K-3 - Pay Application 4, Woodruff Construction - Public Works Building

TO: City of Tiffin DATE: June 5, 2022 PROJECT NO. I0180.02 ATTENTION: Doug Boldt PROJECT: Tiffin Public Works Building RE: Pay Application #4 WE ARE SENDING YOU Attached Under separate cover via hand the following items: Contract Prints/Plans Samples Specifications Pay Request Copy of Letter Change Order COPIES DATE NO. DESCRIPTION 1 4 Pay Applications THESE ARE TRANSMITTED as checked below: For approval No exceptions taken Resubmit copies for approval For your use Make corrections noted Submit copies for distribution As requested For review and comment Return corrected prints Rejected see remarks FOR BIDS DUE REMARKS: Retain one copy for your records. Print one copy and remit along with payment to Woodruff Construction. COPY TO: Electronic File SIGNED: Sarah Coleman, AIA, Architect If enclosures are not as noted, kindly notify us at once.