Laserfiche WebLink
Ibl-1— <br /> RECEIVED <br /> CONTRACTORS APPLICATION FOR PAYMENT <br /> (Unit Price Schedule and Change Order Backup Attached) AUG 141996 <br /> ICI D1 IVIS1((-)iy ,f <br /> OWNER: State of Colorado-Attn: Maggie Van Cleef FROM: ERMNFn�6C§dr�-WIUG Yiin, Inc. APPLICATION NO: 2 <br /> Division of Minerals&Geology 5950 South Willow Drive APPLICATION DATE: July 31, 1996 <br /> 1313 Sherman Street, Room 215 Suite 206 APPLICATION PERIOD: July, 1996 <br /> Denver,Colorado 80203 Greenwood Village,CO 80111 <br /> CONTRACT NO: PKA-6-372 PROJECT NO: ECOP,960007.00 <br /> CONTRACT DATE: June 20, 1996 <br /> SUBJECT: Coal Basin Rock Tunnel <br /> CHANGE ORDER SUMMARY <br /> ADDITIONS DEDUCTIONS CONTRACT WORK <br /> PREVIOUS MONTHS 1. ORIGINAL CONTRACT SUM $77,974.00 <br /> TOTALS: $0.00 $0.00 <br /> THIS MONTH 2. NET CHANGE BY CHANGE ORDERS ($61 1.40) <br /> TOTALS: $1,338.60 ($1,950.00) <br /> 3. CONTRACT SUM TO DATE(Line 1 +2) $77,362.60 <br /> NET CHANGE BY CHANGE ORDERS: $1,338.60 ($1,950 00) <br /> 4. TOTAL CONTRACT'WORK COMPLETED/STORED $41,639.05 <br /> 5. RETAINAGE $0.00 <br /> Undersigned Contractor certifies that to the best of the Contractor's <br /> knowledge,information,and belief,the Work covered by this Application 6. TOTAL AMOUNT INVOICED LESS RETAINAGE $41,639.05 <br /> for Payment has been completed in accordance with the Contract Documents, <br /> all amounts have been paid by the Contractor for Work for which previous 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT $4,387.00 <br /> Certificates for Payment were issued and payments received from the Owner, <br /> and that all current payment shown herein is now due. 8. CURRENT PAYMENT DUE $37,252.05 <br /> 9. BALANCE TO FINISH, FLUS RETAINAGE $35,723.55 <br /> CONTRACTOR: ERM EnviroClean-Rocky Mountain,Inc. DATE: <br /> P:\ec\r\colo-dmg\960007\INV.APP2.XLS Page 1 of 3 <br />