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)9-' cbq <br />CONTRACTOR'S PAY REQUEST <br />DISTRIBUTION: <br />BUNKER LAKE BOULEVARD AND PUMA STREET IMPROVEMENTS <br />CONTRACTOR (1) <br />OWNER (1) <br />CITY PROJECT # 18-05 <br />ENGINEER (1) <br />CITY OF RAMSEY, MN <br />IBONDING CO, (1) <br />BMI R16.115858 <br />TOTAL AMOUNT BID PLUS APPROVED CHANGE ORDERS <br />$923,458.23 <br />TOTAL, COMPLETED WORK TO DATE <br />$930,156.38 <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 />$930,156.38 <br />RETAINED PERCENTAGE 0% <br />$0.00 <br />TOTAL AMOUNT OF OTHER PAYMENTS OR DEDUCTIONS <br />$0.00 <br />NET AMOUNT DUE TO CONTRACTOR TO DATE <br />$930,156.38 <br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES <br />$875,740.65 <br />PAY CONTRACTOR AS ESTIMATE NO. 3 - Final <br />$54,415.72 <br />Certificate for Final 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 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: Douglas -Kerr Underground, LLC <br />2142 330th Ave <br />Mora, MN 55051 <br />By e-^ P , <br />ame itle <br />Date d%tat j,0( <br />CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT: <br />ENGINEER: BOLTON &`M)ENK, INC., 7533 SUNWOOD DRIVE, SUITE 206, RAMSEY, MN 55303 <br />By d � , jZz— , PROJECT MANAGER <br />KEVIN P. KIELB, P.E. <br />Date 10/14/2019 <br />APPROVED FOR PAYMENT: <br />OWNER: CITY OF SEY <br />ey. �✓ �� Tiff T1� /0/2 I <br />Name Title Date <br />And '' e.i — late.: 4G 22% �( <br />Name Title Date <br />