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I. <br />% « <br />l/iBoneitroo <br />fj>Rosene <br />|\|| Associates <br />IflfihmiAltMMCtt <br />Oonf: City of Orono. P. O. Box 66. Cfvital Bay, MN S53M Date: Mav 20.2003 <br />ForPertod: 6/1/2003 to 5/20/2003 Request No;1 AND FINAL <br />Contractor: Buffalo Bituminous Inc.. 2852 Ctv. Rd. 12 N.. P. O. Box 337. Buffalo. MN SS313 <br />CONTRACTOR'S REQUEST FOR PAYMENT <br />NORTH ARM PAVING <br />BRA FILE NO. 13942-121 <br />SUMMARY <br />1 Original Contract Amourtt <br />Change Order • Addition <br />(^nge Order • Deduction <br />Revised (tontract Amount <br />Value Completed to Date <br />Material on Hand <br />Amount Earned <br />Less Retalnage 0% <br />Subtotal <br />Less Amount Paid Previously <br />Liquidated damages * <br />AMOUNT DUE THIS REQUEST FOR PAYMENT NO. <br />2 <br />3 <br />5 <br />6 <br />7 <br />8 <br />9 <br />10 <br />11 <br />12 <br />19.353.75 <br />S <br />$ <br />0.00 <br />0.00 <br />1 AND FINAL <br />19,353.75 <br />19,897.31 <br />0.00 <br />19S97.31 <br />0.00 <br />'19.Mr.31 <br />b.OO <br />000 <br />Recommended for Approval by; <br />BONESTROO. ROSENE, ANDERUK A ASSOCIATES. INC. <br />Approved by <br />BUFFALO BITUMINOUS INC <br />Approved by Owner <br />CITY OF ORONO <br />Specifled Contract Complebon Date:Date; <br />isHtiawsotnMt ‘f-