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~. <br />RfpOR CONSTR., INC. <br />990 27TH STREET S.E. <br />UFFALO, MN 55313 <br />Owner CTTY OF ELK RIVER Date <br />For Period 1/1/2009 to 1/26/2009 Request No. <br />Engineer BDM CONSULTING ENGINEERS,.ST. PAUL, MN <br />WASTEWATER TREATMENT FACILITY 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 />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 />CONTRACTOR: GRIDOR CONSTR., INC. ENGINEER: <br />By: ~ ~ Date: `` Let~g By: <br />State of: MINNESOTA County of: WRIGHT <br />Subscribed and sw rn to before me ~~ day of~~°~~ <br />Notary Public: <br />My Commission Expires: 1-31-2010 <br />Date: <br />Approved by Owner: <br />CITY OF ELK RIVER <br />sc^ri'~~+'vwn <br />`' ~ SHERD L. FULLER <br />{`\,. s~> NOTARY PUBLIC-MINNESOTA <br />':~` My Commission Expires Jan. 31, 2010 <br />r <br />Date <br />$ 31,081 <br />$ 9,731 <br />(763) 559-3734 <br />1 <br />13 <br />$ 3,594,700 <br />$ 3,616,050 <br />$ 3,488,006 <br />$ 5,000 <br />$ 3,493,006 <br />$ 0 <br />$ 3,438,258 <br />$ 54,748 <br />BDM CONSULTING ENGINEERS <br />PAYXLS 1/2f/2009 EQUAL OPPORTUNITY EMPLOYER <br />