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<br />CONTRACTOR'S RECAPITULATION <br />Well House No.4 <br />CITY o'F Ramsey <br />8MI PROJECT NO.: M21.37017 <br /> <br />TOTAL WORK COMPLETED WELL HOUSE NO.4 <br />TOTAL WORK COMPLETED TO DATE <br />RETAINED PERCENTAGE 5% <br />TOtAL AMOUNT OF OTHERPAYMENTS OR (DEDUCTIONS <br />NET AMOUNT DUE TO CONTRACTOR TO DATE <br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES <br />PAY CONTRACTOR PER ESTIMATE NO.4 <br />Certificate for Partial Payment <br />I hereby certify that, tQ the best of my knowledge and belief, aU items quantities .and prices <br />of work and material shown on this Estimate are correct and that all work has been <br />performed in full accordance with the terms and conditions of the Contract for this project <br />between the Owner and the undersigned Contractor, and as amended by any <br />authorized changes, and that the foregoing is a true and correct statement of the <br />contract amount for the period covered by this Estimate. <br /> <br />$195,111.40 <br />$195,111.40 <br />$9,755.57 <br />$0.00 <br />$185,355.83 <br />$146,460.55 <br />$38,895.28 <br /> <br />B <br /> <br /> <br />Rice Lake Construction Group <br />P.O. Box 517 <br />Deerwood, MN 56444 <br /> <br />Contractor: <br /> <br />Name <br /> <br /> <br />Date '1- 3--:u % <br /> <br />CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT: <br />ENG1NEER.~... . ..... ..' ~'.. ...~...N.> ,N NK,INC.., ENGINEERS, 7533 SUNWOOD DRIVE, SUIT.E 206 <br /> <br />By ,~~ .~ ~ . , PROJECT ENGINEER <br /> <br />Date P~p8E. . <br /> <br /> <br />APPROVED FOR PAYMENT: <br />OWNER: City of <br /> <br /> <br /> <br /> <br />By <br /> <br />Name <br /> <br />-55- <br />