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Pay Estimate Summary Sheet <br />Estimate Number: 2 Final <br />Project Number: 19-06 <br />Project Name: RTC 9th Addition Pond Lining Improvements <br />Period Ending August 31, 2020 <br />Contractor: JL Theis, Inc. <br />Address: 860 Quaker Avenue, Suite 102, Jordan, MN 55352 <br />I Original Contract Amount <br />2 Change Order(s) No. Thru No. <br />3 Total Funds Encumbered <br />4 Value of Work Completed <br />Value of Work Remaining $ <br />Percent Complete 100% <br />5 Retainage 0 <br />6 <br />7 <br />8 <br />Previous Payment(s) <br />Deductions or Charges <br />Total Retainage, Payments & Deductions (Lines 5+6+7) <br />Payment Due (Lines 4-8) <br />105,152.00 <br />$ 105,152.00 <br />103,942.00 <br />96, 952.25 <br />$ 96, 952.25 <br />$ 6,989.75 <br />Certificaiton of Final Payment <br />I hereby certify that, to the best of my knowledge and belief, all items, quantities and prices of work and material shown on <br />this Estimate are correct and that all work has been performed in full accordance with the terms and conditions of the <br />Contract for this project between owner and the undersigned Contractor, and as amended by any authorized changes and <br />the foregoing is a true and correct statement of the amount for the Final Estimate, the provisions of M.S. 290.92 have been <br />complied with and that all claims against me by reason of the contract have been paid or satisfactorily secured. <br />JL Theis, Inc. <br />,1 ct„m, e T eis <br />Contractor Name Print Name <br />remduct <br />Title Signat <br />age, <br />9/Ji,'ZDZO <br />Date • <br />City of Ramsey Approval <br />60/2010 <br />Signature (Project Engineer) Date <br />Signature (City Engineer) <br />f <br />Date <br />Pay Estimate Page 1 of 2 <br />