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Contractor <br /> <br />Engineer <br /> <br />By <br /> <br />Owner <br /> <br />By <br /> <br /> I hereby certify that all items and amounts shown <br /> are correct for the work completed to date. <br /> <br /> ........ .. , . W.B. Miller, Ir~(~ .... <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 />r//~ /I :~: /J°hn ~liv//~r & Ass°ciates' Inc' ~/~, ~7/~;~ ~ ' <br /> <br /> A PROVED FOR PAYMENT <br /> City of Ramsey <br /> .... Date <br /> <br />Page 2 of 4 <br /> <br /> <br />