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Owner: City of Centerville, 1880 Main St., Centerville, MN 55038 Date: April 23, 2010 <br />For Period: 3/20/2010 to 4/23/2010 Request 9 <br />Bonestroo Contractor: Forest Lake Contracting, 14777 Lake Dr., Forest Lake, MN 55025 <br />CONTRACTOR'S REQUEST FOR PAYMENT <br />PELTIER LAKE DRIVE STREET AND UTILITY IMPROVEMENTS <br />BONESTR00 FILE NO. 000616 - 09169 -0 <br />CITY PROJECT NO. 2009.01 <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 to Date <br />6 Material on Hand <br />7 Amount Earned <br />8 Less Retainage 5% + $8,000.00 <br />9 Subtotal <br />10 Less Amount Paid Previously <br />11 Liquidated damages - <br />12 AMOUNT DUE THIS REQUEST FOR PAYMENT NO <br />Recommended for Approval by: <br />BONESTROO <br />Approved by Contractor: <br />FOREST LAKE 6 ' CONTRACTING <br />/�.�� <br />Specified Contract Completion Date: <br />0 <br />$ 1,534,085.11 <br />268,899.35 <br />0.00 <br />$ 1,802,984.46 <br />$ 1,635,220.81 <br />$ 0.00 <br />$ 1,635,220.81 <br />$ 89,761.04 <br />$ 1,545,459.77 <br />$ 1,458,771.94 <br />$ 24, 000.00 <br />$ 62,687.83 <br />Approved by Owner: <br />CITY OF CENTERVILLE <br />Date: <br />61609169RE09.xism <br />