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REQUEST FOR PAYMENT <br />ESTIMATED QUANTITIES <br />MAY 1989 <br />PROJECT: Mounds View Business Pk <br />LOCATION: Mounds View, MN <br />CONTRACTOR: <br />Design Electric, Inc. <br />PROJECT NO: 86-106 <br />ADDRESS: <br />P•0. Box 1252 <br />FOR PERIOD: May 1989 <br />FILE: <br />St. Cloud, MN 56302 <br />TRAFFPAY <br />Sb7MMARY. <br />1. original Contract Amount <br />2. Change Order - ADDITION <br />$0.00 <br />$67,847.00 <br />3. Change Order - DEDUCTION <br />$0.00 <br />- NET <br />4. Revised Contr nf- n, ,_nt <br />90.00 <br />5. Value Completed To Date <br />$67,847.00 <br />6. Material on Hand <br />$64,455.00 <br />7. Amount Earned <br />$0.00 <br />8. Less Retainage 5% <br />$64,455.00 <br />9. Subtotal <br />$3,222.75 <br />10. Less Amount Previously Paid <br />$61,232.25 <br />11. AMOUNT DUE THIS REQUEST FOR PAYMENT <br />$32,227.80 <br />$29,004.45 <br />I hereby certify tLat this partial payment request reflects that work has <br />been completed and the stated materials have been delivered to the site <br />in conformance with the plans and specifications for Project No. 86-106. <br />Recommended for Approval By: <br />MERILA AND ASSOCIS, INC. <br />By: <br />Reg. No.: <br />Date: s.i_r. ry <br />Approved By Owner: <br />CITY OF MOUNDS VIEW <br />By: <br />Date: <br />Payment Requested By: <br />DESIGN ELECTRIC, INC. <br />By: <br />Date <br />