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Total Contract Amount $ 189,700. 00 Total Amount Earned $ 69.510.00 <br /> .Material Suitably Stored on Site, Not Incoporated into Bork s <br /> Contract Change Order No. Percent.Complete $ <br /> econtract Change Order No. _ Percent Complete $ <br /> Contract Change Order No. Percent Complete $ <br /> STA� ° 4�6s -oo GROSS AMOUNT DUE...... ... . .. . .. $ 69,510.00 <br /> 3 24 3.00 <br /> Z 37_S c LESS 51 % RETAINAGE. .. .. .. .0 $ 3,475.50 <br /> AMOUNT DUE TO DATE.. ... .. .. . . .. $ 66,034.50 <br /> LESS PREVIOUS APPLICATIONS. . . . . : 41 ,344.00 <br /> g �4t'1 . ao <br /> AMOUNT DUE THIS APPLICATION. . . . $ 24,690.50 <br /> CONTRACTOR'S AFFIDAVIT <br /> The undersigned ontractor hereby swears under penalty of perjury that (1) all previous progress. <br /> payments received from the Owner on account of work performed under the contract referred to <br /> above have been applied by the undersigned to discharge in full all obligations of the under- <br /> signed incurred in connection with work covered by prior Applications for Payment under said <br /> contract, and (2) all <br /> material and equipment incorporated in said Project or otherwise listed in or covered by this <br /> Application for Payment are -free and clear of all liens, -claims, security interests and <br /> encumbrances. <br /> eated December 21 1988 Newmech om anies, Inc. <br /> Contr for <br /> 8y <br /> Na anl <br /> nquinet, Controller <br /> COUNTY OF SS <br /> STATE OF <br /> Before me on this ` Ajkw f t-. 19 0' personally appeared <br /> o <br /> nown t me, bein�Ty sworn, did depose <br /> and say th&V he is the of the Contractor above mentioned; <br /> (Office) <br /> that he executed the above Application for Payment and Affidavit on behalf of said Contractor; <br /> and that all of the statements contained therein are true, correct and complete. <br /> KARL P.WOHLERS • <br /> M(y Commission Exp i : r <br /> }5` <br /> 5 NOTARY PUBLIC-MINNESOTA (Notary Pub] cT <br /> < WASHINGTON COUNTY - <br /> 22 MY COMM.Expires Oct.14,1993 <br /> The undersigned has c eck ! Application for Payment shown above. A part of <br /> this Application is the Contractor's Affidavit stating that all previous payments to his <br /> under this Contract have been applied by him to discharge in full all of his obligations in <br /> connection with the work covered by all prior Applications for Payment. <br /> accordance with the Contract, the undersigned approves payment to the Contractor of the <br /> unt Due. <br /> SHORT ELL HE ON, INC. <br /> Date Z 3 88 <br /> Page 3 of 3, <br />