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Owner: City of Centerville, 1880 Main St., Centerville, MN 55038 Date: November 19, 2009 <br /> For Period: 10/31/2009 to 11/19/2009 Request No: 7 <br /> Bonestroo Contractor: Forest Lake Contracting, 14777 Lake Dr., Forest Lake, MN 55025 <br /> CONTRACTOR'S REQUEST FOR PAYMENT <br /> 2009 STREET IMPROVEMENTS <br /> BONESTROO FILE NO. 000616- 09170 -0 <br /> CITY PROJECT NO. 2009.02 <br /> SUMMARY <br /> 1 Original Contract Amount $ 1,351,737.25 <br /> 2 Change Order - Addition $ 51,307.16 <br /> 3 Change Order - Deduction $ 0.00 <br /> 4 Revised Contract Amount $ 1,403,044.41 <br /> 5 Value Completed to Date $ 1,130,415.21 <br /> 6 Material on Hand $ 0.00 <br /> 7 Amount Earned $ 1,130,415.21 <br /> 8 Less Retainage 5% $ 56,520.76 <br /> 9 Subtotal $ 1,073,894.45 <br /> 10 Less Amount Paid Previously $ 837,821.68 <br /> 11 Liquidated damages - $ 18,000.00 <br /> 12 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. 7 $ 218,072.77 <br /> Recommended for Approval by: <br /> BONESTROO <br /> Approved by Contractor: Approved by Owner: <br /> FOREST LAKE CONTRACTING CITY OF CENTERVILLE <br /> Specified Contract Completion Date: Date: <br /> 61609170REQ7.gs <br />