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r , . <br /> 4. Sample of each nominal 20,000 ( ) Sent under separate cover <br /> IIpound shipment furnished <br /> 5. Weight ticket(s) for each nominal ( ) Sent under separate cover <br /> 20,000 pound load furnished <br /> CONTRACTORS CERTIFICATION: <br /> The undersigned CONTRACTOR certifies that (1) all previous progress payments received <br /> from OWNER on account of work done under the Contract referred to above have been applied to <br /> discharge in full all obligations of CONTRACTOR incurred in connection with Work covered by <br /> prior Applications for Payment; and (2) title to all materials and equipment incorporated in said <br /> Work or otherwise listed in or covered by this Application for Payment will pass to OWNER at <br /> time of payment free and clear of all liens, claims, security interests, and encumbrances (except <br /> such as covered by Bond acceptable to OWNER). <br /> Dated: January 24, 1996 Calgon Carbon Corporation <br /> (Contractor) <br /> i <br /> / i........--- <br /> John M. MacCrum <br /> Title: Senior Vice President <br /> Payment of the above AMOUNT DUE CONTRACTOR THIS APPLICATION is recommended. <br /> IIP Dated: Fee3 - TT 19`A Barr Engineering Co. <br /> (Owner's Repre enta^(i. ,�e,�- <br /> By:,---- —. t1-01 <br /> III <br /> 2362210\19437_11PLS <br />