CC PACKET 03281989 - Laserfiche WebLink

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n. �. .n. Vol . vn . P%11-6.11 - �u111111vau total 'Contract Amount S 189,700. 00 Total Amount Earned $ 180,290.00 • Material Suitably Stored on Site, Not Incoporated into Work $ Contract Change Order No. 1 Percent.Complete 100% $ (3,800.00) Contract Change Order No. Percent Complete s Contract Change Order No. Percent Complete $ "5 J°T 10 NJ _��C�44=lj 15 8 3 o.oQ *1 GROSS AMOUNT DUE.... . .... ... . . . $ 176,490.00 C) 09.So °1 i LESS 5 % RETAINAGE. .. . . .. .. $ 8,824.50 So,zeo.So 1 -11'1 5. o0 913 AMOUNT DUE TO DATE.. . . . .. .. .. .. $ 167,665.50 � S °� °10•�o LESS PREVIOUS APPLICATIONS.. . . . $ 108,936.50 AMOUNT DUE THIS -APPLICATION. .. . $ 58,729.00 CONTRACTOR'S AFFIDAVIT The undowsigned Con tractor hereby swears under penalty of perjury that (1'1411 previous progress. paymepre received from the Owner on account of work performed under the-Laos tract referred to above.name been applied by the undersigned to discharge in full all oblinstions of the under- signen tecurred in connection with work covered by prior Applications fa,*ayment under said contract, and (2) all mate 55ia, ,And equipment incorporated in said Project or otherwise listed_ M. 2r covered by this •Appl f,�aLion for Payment are free and clear of all liens, claims, secur*-filrlterests and encurrbrances. Dated February 28 lg 89 Newmech Com nies, In i Con actor ey Wma and t e Wayne Henquinet COUNTY OF Ramsey SS Controller STATE OF Minnesota Before me on this ;2-X4I day of _ . 19 89" personally appeared �v nown to me, W4 bein—gTuTy sworn, did depose and say t it he it tht of the Contractor above mentioned; cs that he executed the above Application for Payment and Affidavit on behalf of said Contractor; and that all of the statements con d therein are true, correct and complete. My Commissio `6r"es CARLP.w�HLEF5 / � �� ,� NOTARY p�gLIC-MINNESOTA C _ WASHINGTONCOUNTV wry u��T M7 C°mm ExDlres Ovvvv vvv%fw• The undersign Lie Contractor's Application for Payment sham above. A part of this Application is the Contractor's Affidavit stating that all previous payments to him Wder this Contract have been applied by him to discharge in full all of his obligations in onnection with the work covered by all prior Applications for Payment. In accordance with the Contract, the undersigned approves payment to the Contractor of the Amount Due. SHORT E IOTT HE DR KSON, INC. Date 1 c) g9 B