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APPLICATION FOR PAYMENT NO. Twenty-five <br /> To City of St. Anthony (OWNER) <br /> • Contract for Temporary Granular Activated Carbon System <br /> OWNER's Project No. ENGINEER's Project No. 861908-3 <br /> For Work accomplished through the date of June 30, 1990 <br /> CONTRACTOR's Schedule of Valucs Work Completed <br /> ITEM Unit Price Quantity Amount Quantity Amount <br /> I . Furnish & Install S S $ <br /> Treatment System 124,600.00 Lump Sum 124,600.00 100% 124,600.0 <br /> 2. Service Fee 108.0 500 Day 54,000.00 707 76,356.0 <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 ft 40,480.00 0 0.0 <br /> 5. Remove Equipment 38,650.0 Lump Sum 38,650.00 0 0.0 <br /> Total $325,730.00 $266,142.0 <br /> (Ong. Contract) <br /> C.O. No. 1 <br /> C.O. No. 2 <br /> Accompanying Documentation: GROSS AMOUNT DUE ....................... $266,142.00 <br /> • LESS %RETAINAGE ................... $ one <br /> Invoice No- 961045301 AMOUNT DUE TO DATE 5 266,142.00 <br /> LESS PREVIOUS PAYMENTS ................ S262,902. 0 <br /> AMOUNT DUE THIS APPLICATION ......... S 3,240.00-7r <br /> 7Z,L <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 <br /> COyTRACTOR <br /> By <br /> Payment of the above AMOUNT DUE THIS APPLICATION is recommended. <br /> • Dated July 5, 1990 . 19 RIEKE CA L M ER SOCIATES, INC. <br /> ct R <br /> By <br /> EJCDC No. 1910-8-E(1983 Edition) <br /> Prepared by the Enatncers'Joint Contract Documents Committee and endorsed by The Associated General Contractors of America. <br />