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APPLICATION FOR PAYMENT NO. Twenty-Six <br /> To City of St. Anthony (OWNER) <br /> Contract for Temporary Granular Activated Carhon System <br /> OWNER's Project No. ENGINEER's Project No. 861908-3 <br /> For Work accomplished through the date of July 1, 1990 <br /> CONTRACTOR's Schedule of Values Work Completed <br /> ITEM <br /> Unit Price Quantity Amount Quantity Amount <br /> I. Furnish & Install . <br /> Treatment System 124,600.00 Lump Sum 124,600.00 100% 124,600.0 <br /> 2. Service Fee 108.00 500 Day 54,000.00 738 79,704.0 <br /> 3. VOC Removal 860.00 80 Pounds 68,000.00 79.69 lb s . 65,186.0 <br /> 4. Extra GAC 23.30 1600 cu ft 40,480*-OC 0 0.0 <br /> 5. Remove Equipment 38,650.00 Lump Sum 38,650.0c 0 0.0 <br /> Total $ $ <br /> (Orig. Contract) 325,730.00 269,490.0 <br /> C.O. No. 1 <br /> C.O. No. 2 <br /> Accompanying Documentation: GROSS AMOUNT DUE ....................... $269,490.00 <br /> LESS %RETAINAGE ::::::::::::::::::: $�-��—UO <br /> Invoice No. 961070900 AMOUNT DUE TO DATE $ �0 <br /> LESS PREVIOUS PAYMENTS ................ $ 345-00 <br /> AMOUNT DUE THIS APPLICATION ......... $ <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 July 31, 1990 19 <br /> CONTRACTOR <br /> By <br /> Payment of the above AMOUNT DUE THIS APPLICATION is recommended. <br /> Dated J. (iz /I C3 19 EN ER <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 /> Repnmea 3185 <br />