contract agreement · K-2
Discussion and Consideration of Pay Application #12 – Miron Construction – Tiffin Recreation Center Project – Motion to Approve — K.2
Page 28 of 41
Text read by the vision model; check the PDF for anything that matters.Miron Construction Co., Inc.
REQUEST FOR PAYMENT
DATE: 02/17/2026
PROJECT NAME: City of Tiffin Community Recreation Center
ADDRESS: Tiffin, IA
CONTRACT FOR: FI-09.66_32.18/Resilient Athletic Flooring_Turf Surfacing
MIRON PROJECT: 250120
REQUEST NUMBER: #2
INVOICE NUMBER: #2
CONTRACT #: 250120-000026
PERIOD FROM: 4/1/2026
INVOICE DATE: 4/19/2026
VENDOR #: 00017926
TO: 4/30/26
ORIGINAL CONTRACT AMOUNT $266,500.00
APPROVED CHANGE ORDERS AS OF 02/17/2026 $1,050.00
ADJUSTED CONTRACT AMOUNT $267,550.00
TOTAL COMPLETED TO DATE $148,875.00
PREVIOUS REQUESTS FOR PAYMENT $777.10
TOTAL EARNED THIS REQUEST $148,097.90
LESS % RETAINAGE $7,443.75
CURRENT PAYMENT DUE $140,654.15
VENDOR: Phillips Floors Inc
SIGNED: [signature]
TITLE: Mark A. Bjork-Vice President
*** REQUESTS WILL NOT BE PROCESSED UNTIL THEY ARE SUBMITTED TO MIRON VIA E-MAIL IN A PDF FORMAT TO [email protected] OR ORIGINALS ARE RECEIVED IN OUR CORPORATE OFFICE: PO BOX 509 NEENAH, WI 54957-0509. FAX COPIES WILL NOT BE ACCEPTED.
EACH PAY REQUEST MUST INCLUDE AN UP TO DATE SCHEDULE OF VALUES, INCLUDING SUB TIER SUPPLIER/CONTRACTOR BREAKDOWN AND CURRENT PAYMENT STATUS. CHANGE ORDERS ISSUED TO DATE MUST BE REFLECTED ON THE CURRENT SCHEDULE OF VALUES.
Sources
- revize: K.2 (B2fPpimpwMa7H9wwbMqqtqg1yqDQuS.pdf) — where it was found ↗ first seen Oct 12, 2026
Attached to agenda item: K-2 Discussion and Consideration of Pay Application #12 – Miron Construction – Tiffin...
Data last updated October 16, 2026. Built from the archive's documents; see how the data is built.