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4.m. Application for Payment - Well #8
J_ i ' _ _ � � �� : i ! 1 ; • j t . � Com. No! ����= Cert. No. 1 � � St. Paul,.Minu:, Ju1y ;21 : I:s� , � ; . , a , , � , : � ; • � ; : , O.wner± To City of Rosemount, Minnesota , ; This Certifies that Keys Wei 1 Dri 11 i ng � Contractot � � s . For Constructian of Wel1 No. $ Twenty Five Thousand Two Hundred Is entitled to Seventeen Dollars and 7�/100---- --- - ----- -($-2�-� �� ) being �S t estimate for partial payment on contract with pou dated May 2 �. I.9 89 � TOLTZ, KIhtG, bUVALL, AND£f2SON RecGived payment in full of above certificate. ANc► Assoc�ATEs, �N�Q���+,�o ", e � EtiQtN1&L�RB/lN0 ARCH116CTS , . ' � �' s ''; 2500 n �a'tional Bank�`Bl dg.'' , cc>rrr�scro� f=��j:St;�� a�l:;'.Mi�in ata� �� 1 � � . . • . . . i + . +/t.Ly.� � . . . .. 9 �� � � . � David.'L:�.Moore, P.E. . { RECAPITULATtON QF'�ACCOUNT ' , GOMTRACT * " - pqYMENTS CR£btTS � , . PLUS EXTRA3 � ' � --�'-- � Contract price plus eatras ' ' . ` : 120;820 OU .{� . . : . ..- � Qp All previous papments i A11 previovs credits , . . _ �� ", . n �:�:: ,���, r- .,. i{"� Extra No. � :1 .� « . . . ,, .� .. .. . . . �' « .. �� , ' . . , �� .. , ,�.,_,;,,_..�.. . �� • , .. , Credit No. . , �' .. .. . . �; �; .. .. i « .� . � AMOUNT OF THIS CERTIFICATE -.._ 25 217 75 j � __-.._..____...., , ,% Totals 25,217 75 � Credit$alance ��• There will remain unpaid on cantract aft�r payment of this 95,602 25 � Certificate � i . . . . . . .. . . . ° 120,82Q 0 120,820 00 , t � i .._1d..�.t�, . 1 . ( �. . � . . . TOLTl, KiNG, L�UVALL, ANDERStM+1 AND ASSQCtATES, IN(�RPORATED Engi�eers-Archtfiects-Planners Saint Paul, Minnesata 531�t PER 1001 C1�. EST I MATE PDR PART tAL PAYNENTS E st i ma fie No.,,,,L, Per t od E�d t n o J u i v 20. 19 89 Pa ge 1 of 1 Cc�m. No.4T�QL. PiroJect Con�,tL,�,�tQn of �,�{ t �lo. 8 4riginai Qontract Amoant Loca�fiT v� Ra1erttount. Mt n�,�t�„- � 12Q.8�9.Q0 Cv ntr act or K�y,� W e t i .Q�"t 1 1.�n� , , 1'otal Gontract Work Cc�mpteted � ��2,375•�._.� Total Appra�ed Credlts E Tofia! App-oved E�ct�ra Work Compl e#ed � Appraved Extra Orders Amounfi Compt eted S Matertal s o� Mand � 4.17A�QS� Tota! Amount Earned Thts Esttmate � 2�,�4�.QQ Less Appraved Credits � Less___�__ � Reta t ned � t.327.25 Less Pr-e�v tous Payments � U.0�1 Total Deducttons � 1 .3�7.25 Amount Due Thts Esttmate � 25.2�7.75 Co ntr actor Da fie G� j�����:. L Enginecr V'" Oate � � �� ,. .,�_k. ._ . I E.�T 11!9A.IF_ No, t OONSTf?UGT ION OF WELL PIO. 8 ROSEM}UNT, MINNESOTA O�MMISS ION N0. 9230-01 ITEM N0. DESCR IE`L�.Q.L`!. 0l�l4�1.LI�' .�lHLT ER�_�. OOST i MQB IL IZ AT IQN/REAUB IL IZ AT tON 0.50 i.S 80Q0.00 4,000.00 2 RR ii.l. 30" k?1 A C�15E0 HQt.� 65.00 LF 200.4Q 13,OOQ.OQ 3 INSTALL 2�4�� CAS INt3 65.00 tF 55.00 3.575.04 4 DRI�L 24p DIA CAS�p Nd.� i5.40 l�' 12Q.Q�t f,$QO.QO , 5 DRIIL 23��D�IA RU�1C HtX.E � � Q.00 t�' 6Q.00 O.QO 6 F1�1 18TM D tA 1NNER CAS ING 0.00 Lf 39.00 O,QO 7 CENENT GRqJT /WI�ILAR SPACE 0,00 CY 20Q.00 0.00 8 EXPi.OSIVES 0.00 LB 10.00 Q.4U 9 RENpVE ROCK O.QQ CY 70.OQ 0.00 10 OOMFRESSOR FOR A(R SUF�ING 4.00 lS 3QOa.00 0.00 i 1 A(R SUi�ING O.UG HR f 30.Q0 Q.00 �2 ADD1 TIONI�L. A IR SUI�tNG EQU I PMT t1.00 lS 50Q.00 0.00 13 T�ST PUMP Q.OQ LS 3000.40 0.00 t 4 WEIL TEST ING 0.00 HR i i 0.00 O.QO 15 F/I/R WELL RJMR FOR AQONI TEST 0.00 !S 500,Q0 Q.Op 16 ADOMI SAtJD OONTENT TES7S 0.00 EA 5fl.00 0.00 17 CHEMI CRt./BACTER 10L�OG I CJ�t TEST 0.00 CS 300.Ofl 0.04 22,375.OQ Telephones: 646-7871 . 413 Narth Lexington Parkway �. � 64�.7872 1NVOICE $t.Paul,Minnesat� SS l04 � WATER PRODUCERS � C�ty of Roaemount , � c/a TKDA 2�00 A�erican National Bank Buflding Saint Paul, Alinnesata 55101-1$93 � TERhiS: NET 10 DAYS , � � Prenaiting inhreat ratea taiJ!be charped+sr e!lne�er•dut acceunt�. - , DATF, INVOICE N0. CUSTOMER ORDER NO. LOGATION OF WO �uly 20, 19.g9 8977 Weil �8 1. Move � Set 50� � $,040 00 $ 4,D40 00 2. F & D 34" 65' @ � 200,00if`t $ 13.000 q0 3. z� � 3 2t��� 65' � � 55.ooltt $ 3�575 00 �t. F ik D 2k" 1�" � � X2Q.00/t't . $ 1.,$00 00 � 22,375 00 Pi�� on Site 24" PiP� lOQ' � $ �]..70/Pt � 4,2T0 Od AaloUnt Tnvoiced � 26,5k5 00 : I�se 5$ $ 1,327 25 Amount Due This Invoiee � 25,217 75 u ..�_�.. . .