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Ronestroo Owner: City of Centerville 1880 Main StCenterville, MN, 55038 Date: November 17, 1999 <br /> Roserre <br /> to Andellik& For Period: 7/29/99 to 11/17/99 Request No: 2/Final <br /> Ell Associates <br /> Engineers & IVNlter[s Contractor: Allied Blacktop Co. 10503 89th Ave N, Maple Grove, MN, 55369 <br /> REQUEST FOR PAYMENT <br /> 1999 SEAL COAT <br /> BRA FILE NO. 616 -99 -103 <br /> CLIENT PROJECT NO. <br /> CLIENT CONTRACT NO. <br /> SUMMARY <br /> 1 Original Contract Amount $ 37,923.00 <br /> 2 Change Order - Addition $ 0.00 <br /> 3 Change Order - Deduction $ 0.00 <br /> 4 Revised Contract Amount $ 37,923.00 <br /> 5 Value Completed to Date $ 35,306.75 <br /> 6 Material on Hand $ 0.00 <br /> 7 Amount Earned $ 35,306.75 <br /> 8 Less Retainage 0% $ 0.00 <br /> 9 Subtotal $ 35,306.75 <br /> 10 Less Amount Paid Previously $ 33,541.41 <br /> 11 AMOUNT DUE THIS REQUEST FOR PAYMENT NO. 2/Final $ 1 765 34 <br /> Recommended for Approval by: <br /> BONESTROO, ROSENE, & ASSOCIATES, INC. <br /> G . _ I ku . I `G i <br /> Approved by Contractor: Approved by Owner: <br /> ALLIED BLACKTOP CO. CITY OF CENTERVILLE <br /> D <br /> 1 ai ∎ 1 Aea•Nrs.* <br /> Specified Contract Completion Date: Date: <br /> July 7, 1999 <br /> RFP -stdl <br />