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/-/(.3 <br /> <br />I hereby certify that ali items and amounts shown <br />are correct for the work completed to date. <br /> <br />Contractor <br /> <br />W.B. Miller, Inc. <br /> <br />By <br /> <br />(Name and Title) <br /> <br />The work on this project and the application for payment have been <br />reviewed and the amount shown is recommended for payment. <br /> <br />Engineer <br /> <br />John Oliver & Associates, Inc. <br /> <br />APPROVED FOR PAYMENT <br /> <br />Owner <br />By <br /> <br /> City of Ramsey <br /> ~~"' 'd~~T/[/~~'~ Ti e, <br />-- (Nam,- _ ~,d ~ ,, [ ,~ ~*-. ,~ ,,-~, ,.. <br /> <br />Date <br /> <br />Pege 2 o~ 4 <br /> <br /> I <br /> I <br />I <br />I <br />I <br />I <br />I <br /> <br />I <br />I <br />I <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br />