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<br />CONTRACTOR'S PAY REQUEST NO.4. FINAL
<br />ERMINE BOULEVARD CULVERT REPLACEMENT
<br />CITY OF RAMSEY
<br />ElMI PROJECT NO. R13.39195
<br />
<br />TOTAL CONTRACT AMOUNT WITH APPROVED CHANGE ORDERS""""""""....",,,..,......
<br />
<br />CONTRACTOR
<br />OWNER
<br />ENGINEER
<br />
<br />$140.394,08
<br />
<br />TOTAL. COMPLETED WORK TO DATE"........,........"......""'...."......,................"'.......".......,..... $ 1611.617.50
<br />TOTAL., STORED MATERIALS TO DATEt..",....",.......,....................................................,..,......" $
<br />oeOUCTION FOR STOReD MATERIALS useD IN WORK COMpLETeD,......,,,.....,,......,,...,,.,, $
<br />TOTAL. COMF'LETEO WO~K e. STORED MATERIAl.S........."...........,,,,,,..................,,.............,. $ 1I5S.!l17,1l0
<br />
<br />RETAINED peRCENTAGE (
<br />
<br />0%) !,/f........Ij.II........'.I;...".,J,...'..UI.'...j,..t1"jlll',"IIt',"."\>",, $
<br />
<br />TOTAL AMOUNT OF OTHER DEDUCTIONS............"....".."".......,......."........"........,,,..,,,,.. $
<br />NET AMOUNT Due TO CONTRACTOR TO DATE....................".................,............,..,........,..... $ 156,617.50
<br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES ........................................................... $ 155,445,15
<br />PAY CONTRACTOR AS ESTIMAT5 NO, <I. FINAL ............'.........."................"...."... $ 3,172.35
<br />
<br />Certificate for Final Payment
<br />
<br />I hereby certify that. to the best of my knowledge and belief, all 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 /ilmended by any
<br />authori7:ed changes, and that the foregoing is a true and correct statement of the amount
<br />for the Final 5stlmllte, that the provisions of M. S. 290,92 have been complied with and that
<br />all claims against me by reason of the Contract have been paid or satisfactorily secured,
<br />
<br />Contractor:
<br />
<br />Dryden Excavating
<br />6700 Viking Blvd.
<br />Anoka, MN 56303
<br />
<br />By
<br />
<br />Name
<br />
<br />Title
<br />
<br />Date
<br />
<br />CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT:
<br />BOLTON & MENK, INC., ENGINEERS, 638 SHADOW l.N, SUITE 200, CHASKA MN 55318
<br />"
<br />
<br />
<br />, Project Manager
<br />
<br />Date: JULY 2. 2009
<br />
<br />APPROVED FOR PAYMENT:
<br />Owner: CITY OF RAMSEY
<br />
<br />By
<br />Name
<br />
<br />Title
<br />
<br />Date
<br />
<br />F:\RAMS\R1339195\Exc:el\pay request 4 . Flnal.xls
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