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CC PACKET 01121999
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CC PACKET 01121999
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Last modified
12/30/2015 4:06:05 PM
Creation date
12/30/2015 4:05:46 PM
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SP Box #
17
SP Folder Name
CC PACKETS 1999-2001
SP Name
CC PACKET 01121999
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APPLICATION FOR PAYMENT NO. 2 <br /> To: City of St. Anthony, Minnesota (OWNER) <br /> From: Standard Sidewalk Inc. (CONTRACTOR) <br /> Contract: t of St. Anthony <br /> Project: Sidewalk Construction: St. Anthony Blvd. and Kenzie Terrace <br /> OWNER's Contract No. -- ENGINEER's Project No. 10415.02 <br /> For Work accomplished through the date of: November 1.4, 1998 <br /> 1. Original Contract Price: S 147,088.75 <br /> 2. Net change by Change Orders and Written Amendments(+or-): S 0.00 <br /> 3. Current Contract Price(i plus 2): S 147,088.75 <br /> 4. Total completed and stored to date: S 145.404.10 <br /> 5. Retainage(per Agreement): <br /> 5 %of completed Work: S 7,270.20 <br /> %of stored material: S <br /> Total Retainage: S 7,270.20 <br /> 6. Total completed and stored to date less retainage(4 minus-5): S 138,133.90 <br /> 7. Less previous Application for Payments: S 102,143.90 <br /> 8. DUE THIS APPLICATION(6 MINUS 7): S 35,990.00 <br /> Accompanying Documentation: <br /> CONTRACTOR'S Certification: <br /> The undersigned CONTRACTOR certifies that(1)all previous progress payments received from OWNER on <br /> 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 for <br /> Payment numbered 1 through 1 inclusive;(2)title of all Work,materials and equipment incorporated in said <br /> Work or otherwise listed in or covered by this Application for Payment will pass to OWNER at time of payment <br /> free and clear of all Liens,security interests and encumbrances(except such as are covered by a Bond acceptable to <br /> OWNER indemnifying OWNER against any such Lien,security interest or encumbrance);and(3)all Work covered <br /> by this Application for Payment is in accordance with the Contract Documents and not defective. <br /> Dated //_ 3 0 - 9 Standard Sidewalk, Inc. <br /> CONTRACTOR <br /> By: <br /> State of <br /> County of <br /> Subscribed and sworn to&Ibre me this COME S.SCH�DT <br /> day of��o.+�.r.�� CONNIE S.SCHMIDT <br /> ��' ,"�•. i <br /> IIjr� # Notary Public-Minnesota <br /> Notary Public MY Comm.Expires+an.31�2000 <br /> My Commission expires: <br /> Payment of the above AMOUNT DUE THIS APPLICATION is recommended. <br /> Dated NnvamhPr 17, 1448 <br /> EN <br /> By: <br /> EJCDC No.1910-8-E (1996 Edition) <br /> Prepared by the Engineers Joint Contract Documents Committee and endorsed by The Associated General Contractors of America and the Construction Specification <br /> Institute. <br />
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