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<br />Ju1 21 2005 10:50 <br /> <br />,. <br /> <br />BONESTROO ROSENE ANDERLIK 6516361311 <br /> <br />, n, Bonestroo <br />e Rosene <br />n AnderIH( & <br />~~~ Auodates <br />Engin!ets.. An;hitect! <br /> <br />Owner: CI of CentelVille, 1880 Main St., CentelVille, MN 55038 <br />For Penod: 12/24/2004 10 7/20/2005 <br /> <br />Oate: <br />Ruest No: <br /> <br />Contractor: Northda.. Construction Com an Inc., 14450 Northdale Blvd, Ro ers, MN 55374 <br /> <br /> $ <br />$ 0.00 <br />$ 0.00 <br /> $ <br /> $ <br /> $ <br /> $ <br /> $ <br /> $ <br /> $ <br /> $ <br /> $ <br /> <br />CONTRACTOR'S REQUEST FOR PAYMENT <br />HUNTERS CROSSING 2NO ADDITION PHASE 1 <br />UTILITY AND STREET IMPROVEMENTS <br />BRA FILE NO. 000616-03132-0 <br /> <br />SUMMARY <br />1 Original Contract Amount <br />2 Change Order - Addition <br />3 Change Order - Deduction <br />4 Revised Contract Amount <br />5 Value Completed \0 Date <br />6 Material on Hand <br />7 Amount Earned <br />8 Less Retalnage 2% <br />9 Subtotal <br />10 Less Amount Paid Previously <br />11 Uquld.ted dam.ges - <br />12 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. <br /> <br />6 <br /> <br />Recommended for Approval by: <br />BONESTROO, ROSENE, ANDERLlK & ASSOCIATES, INC. <br /> <br />-;~~tI<<~ -.-> <br /> <br />Approved by Contractor: <br />NORlllOALE CONSTRUCTION COMPANY tNC <br /> <br />Specified, Contract Completion Date: <br />Augusl20, 2001 <br /> <br />Date: <br /> <br />G1603132REQS.J:Is <br /> <br />Approved by Owner. <br /> <br /> <br />=~r"~~ <br /> <br />p.2 <br /> <br />Jut 20,2005 <br />6 <br /> <br />598,749,66 <br /> <br />598,749.66 <br />565,540.00 <br />0.00 <br />565,540.00 <br />11.310.80 <br />554,229.20 <br />539,262.00 <br />0.00 <br />14967.20 <br /> <br />/7' <br />