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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 Services, Inc. <br /> <br />By <br /> <br />O~U (~ame and Title) <br /> <br />Date <br /> <br />The work on this project and the application for payment have been <br />reviewed and the amount shown is recommended for payment. <br /> <br />Engineer~ <br />By~ <br /> <br />Oliver & Associates, Inc. <br /> <br />Date <br /> <br />APPROVED FOR PAYMENT <br /> <br />Owner City o~ Ramsey <br /> <br /> · ' (Name a'np"T~tle) <br /> / <br /> <br />Date <br /> <br />Page 2 of 3 <br /> <br /> <br />