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Pay Estimate No, 1, Final <br />Sunfish Lake Business Park 2nd Addition <br />City of Ramsey <br /> <br />Please verify the amount of previous payments, and the receipt of the following items prior to making payment. <br />1. Certificate of claims payment (lien waiver), <br />2. Affidavit of payment of States taxes (MN State TAX Form 134), <br /> <br />APPROVALS: <br />CONTRACTOR: TWIN PINES EARTHWORKS <br /> Cert, j.fi4ea't'fe~n by ,C(.c~c!or! I certify that all items and amounts are correct for the work completed. <br />Signed: ~)4_,'~"'~'"'~'~/" I <br /> <br />ENGINEER: Certification by Engineer: We recommend final payment for work and quantities as shown and release of all retainage <br /> HAKANSON AND~..~ERSON ASSOCIATES, INC <br />Signed ~_~_~ ~ ~~-~-¢'~__ <br />Titl~--~~ 4~..~g.~,..~4.~ate --"_/,,//-~ ~ <br /> <br />OWNER: : _~~.... ~ <br /> CITY OF <br />Signed: <br />Title:~ Date <br /> <br />shared docslmunicipallaramsey16301ra166quote.xls <br />Sheet: Pay Estimate BP-3 <br /> <br /> <br />