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n Bcnestroo Owner: City of Centerville 1880 Main St, Centerville, MN, 55038 Date: June 28, 1999 <br /> Roselle <br /> 0 Mderlik & For Period: 12/11/98 to 06/25/99 Request No: 4 /Final <br /> Assodates <br /> Engineers & NUltett, Contractor: Forest Lake Contracting Inc 14777 Lake Dr, Forest Lake, MN, 55025 <br /> REQUEST FOR PAYMENT <br /> LAURIE LAMOTTE MEMORIAL PARK IMPROVEMENTS <br /> BRA FILE NO. 00616 -98 -804 <br /> SUMMARY <br /> 1 Original Contract Amount - $ 153,227r <br /> 2 Change Order - Addition $ 50,020.10 <br /> 3 Change Order - Deduction $ `— <br /> 4 Revised Contract Amount $ 203,248.00 <br /> 5 Value Completed to Date $ 196,952.80 <br /> 6 Material on Hand $ 0.00 <br /> 7 Amount Earned $ 196,952.80 <br /> 8 Less Retainage 0% $ 0.00 <br /> 9 Subtotal $ 196,952.80 <br /> 10 Less Amount Paid Previously $ 186,862.91 <br /> 11 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. 4/Final $ 10,089.89 <br /> Recommended fqr Approval by: <br /> BONESTROO, ROSENE, ANDERLIK & ASSOCIATES, INC. <br /> 1 ES 74,in CN E <br /> Approved y tracto Approved by Owner: <br /> FORES AK N RA TING INC CITY OF CENTERVILLE <br /> Specified Contract Completion Date: Date: <br /> October 12, 1998 <br /> rsguest4Fetelads <br />