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CONTRACTOR'S PAY REQUEST NO. 1 <br />KELLY AVENUE STORM SEWER OUTFALL <br />CITY OF ORONO <br />BMI PROJECT NO. C13.110197 <br />TOTAL AMOUNT BID PLUS APPROVED EXTRA WORK.................................................................. $69,718.00 <br />TOTAL, COMPLETED WORK TO DATE............................................................................................. $ 64,161.35 <br />TOTAL, STORED MATERIALS TO DATE............................................................................................ $ <br />DEDUCTION FOR STORED MATERIALS USED IN WORK COMPLETED ......................................... $ <br />TOTAL, COMPLETED WORK & STORED MATERIALS...................................................................... $ <br />RETAINED PERCENTAGE ( 5%)............................................••...................................... $ 3,208.07 <br />TOTAL AMOUNT OF OTHER DEDUCTIONS............................................................................... $ <br />NET AMOUNT DUE TO CONTRACTOR TO DATE............................................................................. $ 60,953.28 <br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES................................................................... $ <br />PAY CONTRACTOR AS ESTIMATE NO. 1.................................................................... $ 60,953.28 <br />Certificate for Partial Payment <br />I hereby certify that, to the best of my knowledge and belief, all items quantities and prices <br />of work and material shown on this Estimate are correct and that all work has been <br />performed in full accordance with the terms and conditions of the Contract for this project <br />between the Owner and the undersigned Contractor, and as amended by any <br />authorized changes, and that the foregoing is a true and correct statement of the <br />contract amount for the period covered by this Estimate. <br />Contractor: KUSSKE CONSTRUCTION <br />424 CHESTNUT STREET <br />SUITE 204 <br />CHASKA, MN 55318 <br />By <br />Name Title <br />Date 115116 <br />CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT: <br />BOLTON & MENK, INC., ENGINEERS, 2638 SHADOW LN, SUITE 200, CHASKA MN 55318 <br />By CONSULTANT CITY ENGINEER <br />DAVID P. MARTINI, P.E. <br />Date <br />APPROVED FOR PAYMENT: <br />Owner: CITY OF ORONO, MINNESOTA <br />By _ <br />Title <br />