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i *i Bents If oo <br />AndtrUk ft <br />Ivil <br />•* • A0€*mrt\$ <br />U fftMi <br />Owner (’Hy of Qrono, im Hrowii KuaJ, Crystal Hay. MN 55132 <br />I’^f Auj;ust 7, Vm In ScpIciiilHr S. mi Dale ScpJcmt'.T 8, I‘J92 <br />C^ml.»:l.„ l»r„e,c«ivc Cu,il,«l.i,s. Inc.. S7.1ft /..ohw l.,nc. Os., ,, MM <br />RI’QUIuST I.-QK rAYMI'NT <br />Stubbs Hay <br />Sanitary’ Sewer Intproveinciits <br />I’ile No. 1.39.37 <br />SUMMARY <br />1 Original 0)ntraet Amount <br />2 Change Order - Addition <br />3 Change Order - Deduction <br />4 Reviseil Contract Amount <br />5 V'alue Completed to Date <br />6 Material on Hand <br />7 Amount liarned <br />8 I.ess Retainage 5% <br />9 Sub-Total <br />lU Less Amount Paid Previously <br />11 AMOUNT DU1-: I IKS Rl iOUli.S^P FOR PAYMFN K NO. <br />$ <br />s <br />9,.3‘X).nO <br />Ueeommem»”d for Approval by: <br />DONiiSTKO(>j/1<OSI’:Nli, ANDl’RLIK & ASSOTIATliS, INC. <br />Approved by Contractor: <br />PROORIuSSlVIi CON I RAf'rORS. INC./\p; roved by Owner: <br />CTIY Ob' ORONO, MN <br />Specified Contract (\>mnletion Dale: <br />OcTOIII U |5. 1992; JUl.Y .3|, 199.3 <br />Dale:. <br />1.480..33I.95 <br />5 1,489,721.95 <br />$444,245.11 <br />S 0.(K) <br />S 444,245.11 <br />$22,212.26 <br />$422,0.32.85 <br />S 116,155.77 <br />$305,777.08 <br />3 <br />13937 lU-T