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Oc~cober 2, 1991 <br /> <br />PAY ESTIMATE NO. 1 - FINAL <br /> RIVER'S B~lqD PARK <br />~ ~ 90-29 <br /> <br />Honorable Mayor & city Council <br />City of Ramsey <br />/5153 Nc~en Blvd. N.W. <br />Ramsey, MN 55303 <br /> <br />Imp~t Project 90-29, River's Bend Park /mlorovements <br />Contractor: Diversified Pavir~, 6957 N.W. Hwy 10, Ramsey, MN 55303 <br />C~letion Date: September 30, 1991 <br /> <br />The following work has been completed on the above referenced project by <br />Diversified Paving. <br /> <br />I <br />I <br /> <br />I <br /> <br /> Estimated Used <br />Item Quantity To Date Unit Price <br /> <br />Extension <br /> <br />1o Bitlmninous Pad 43 SY 43 SY $20.00 /SY <br /> <br />$860.00 <br /> <br />~ ~ FINAL PAYMt~T TO DIVERSIFIED PAVING OF: <br /> <br />Please verify the amount of previous payments, if any, and receipt of the <br />following items from the contractor prior to making payment. <br /> <br />$860.00 <br /> <br />1. Certificate of Claims Payment (lien waiver), <br />2~ Affidavit for Payment of State Taxes ~4J/~. State Tax Form 134)o <br /> <br />Certification by Contractor: I certify that all items and <br />amounts shown are correct for the work completed to date. <br /> <br />D/VERSIFIED PAVING <br /> <br />'1 <br /> I <br /> <br />Title: <br /> <br />Date: _. <br /> <br />Signed: <br /> <br />Title: <br /> <br />I <br />I <br />I <br />I <br />I <br /> <br />File: RA7:02-24 <br /> <br /> <br />