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PAY ESTIMATE #6 (Final) <br /> CITY OF RAMSEY <br /> 141ST AVE. NW, AZURITE ST. NW AND BASALT AVE. NW <br /> IMPROVEMENT PROJECT 03-27 <br /> <br />Please verify the amount of previous payments, if any, and the receipt of the following items prior to making payment. <br /> <br /> 1. Certificate of claims payment (lien waiver), - <br /> 2, Affidavit of payment of States taxes (MN State TAX Form 134), <br /> <br /> 3. Letter of consent from surety firm. <br /> Signed: ~'~,..~]z~.-~ <br /> <br />ENGINEER: Certific:,tion by Enginee,': We recommend payment for work and quantities as shown. <br /> l-Ialmnson Anderson Associates, [nc. <br /> <br />OWNER: <br /> City of Ramsey ..... ~ <br /> <br /> Signed: ' ~ <br /> Title Date: <br /> <br />ENGINEER <br /> <br />* FIELD CltANGF~ 4 <br /> <br /> <br />