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I <br />*1 <br /> <br /> I <br /> I <br /> I <br /> i <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> i <br /> I <br /> I <br /> I <br /> I <br /> I <br /> <br />I hereby certify that all items and amounts shown <br />are correct for the work completed to date. <br /> <br />Contractor <br /> <br />Barbarossa & Sons <br /> <br />Date <br /> <br />(Na~ and TIUe) <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 />Engin?~/ /~ ~~.ver&Associates, lnc. <br /> fV (~N~..et~anal;~ed v <br /> <br />Date <br /> <br />APPROVED FOR PAYMENT <br /> <br />Owner <br /> <br />By <br /> <br /> City of Ramsey <br /> <br /> · , /~~/ <br /> <br />(Name ~nd~ritle) / <br /> <br />Date <br /> <br />Page 2 o! 6 <br /> <br /> <br />