Packet: Tiffin Regular City Council Meeting (02/17/2026)

PAYMENT APPLICATION DATE: December 15, 2025 PROJECT NAME: City of Tiffin Community Recreation Center ADDRESS: Tiffin, IA CONTRACT FOR: FI-23.00/HVAC MIRON PROJECT: 250120 CONTRACT #: 250120-000025 VENDOR#: 00005737 REQUEST NUMBER: 2 PERIOD FROM: 12/01/2025 TO: 12/31/2025 INVOICE NUMBER: 63477 INVOICE DATE: 12/15/2025 <table> <tr> <th>ORIGINAL CONTRACT AMOUNT</th> <td>$719,950.00</td> </tr> <tr> <th>APPROVED CHANGE ORDERS AS OF August 21, 2025</th> <td>0</td> </tr> <tr> <th>ADJUSTED CONTRACT AMOUNT</th> <td>719,950.00</td> </tr> <tr> <th>TOTAL COMPLETED TO DATE</th> <td>27,005.00</td> </tr> <tr> <th>PREVIOUS REQUESTS FOR PAYMENT</th> <td>9,775.00</td> </tr> <tr> <th>TOTAL EARNED THIS REQUEST</th> <td>17,230.00</td> </tr> <tr> <th>LESS 5% RETAINAGE</th> <td>861.50</td> </tr> <tr> <th>CURRENT PAYMENT DUE</th> <td>16,368.50</td> </tr> </table> VENDOR: Illens Inc SIGNED: TITLE: 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. FAX COPIES WILL NOT BE ACCEPTED. • EACH PAYMENT APPLICATION MUST INCLUDE AN UP TO DATE SCHEDULE OF VALUES, INCLUDING SUB TIER SUPPLIER/SUBCONTRACTOR BREAKDOWN AND CURRENT PAYMENT STATUS. CHANGE ORDERS ISSUED TO DATE MUST BE REFLECTED ON THE CURRENT SCHEDULE OF VALUES.