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,IDOR CONSTR., INC. <br />90 27TH STREET S.E. <br />lUFFALO, MN 55313 <br />(763) 559-3734 <br />Owner CITY OF ELK RIVER Date 12/31/2008 <br />For Period 11/30/2008 to 12/31/2008 Request No. 12 <br />Engineer BDM CONSULTING ENGINEERS, ST. PAUL, MN <br />WASTEWATER TREATMENT FACII..ITY PHASE II IMPROVEMENTS <br />SUMMARY: <br />1 ORIGINAL 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 STORED <br />7 AMOUNT EARNED TO DATE <br />8 LESS RETAINAGE - 0% <br />9 LESS AMOUNT PREVIOUSLY PAID <br />10 AMOUNT DUE THIS REQUEST <br />$ 31,081 <br />$ 9,731 <br />The undersigned Contractor certifies that to the best of Contractor's knowledge, <br />information and belief the Work covered by this Application for Payment has been completed <br />in accordance with the Contract Documents, that all amounts have been paid by the Contractor <br />for Work for which previous Certificates for Payment were issued and payments received <br />from the Owner, and that current payment shown herein is now due. <br />$ 3,594,700 <br />$ 3,616,050 <br />$ 3,433,258 <br />$ 5,000 <br />$ 3,438,258 <br />$ 0 <br />$ 3,378,658 <br />$ 59,600 <br /> <br />CONTRACTOR: GRIDOR CONSTR., INC. ENGINEER: BDM CONSULTING ENGINEERS <br />By: ( _-~ ~'`-- Date: ,~~~ \~~~ By: <br />Date: <br />State of: MINNESOTA County of: WRIGHT Approved by Owner: <br />CITY OF ELK RIVER <br />Subscribed an ~ to before a~~ day o : ~ - <br />Notary Publi <br />My Commission Expires: 1-31-2010 <br />• ERI L. FULLER <br />~ SH Y pUBLIC•MINNESOTA <br />ttir~ NOTAR 3t,2ot0 <br />e~ mission ExPi~es Jan. ~ <br />~o,~a MY Com <br />:;F <br />r <br />Date <br />PAYXLS 12/31/2008 EQUAL OPPORTUNITY EMPLOYER <br />