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APPLICATION FOR PAYMENT NO. 1 <br /> To: City of St. Anthony(OWNER) <br /> From: Maguey Contraction,Inc. (CONTRACTOR) <br /> Contract: Contract B <br /> Project: Maintenance Work at the G.A.C. Water Filtration Plant <br /> OWNER's Contract No.. . ENGINEER'S Project No. <br /> For Work accomplished through the date of 6-25-99 <br /> 1.) Original Contract Price: $27,200.00 <br /> 2.)Net change by Change Orders(Written Amendments(+-) $ 4-909.00 <br /> 3.) Current Contract Price (1 plus 2): $32.809.00 <br /> 4.) Total completed and stored to date: $ 32,809.00 <br /> 5.) Retainage (per Agreement): <br /> -5--=' % of completed work $V&1(.40.4-5 <br /> - 0 % of stored material: $om <br /> Total Retainage: $ ((040.4-5 <br /> Total completed and stored to date less retainage (4-5) $ 311 GS-SS <br /> 7.) Less previous Application for Payments: $ 0.00 <br /> 8.) DUE THIS APPLICATION(6-7) $ 31 It bS.SS <br /> Accompanying Documentation: <br /> CONTRACTOR'S Certification: <br /> • The undersigned CONTRACTOR certifies that(1)all previous progress payments received from OWNER <br /> on account of Work done under the Contract referred to above have been applied on account to discharge <br /> CONTRACTOR's legitimate obligations incurred in connection with Work covered by prior Applications <br /> for Payment numbered 1 through 1 inclusive;(2)title of all Work,materials and equipment incorporated <br /> in said Work or otherwise listed in or covered by this Application for Payment will pass to OWNER at <br /> time of payment free and clear of all Liens,security interests and encumbrances(expect such as are <br /> covered by a Bond acceptable to OWNER indemnifying OWNER against any such Lien,security interest <br /> or encumbrance);and(3)all Work covered by this Application for Payment is in accordance with the <br /> Contract Documents and not defective. <br /> Dated June 28. 1999 Magney Con ction,Inc (contractor) <br /> By._f��4 <br /> kl-:Ii Mark C.Magney,Preside <br /> State of County of . <br /> Subscribed and sworn before me this day of 1999. <br /> Notary Public LAACL PAMEL M. CRIEGO <br /> My Commission expires: 140 TARY 2Lc•A1INNESOTA <br /> My Comm._x3ves,,an.31:2000 <br /> Payment of the above AMOUNT DUE THIS APPLICATION is reco <br /> Dated Consoer.Townsend.Envirod a Engineers(engin_= <br />