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r. <br /> Bonestroo Owner: City of Centerville 1880 Main StCenterville. MN, 55038 Date: October 26, 1999 <br /> Rosen <br /> wris Anderlik& For Period: Start to 10/26/99 Request No: 1 <br /> Associates <br /> Engineer's Architects Contractor: W B Miller Inc 6701 Norris Lake Rd NW, Efk River, MN, 55330 <br /> REQUEST FOR PAYMENT <br /> WATER INTERCONNECT <br /> BRA FILE NO. 616 -98 -809 <br /> SUMMARY <br /> • <br /> 1 Original Contract Amount $ 57,894.50 <br /> 2 Change Order - Addition $ 0.00 <br /> 3 Change Order - Deduction $ 0.00 <br /> 4 Revised Contract Amount $ 57,894.50 <br /> 5 Value Completed to Date $ 55,148.00 <br /> 6 Material on Hand $ 0.00 <br /> 7 Amount Earned $ 55, 148.00 <br /> 8 Less Retainage 5% $ 2,757.40 <br /> 9 Subtotal $ 52,390.60 <br /> 10 Less Amount Paid Previously $ 0.00 <br /> 11 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. 1 $ 52,390.60 <br /> Recommended for Approval by: <br /> BONESTROO, ROSENE, ANDERLIK & ASSOCIATES, INC. <br /> 7 <br /> ling <br /> Approved by Contractor: Approved by Owner: <br /> W B MILLER NC CITY OF CENTERVILLE <br /> . G 1L <br /> Specified Contract Completion Date: Date: <br /> October 29, 1999 <br /> • <br /> request.xls <br />