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R� <br /> APPLICATION FOR PAYMENT NO. <br /> Twenty-four <br /> To City of St Anthony 'OVA'NER) <br /> Contract for Temporary Granular Activated Carhnn Svctprn <br /> OWNER's Project No. --- ENGINEER's Project No. 861908-3 <br /> For Work accomplished through the date of May 21, 1990 <br /> COI:TRACTOR's Schedule of Values work Completed <br /> ITEM Unit Price Quantity Amount Quantity Amount <br /> 1. Furnish & Install <br /> S s s <br /> Treatment System 124,600.00 Lump Sum 124,600.00 1008 124,600.0 <br /> 2. Service Fee 108:0 500 Day 54,000.00 677 13,116.0 <br /> 3. VOC Removal 860.0 80 Pounds 68,000.00 76.69 lbs. 65,186.0 <br /> 4. Extra GAC 25.3 1600 cu/f - 40,480.00 0 0.0 <br /> 5. Remove Equipment 38,650.0 Lump Sum 38,650.00 0 0.0 <br /> Total 5325,730.00 $262,902.0 <br /> (Orig.Contract) <br /> C.O. No. 1 <br /> C.O. No. 2 <br /> Accompanying Documentation: GROSS AMOUNT DUE .. S 262,902.00 <br /> LESS %RETAINAGE ................... S — <br /> Invoice f;o. 961024901 AMOUNT DUE TO DATE ... 26 ,902.00 <br /> LESS PREVIOUS PAYMENTS ................ S 259,554.00 <br /> AMOUNT DUE THIS APPLICATION ......... S 3,348.0ww <br /> CONTRACTOR'S Certification: <br /> The undersigned CONTRACTOR certifies that (1) all previous progress payments received from OWNER on account of <br /> Work done under the Contract referred to above have been applied to discharge in full all obligations of CONTRACTOR <br /> incurred in connection with Work covered by prior Applications for Payment numbered 1 through inclusive: and <br /> (2) title to all materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for <br /> Payment will pass to OWNER at time of payment free and clear of all liens, claims, security interests and encumbrances <br /> (except such as covered by Bond acceptable to OWNER). <br /> Dated , 19 CONTRACTOR <br /> By <br /> Payment of the above AMOUNT DUE THIS APPLICATION is recommended. <br /> Dated dune 8 , 1990 RIEKE C RROLL MULLER ASSOCIATFS- TNC <br /> ENGINEER <br /> By <br /> EJCDC No. 1910-8•E(1983 Edition) , <br /> Prepared by the Engineers'Joint Contract Documents Committee and endorsed by The Associated General Contractors of America. <br /> awed%%s <br />