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Pay Estimate Summary Sheet <br />IP 10-25; Chameleon Street Paving <br />City of Ramsey <br />Estimate No. <br />TOTAL CONTRACT <br />CHANGE ORDER NO <br />TOTAL WITH CHANGE ORDERS <br />1 <br />$ 268,222.08 <br />$ 268,222.08 <br />STORED MATERIALS $ <br />TOTAL, COMPLETED WORK TO DATE $ 87,550.50 <br />TOTAL WORK COMPLETED PLUS STORED MATERIALS $ 87,550.50 <br />RETAINED PERCENTAGE 5% $ 4,377.53 <br />NET AMOUNT DUE TO CONTRACTOR TO DATE $ 83,172.98 <br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES $ - <br />PAY CONTRACTOR PER ESTIMATE NO. 1 $ 83,172.98 <br />Certificate for Partial Payment <br />I hereby certify that, to the best of my knowledge and belief, all items, quantities and prices of work <br />and material shown on the this Estimate are correct and that all work has been performed in full <br />accordance with the terms and conditions of the Contract for this project between owner and the <br />undersigned Contractor, and as amended by any authorized changes and the foregoing is a true <br />and correct statement of the contract amount for the period covered by this estimate. <br />Contractor: Omann Brothers Paving, Inc. <br />By <br />Name <br />Date <br />Title <br />CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT: <br />ENGINEER: CITY OF RAMSEY <br />By <br />Date <br />APPROVED FOR PAYMENT: <br />OWNER: City of Ramsey <br />By <br />Tim Himmer, PE <br />City Engineer <br />Name Title Date <br />