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1 0vvner: City of Centerville, J880 lla St., Centerel �JejviN 55038 Date: Septen 23, 2110 <br />_ <br />For Period; 7/1/2010 to 8/31/2010 Request 111 <br />[31 o o L�o�ntr ctor: Asphalt Surface Technoioqles Corp,, 8348 Ridqcwood Rd., St. Joseoh. Mil 56374 <br />r-0NT[1V)1CT0r1 FOR <br />2010 SEAL COAT <br />BONESTROO FILE 1\ 000616-10172-0 <br />SUMMARY <br />I Original Contract Amount <br />2 Change Order - Addition <br />3 Change Order - Deduction <br />Revised Contract Amount <br />5 Value Completed to Date <br />6 Material on Hand <br />7 Amount Earned <br />8 Less Retainagle 5% <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 />ASPHALT SURFACE TECH . LOGIES CORP. <br />16 <br />Specified Contract Completion Date. <br />L1 <br />$ 192,130.65 <br />$ 132,161,90 <br />$ 0,00 <br />$ 132,161.90 <br />$ 6,608.,10 <br />$ 125,55181 <br />$ 0.00 <br />$ 0,00 <br />$ 125,553.81 <br />Approved by Owner: <br />CITY OF CEHTERVILLE <br />Date: <br />616-10172REC1 x1sm 11 <br />