Discussion and Consideration of Pay Application #10 – Miron Construction – Tiffin Recreation Center Project – Motion to Approve — K.2

Month of Pay Request: | Appz feb Goze Building Excellence Zephyr Alurninum Products Subcontractor/Supplier Contract List Miron Project Name: City of Tiffin Community Recreation Center Miron Project #: 250120 Contract #: 250120-000015 Contract Amount: $389,300.00 Requested Original Sub-tier Payment for Maieriai Phone Contract / Previous | this month's Balance Lien Waiver Sub-tier Name PO# Description Address # [Estimate Amount] Payments billing Remaining Rec'd Lictwoet te, LALA AA 123,420.00 | Jl 06 BE, I20.20 2| Maoes Canopies 19,690.60 iV696,0 |e 31 Olabasrde Glas 64,656.00 C4 F550 44 Doors ine Hotdware FL 123.00 72)t5.00 | & 5 6 7 & 9 10 |Labor, Misc Material, etc. ZAL | phoot 164 10j0 0% [oT 010.00 TOTAL: sfiew [39/850 | ¢7ab4¢5 [¢ a7 DIB Change Orders (at option of Miron's Project Manager} 4 2 3 A 7-4 53-4 84-08B3 31 TOTAL: $ $ $ $ Please email compieted form to: [email protected] S6E7B38D-8 E Please provide a detailed breakdown showing the amount fo be paid to each sub-tier {subcontracto ID. r or supplier) on all pay requests. This information should also be identified on your Schedule of Values. In addition, we ask that you provide Lien Waivers from your sub-tiers. ff for any reason lien waivers are not lope received and payment has not been met, Miron will hold future payments due to your company until It is confirmed that the previous pay requests have been Envel paid out. “sign Dor.