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'-W�6 <br />REQUEST FOR PAYMENT <br />ESTIMATED QUANTITIES <br />March 31, 1988 <br />PROJECT: Mounds View Business Pk CONTRACTOR: C. W. Houle, Inc. <br />LOCATION: Mounds View, MN ADDRESS: 1300 West Cty Rd I <br />PROJECT NO: 86-,06 Shoreview, MN 55126 <br />FOR PERIOD: 3/17/88-3/31/88 FILE: MVPAY <br />SUMMARY: <br />1. <br />Original Contract Amount <br />4876,685.62 <br />2. <br />Change Order - ADDITION 00.00 <br />3. <br />Change Order - DEDUCTION 00.00 <br />- NET <br />80.00 <br />4. <br />Revised Contract Amount <br />0876,685.62 <br />5. <br />Value Completed To Date <br />0202,109.22 <br />6. <br />Material on Hand <br />$56,810.81 <br />7. <br />Amount Earned <br />$258,920.03 <br />S. <br />Less Retainage 5% <br />$12,946.00 <br />9. <br />Subtotal <br />0245,974.03 <br />10. <br />11. <br />Lena Amount .Pr6JiCL'IIly Paid <br />AMOUNT DUE THIS REQUEST FOR PAYMENT <br />$0.00 <br />$245,974.03 <br />I hereby certify that this partial payment request reflects that work has <br />been completed ane the stated materials have been delivered to the site <br />in conformance with the plans and specifications for Project No. 86-106. <br />Recommendod for Approval By: <br />MERILAA/� /AND jjASSOCIATES, INC. <br />By: 111� <br />Reg. No.: IJ5j <br />d /is/rll _ <br />Approved By Owner: <br />CITY OF MOUNDS VIEW <br />By: <br />Date: <br />Payment Requested By: <br />C.W. HOULE, INC. <br />By <br />Date: <br />