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i <br />GRIDOR CONSTR., INC. <br />3990 27TH STREET S.E. <br />BUFFALO, MN 55313 <br />(763) 559-3734 <br />Owner CITY OF ELK RIVER <br />For Period 1/27/2009 to 3/20/2009 Date 3/17/2009 <br />Engineer BDM CONSULTING ENGINEERS, ST. PAUL, MN Request No. 14 <br />WASTEWATER TREATMENT FACILITY PHASE II IMPROVEMENTS <br />SUMMARY: <br />1 ORIGINAL CONTRACT AMOUNT $ 3,594,700 <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 />$ 87,516 <br />$ 11,076 <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. <br />By: ~~ Date: ~~ \~-~o <br />~l <br />State of: MINNESOTA County of: WRIGHT <br />Subscribed ands to before me is ~~ day of~c'C~1-d`~ <br />Notary Public: <br />My Commission Expires: 1-31-2010 <br />s ERI L• F M NNE p A <br />SH UBUC- <br />~~ NpTARY P 91.2010 r <br />~ Ices Jan' <br />~'.~ MY commission ExP <br />tt <br />PAYXLS 3/17/20 <br />$ 3,671,140 <br />$ 3,629,640 <br />$ 0 <br />$ 3,629,640 <br />$ 0 <br />$ 3,493,006 <br />$ 136,634 <br />ENGINEER: BDM CONSULTING ENGINEERS <br />By: <br />Date: <br />Approved by Owner: <br />CITY OF ELK RIVER <br />Date <br />09 EQUAL OPPORTUNITY EMPLOYER <br />