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k <br />APPLICATION FOR PAYMENT NO.-' <br />ROJECT Mounds View/SYSCO <br />OWNER City of Mounds View <br />88-15 98 <br />OWNER'S Project No .......................... ENGINEER'S Project No......-.129........... <br />Lametti & Sons <br />CONTRACTOR............................................................................... <br />Utilities & Grading Street March 15, 1989 <br />Contract For ......................................... Contract Date ...................... <br />For Work accomplished through the date of... Septemil .A,,.1989. <br />.......................... <br />STATEMENT OF WORK <br />517,929.50 554,893.22 <br />Original Contract Amount $.......sees Work To Date S•......••••• <br />-0- <br />Net Change Orders $............. Amount Retained ( 2 %) S 11:097:86 <br />Current Contract Amount S. 517f92°;50 Subtotal S 593:795.36 <br />Previous Payments Recommended S ,s74.809.12. <br />Amount Due This Payment S. 68.986.2A• <br />CONTRACTOR's Certification: <br />The under.Igned CONTRACTOR eortlfbs the (I) dl pFort*.. groan.. payment. received from OWNER an account of work 4... <br />under the Contract refa,ed to adore have been applied to discharge Into 11 obllgatlano of CONTRACTOR Incurred In ..n.Soll.e Wllh <br />Work covered by prior ApplIcallen. tar Payment numbered t through _ Inel.aet and (a) till. to all Aaf nl.h and eeulPment <br />Incorporated In Sold Work e, ofh.,wbe listed In a, c...1.4 by this APPile.flan tar garment w111 P... to OWNER It If.. of PTlwadt <br />free and al.., of all II... , claim. , nl..'Itty Internet. and encumbrances It ...h An caned by Rend aaeplsble is OWNER I. <br />Dates <br />—TCONTRACT -eel le <br />ENGINEER'S Recommendation; <br />This Application (with accompanying documentation) meat, the requirements of the Contract Documents and Payment <br />of the above AMOUNT DUE THIS APPLICATION Is recommended. <br />Dated 9 ,A Westwood Professlonal Services Inc. <br />N ER <br />By_ <br />0y� <br />