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L’ <br />Ow»«r City of Orono, P.O. Box 66, Crystal Bay. MN 5323 Datejnly 13, 1995 <br />For Period February 13, 1995 to July 13. 1995 Request No. 4 <br />I <br />Buffalo BitMiiuBoua, 2852 County Road 12 North, Buffalo. MN 55313 <br />REQUEST FOR PAYMENT <br />MUNICIPAL STATE AID IMPRON EMENTS <br />BROWN ROAD RECONSTRUCTION - SAP 152-107-01 <br />WATERTOWN ROAD CUL3TRT- SAP 152-103 01 <br />FUc No. 13972 <br />SUMMARY <br />1 Origmal 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% <br />9 Sub-Total <br />10 Less Amount Paid PreNiously <br />11 AMOUNT DUE nilS REQUEST FOR PAYMENT NO. <br />$ <br />$ <br />Recommended for Approval by: <br />BONESTR ANDJERLIK & ASSOCIATES, INC. <br />Approved by Contractor: <br />BUFFALO BITUMINOUS, INC. <br />Approved by Owner: <br />CITY OF ORONO <br />Specified Contract Completion Date: <br />June 16, 1995 Date: <br />566,506.5< <br />$566,506.5< <br />$411,942.4- <br />$1,94h.0‘ <br />$413,886.41 <br />s 20,694.32 <br />$393,192.16 <br />$315,157.65 <br />$78,034.51