - Deduction $ 0.00 <br />4 Revised Contract Amount $ 598,749.66 <br />5 Value Completed to Date $ 550,267.34 <br />6 Material on Hand $ 0.00 <br />7 Amount Earned $ 550,267.34 <br />8 Less Retainage 2% $ 11,005.35 <br />9 Subtotal $ 539,262.00 <br />10 Less Amount Paid Previously $ 484,733.92 <br />11 liqUidated damages - $ 0.00 <br />12 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. 5 $ 54.528.08 <br /> <br />Recommended for Approval by: <br />BONESTROO, ROSENE, ANDERlIK & ASSOCIATES, INC. <br /> <br />~~~ <br /> <br />Approved by Contractor: <br />NORTHDALE CONSTRUCTION COMPANY INC <br /> <br />Approved by Owner: <br />CITY OF CENTERVILLE <br /> <br />~~~~ <br />-+1vkvcr> &JI.I'~ <br /> <br />Specified Contract Completion Date: <br />August 20, 2001 <br /> <br />Date: <br /> <br />\HO~ <br /> <br />61603132REQS.xls <br />