Packet: Tiffin Regular City Council Meeting (05/19/2026)

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.