Laserfiche WebLink
� r <br /> APPLICATION FOR PAYMENT NO. 1 <br /> To: City of St. Anthony, Minnesota (OWNER) <br /> From: V.E. Gray and Son Contracting Co. (CONTRACTOR) <br /> Contract:Ci ty of St Anthony <br /> Project: Rehabilitation and Recoating of Existing Elevated Water Storage Tank <br /> OWNER's Contract No. -- ENGINEER's Project No. 10456.03 <br /> For.Work accomplished through the date of: 7/31/98 <br /> 1. Original Contract Price: $ 166,642-00 <br /> 2. Net change by Change Orders and Written Amendments(+or-): $ n_nn <br /> 3. Current Contract Price(1 plus 2): $ 166,652.00 <br /> 4. Total completed and stored to date: S 96.429.3n <br /> 5. Retainage(per Agreement): <br /> 5 %of completed Work: $ 4,821.46 <br /> %of stored material: $ <br /> Total Retainage: $ .4,821.46 <br /> 6.'. Total completed and stored to date less retainage(4 minus 5): $ 91.607.84 <br /> 7. Less previousApplication for Payments: S. 0.00 <br /> 8. DUE THIS APPLICATION(6 MINUS 7): $ g1 ,60_R4 <br /> Accompanying Documentation: <br /> CONTRACTOR'S Certification: <br /> The undersigned CONTRACTOR certifies that.(])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 -- 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 /> 0 <br /> Dated V.E. Gray.and Son.Contracti Co. <br /> C0 CT <br /> By. <br /> State of <br /> County of <br /> Subscribed and sworn to before me this <br /> day of , <br /> Notary Public <br /> My Commission expires: <br /> Payment of the above AMOUNT DUE THIS APPLICATION is recommended. <br /> DatedJuly .31, 1998 Rieke Carroll Muller sociates 14. <br /> By: <br /> VCDC No.191 0-8-E (1996 Edition) onstruCtion Services Engineer <br /> Prepared by the Engineers Joint Contract Documents Committee and endorsed by The Associated General Cootnetors of Ametia and the Construction Specification <br /> institute. <br />