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E-1
<br />4W
<br />40
<br />Nama of Contractor;
<br />Name of Qwner:
<br />Description of Job:
<br />Item
<br />CERTIFICATE TQR PARTIAL PAYMENT
<br />Pay Request 1k_ --
<br />TLC D %vniCed, I-.
<br />Indian Rivet C-ty _
<br />Con�ersioa of North Beach Water Traatment Plaat _
<br />Contract ltrans Ti9i9 Pcnad _
<br />Quant.. �vUait-- ----Knit_ . Quon1- ---Amomit
<br />haiigg Orders
<br />Alt Instrumentation Credit
<br />Alt Air Release Valves Credi
<br />Office Trailer Credit
<br />Fuel Storage Tank Slab
<br />Electrical Layout Mods
<br />Sodium Hypo Room Mods
<br />Ground Star Tank Drain Mod
<br />10" Bypass Piping Mods
<br />Concrete Sidewalk @ Exist C
<br />RTU Modifications
<br />Elect Mods, Sod Hypo Room
<br />Huriean@ Irene Damage
<br />Panic Button, Sod Hypo Roo'.
<br />Credit for Mise Wk Allow
<br />Credit Add'1 Wire & Conduit
<br />Credit Computer Upgrade
<br />Credit Monorail Repair
<br />Credit Bldg Permit Allow
<br />Floor Coating, Misc Areas
<br />TOTAL THIS PAGE
<br />TOTAL
<br />1.01 LS I
<br />1.0 LS
<br />1.0 LS
<br />1.0' LS
<br />1.0I -S
<br />Lo I'S
<br />1.0 I_S
<br />1.0 , I.S
<br />1.0! LS
<br />1.0 LS
<br />1.0 LS
<br />1.0 L5
<br />1.0 I.S
<br />1.0 LS
<br />I.0 LS
<br />1.0 LS
<br />10 LS
<br />1.0 LS
<br />1.01 LS
<br />(52,130.00
<br />(5,000.00
<br />(1,200.00
<br />5,883.00
<br />3,881.00
<br />5,687.00
<br />2,397.00
<br />9,320.00
<br />4,345.00
<br />11,269.00
<br />1,615.00
<br />2,078.00
<br />686.00
<br />(I 5,00U.ou;
<br />(170.00',
<br />(1,450.00
<br />11,936.00
<br />0
<br />Page 6
<br />1.00
<br />1.00
<br />I.00
<br />I.00
<br />1.00
<br />1.00
<br />1.00
<br />1.00
<br />I.00
<br />Total to Date
<br />-T--Arnomt
<br />(52,I30.00
<br />{5,000.00
<br />(1,200.00
<br />5,883.00
<br />3,881.00
<br />5,687.00
<br />2,397.00
<br />9,320.00
<br />4,345.00
<br />11.269.00
<br />1,615.00
<br />2,078.00
<br />686.00
<br />(15,000.00
<br />(170.00
<br />(1.450.00
<br />11,936.00
<br />{85,853.00
<br />_1,422,047.00
<br />TLC Job 98-09
<br />100% I
<br />'
<br />I t7tYlru h
<br />IOU-/.
<br />1
<br />1000/0
<br />100%1
<br />I (W/a
<br />100%,
<br />1001/o
<br />1,615.00
<br />i 00°/a
<br />2,078.00
<br />1000/0
<br />686.00
<br />1000/a
<br />{40,000.00
<br />1 Wlo
<br />(30,000.00
<br />100%
<br />(15,000.00
<br />100%
<br />( 170.00
<br />1001/a
<br />(1,450.00).
<br />1 L10a/1
<br />11,936.00
<br />100%
<br />(52,I30.00
<br />{5,000.00
<br />(1,200.00
<br />5,883.00
<br />3,881.00
<br />5,687.00
<br />2,397.00
<br />9,320.00
<br />4,345.00
<br />11.269.00
<br />1,615.00
<br />2,078.00
<br />686.00
<br />(15,000.00
<br />(170.00
<br />(1.450.00
<br />11,936.00
<br />{85,853.00
<br />_1,422,047.00
<br />TLC Job 98-09
<br />
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