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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 />I <br />I <br />I <br /> <br />Contractor <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 />Bonine Excavating <br /> <br /> · : <br />/ ' (Name and Title) <br /> <br />Date <br /> <br />The work on this project and the application for payment have been <br />ctWed and the~amount shown is recommended for payment, <br /> r~an~ag.~) Date ')l [ ~/~:~ <br /> <br />APPROVED FOR PAYMENT <br /> <br />City of Ramsey <br /> <br />i(Name and Title) <br /> <br />Date <br /> <br />Pa.qe 2 of 5 <br /> <br /> <br />