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Exhibit B <br /> Application for Payment Surnman <br /> To (Owner) : Indian River County Solid Project: BORROW POND Agreement No. : <br /> Waste Disposal District <br /> (SWDD) 2009-001 <br /> Agreement Date: 1 I -May-O <br /> From Waste Management, Inc. Agreement Indian River Vertical Expansion & ii� Application No . : 5 <br /> ( Supplier) : of Florida (WMIF) North For: Partial Closure k Period Covered : 9/1 !09 - 9.130/Q9 <br /> Lir-ttnr14 CN"� <br /> CHANGE ORDER SUMMARY 1 . Origio31 Contract S 2499053. 7 / l n <2r14Z V11 <br /> Price : Z o <br /> 2. Net Change by S 295854.7 <br /> Change Orders : <br /> j 3. Contract Price to S 278,908,5 ! smT SZ <br /> Date: <br /> Net total of previously approved Change Application is made for Payment as shown below and i <br /> v I.� <br /> Orders: S on the <br /> Approved This Month ADDITIONS DEDUCTIONS attached sheets itemizing the cost breakdown. L9! � r <br /> Number Date Approved <br /> 4. Total Completed <br /> Through This <br /> 1 ,21314 8/ 10/2009 6,847. 731 ADolication for S 278 ,908.5 <br /> 5. Less Retainage <br /> 10 % of Total <br /> 5 ,6, 7 41 ,762 .01 Requested to Date S S <br /> Deduct for Item 6. Less Previous <br /> 11 18, 755 .00 S 202 <br /> Applications for ,219.8 <br /> 7. Current Payment <br /> i <br /> S 76,688.6 Due S <br /> Net Total This Month $ 29, 854. 74 <br /> Net Change by Change Orders S 29, 854 . 73 WM USE ONLY Dates: <br /> The undersigned Supplier certifies that the Work covered by this Application for Payment has beer <br /> completed in accordance with the Agreement and that the current payment shown herein is now due_ Th <br /> Supplier further certifies that alt amounts have been p <br /> >k t� S) (�, "7 0 •� 1 � ,ti ,ntits t Gee . ,, <br /> Approved by l 1 <br /> ( Geosyntce Consultants: �. "y l <br /> Approve y <br /> 1l2CSWDD : ✓� / 7 �Q <br /> SUPPLIER: W age nc. of Florida Peter D . O ' Bryan, Chair an <br /> Check Issued (or <br /> payment made): <br /> By: Deborah A. V'USjq,-6istrict Manager Date: 9/30/09 <br />