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VILLAGE OF GOWANDA PREPAY CHECK: | 27 East Main Street CONTRACT : Gowanda NY 14070 NEW X_DATE: ! Department CAPITAL PROJECT - WWTP Project FUND APPROP |CODE AMOUNT Claimant's | Quackenbush Co. Inc. H6989.63 $16,606.09 Nameand 495 Kennedy Road Construction- WWTP Address Buffalo, NY 14227 DUE: 7/14/2026 a TOTAL $ 16,606.09 DATES INVOICE DESCRIPTION OF MATERIALS UNI AMOUNT WWTP Capital Project 6/16/2026 Pay App #5 thru 12/31/25 $ 5,235.69 Pay App #6 thru 3/31/2026 $ 3,325.00 Pay App #7 thru 3/31/2026 - Final $ 8,045.40 Pay app detail attached Retainer (5%) Total Paid Retainage Pay App #1 $11,283.15 $593.85 Pay App #2 $55,521.23 $2,922.17 Pay App #3 $69,338.22 $3,649.38 Pay App #4 $8,159.31 $429.44 Pay App #5 $5,235.69 $275.56 Pay App #6 $3,325.00 $175.00 $152,862.60 $8,045.40 Pay App #7 $8,045.40 Release of Retahage $160,908.00 157.408; TOTAL $ 16,606.09 CLAIMANT'S CERTIFICATION 1, certify that the above account in the amount of $ is true and correct; that the items, services and disbursements charged were rendered to or for the municipality on the dates stted;thatno part has been paid or satisfied, that taxes, from which the municipality is exempt, are not included; and that the amount chimed is actually due. ect DATE SIGNATURE TITLE (Space below for Municipal Use) DEPARTMENT APPROVAL APPROVAL FOR PAYMENT The above services or materials were rendered to or furnished to the Thisclain is approved and ordered paid from the approx.- municipality on the dates “Sh charges are correct. Priaions indicated above. Lol. 2% DATE opt AUTHORIZED OFFICIAL DATE AUDITING BOARD DATE VILLAGE CLERK