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CONTRACTOR'S PAY REQUEST <br />DISTRIBUTION: <br />MISSISSIPPI RIVER TRAIL <br />CITY OF RAMSEY, MN <br />SP 199-090-001 <br />CONTRACTOR (1) <br />OWNER (1) <br />ENGINEER (1) <br />BONDING CO. (1) <br />TOTAL AMOUNT BID PLUS APPROVED CHANGE ORDERS <br />$183,272.52 <br />TOTAL, COMPLETED WORK TO DATE <br />$62,200.97 <br />TOTAL, STORED MATERIALS TO DATE <br />$0.00 <br />DEDUCTION FOR STORED MATERIALS USED IN WORK COMPLETED <br />$0.00 <br />TOTAL, COMPLETED WORK &STORED MATERIALS <br />$62,200.97 <br />RETAINED PERCENTAGE ( 5%) <br />$3,110.05 <br />TOTAL AMOUNT OF OTHER PAYMENTS OR (DEDUCTIONS) <br />$0.00 <br />NET AMOUNT DUE TO CONTRACTOR TO DATE <br />$59,090.92 <br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES <br />$2,061.41 <br />PAY CONTRACTOR AS ESTIMATE NO. 2 <br />$57,029.51 <br />Certificate for Partial Payment <br />I hereby certify that, to the best of my knowledge and belief, all items quantities and prices <br />of work and material shown on this Estimate are correct and that all work has been <br />performed in full accordance with the terms and conditions of the Contract for this project <br />between the Owner and the undersigned Contractor, and as amended by any <br />authorized changes, and that the foregoing is a true and correct statement of the <br />contract amount for the period covered by this Estimate. <br />Contractor: North Valley, Inc. <br />20015 Iguana St NW #100 <br />Nowthen, MN 55330 <br />By 'AMP <br />r <br />4 l' Presid snt <br />Name P ad atIllidthaLET Title <br />Date Jive 1, 2015 <br />CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT: <br />ENGINEER: BOLTON & MENK, INC., 7533 SUNWOOD DRIVE, SUITE 206, RAMSEY, <br />� 4 <br />By ✓J�''`" , SENIOR PROJECT <br />MN 55303 <br />MANAGER <br />Kevin Kielb, P.E. <br />Date .. ✓1€, ) .L5 <br />APPROVED FOR PAYMENT: <br />OWNER: CITY F RAMSEY, MN <br />By 0 (Ul Gi/dil� 6 /1-l/ <br />Name Title Date <br />(1-. Li �no c'i\e.vz— C,(( <br />(f S <br />And <br />Name V Title Date <br />