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I hereby certify that all items and amounts shown <br />are correct for the work completed to date. <br /> <br />Contractor <br /> <br />Kadlec Excavating <br /> <br />By ....... Date <br /> !Name and Title) <br /> <br />The W, ork on this project and the application for payment have been <br />rev_iewed and the amount shown is recommended for payment. <br /> <br />~___ ~~Jo~~ssociates, <br /> <br />Irlc. <br /> <br />Date <br /> <br />APPROVED FOR PAYMENT <br /> <br />Owner City of Ramsey <br /> <br />(Name and Title) <br /> <br />Date <br /> <br />Page 2 of 5 <br /> <br /> <br />