HomeMy WebLinkAboutPAY ESTIMATE INVOICE 420 (2) A
PAY ESTIMATE NO.
TO i c.-t(s 4.4" ++
�� ��� . �,�°� '�- KVu\ia�,'h CDBGNO.
(Contractor)
EXPENSE CODE
ADDRESS 137 Coil een A 4e .
II DATE OF BILL to -4-c (D
(AL!ticrioo 74 50110 '�
INVOICE NO. '`1
OWNER C;
ADDRESS '1 1 c' LAIL e
CONTRACT DATE 9 - -S —o
SUMMARY OF PAY ESTIMATE
ORIGINAL CONTRACT SUM $ S) I(X).
CHANGE ORDER NUMBERS $ U. d v
TOTAL CONSTRUCTION COST $ 1'; 100,
LESS AMOUNT PREVIOUSLY PAID $ 0, OCI
BALANCE STILL IN CONTRACT $ ' 100. 83
PAYMENT REQUESTED $ �� I OU (It
LESS % RETAINED (')
TOTAL DUE CONTRACTOR THIS ESTIMATE $_ 140 SC _ __
I have made a progress inspection of the property being rehabilitated at the above address.
The construction work for which payment has been requested has been satisfactorily
completed in accordance with the construction contract. StcbjeLT` +o repairs (-thy (ckst
DATE R HABILITATION SPECIALIST
APPROVED FOR PAYMENT
/�//I�Z Di. VI
Al
U �' \�. COMMUNITY DEVELOPMENT DIRECTOR
a �'`� OR DESIGNEE