HomeMy WebLinkAboutPAY ESTIMATE INVOICE 236 n ;..
PAY ESTIMATE NO.
V
TO a Str 01(4r/Nb no.,` ta+i tsiC CDBG NO._
(Contrac` or)
EXPENSE CODE
�.1
ADDRESS ``1 A y m tmJ. Rct
l DATE OF BILL 4-c O"(3 o
tA,akrt oo j tP • 50`)01
INVOICE NO. 3(
OWNER It, ater 60 . "'
ADDRESS Its 4ommoncl Nile
CONTRACT DATE re19> d 4 a00
•
SUMMARY OF PAY ESTIMATE
ORIGINAL CONTRACT SUM $ I q ii S• °
CHANGE ORDER NUMBERS $ C). n )
TOTAL CONSTRUCTION COST
LESS AMOUNT PREVIOUSLY PAID $ O. 0 0
•
BALANCE STILL IN CONTRACT $ 11 ,q L S• o0
PAYMENT REQUESTED $ 1 q �•
LESS 10% RETAINED $ Q.O0
TOTAL DUE CONTRACTOR THIS ESTIMATE $ 117
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. �y
`� sae(-t' 1)61-u.A.,
,
DATE2 REHABILITATION SPECIALIST
APPROVED FOR PAYMENT
DATE COMMUNITY DEVELOPMENT DIRECTOR
OR DESIGNEE