Laserfiche WebLink
CONTRACTOR'S PAY REQUEST DISTRIBUTION: <br />RAMSEY WELL HOUSE NO. 3 NATURAL GAS GENERATOR CONTRACTOR (1) <br />CITY OF RAMSEY, MN (OWNER (1) <br />CITY PROJECT NO. 17-06, BMI PROJECT NO. R16.113601 'ENGINEER (1) <br />'BONDING CO, (1) <br />TOTAL AMOUNT BID PLUS APPROVED CHANGE ORDERS $90,500.00 <br />TOTAL, COMPLETED WORK TO DATE $53,530.00 <br />TOTAL, STORED MATERIALS TO DATE $0.00 <br />DEDUCTION FOR STORED MATERIALS USED IN WORK COMPLETED $0.00 <br />TOTAL, COMPLETED WORK & STORED MATERIALS $53,530.00 <br />RETAINED PERCENTAGE ( 5%) $2,676.50 <br />TOTAL AMOUNT OF OTHER PAYMENTS OR (DEDUCTIONS) $0.00 <br />NET AMOUNT DUE TO CONTRACTOR TO DATE 1 $50,853.50 <br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES 1 $9,661.50 <br />PAY CONTRACTOR AS ESTIMATE NO. 21 $41,192.00 <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 amount <br />for the Final Estimate, that the provisions of M. S. 290.92 have been complied with and that <br />all claims against me by reason of the Contract have been paid or satisfactorily -secured. <br />Contractor: <br />KILLMER ELECTRIC CO., INC. <br />5141 Lakeland Ave N <br />ystal, MN 55429 <br />(! �/ Name Tile <br />Date c/'-( 1 / <br />CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT: <br />ENGINEER: BOLTON & MENK, INC., 7533 SUNWOOD DRIVE, SUITE 206, RAMSEY, MN 55303 <br />, SENIOR PROJECT MANAGER <br />Kevin Kielb, P.E. <br />Date May 15, 2018 <br />APPROVED FOR PAYMENT: <br />OWNER: CITYITOF RAMSEY, MN <br />By 11il.t.Aca— ��t,►-, C i Eh9 f�l�tt^�� `J/ <br />Name Titre Date <br />And <br />Name Title Date <br />