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CONTRACTOR'S PAY REQUEST <br />2020 PUMA STREET IMPROVEMENTS <br />SAP 199-109-007 <br />CITY OF RAMSEY <br />CITY PROJECT NO. 20-04 <br />BMI PROJECT NO. R12.121681 <br />TOTAL AMOUNT BID PLUS APPROVED CHANGE ORDERS <br />TOTAL, COMPLETED WORK TO DATE <br />TOTAL, STORED MATERIALS TO DATE <br />DEDUCTION FOR STORED MATERIALS USED IN WORK COMPLETED <br />TOTAL, COMPLETED WORK & STORED MATERIALS <br />RETAINED PERCENTAGE <br />5%) <br />TOTAL AMOUNT OF OTHER PAYMENTS OR (DEDUCTIONS) <br />NET AMOUNT DUE TO CONTRACTOR TO DATE <br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES <br />PAY CONTRACTOR AS ESTIMATE NO. 2 <br />DISTRIBUTION: <br />CONTRACTOR (1) <br />OWNER (1) <br />ENGINEER (1) <br />BONDING CO. (1) <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: <br />Douglas -Kerr Underground, L.L.C. <br />P 0 Box 85 <br />Mora, MN 55051 <br />By �. <br />Date <br />/V� <br />$622,062.11 <br />$464,361.98 <br />$o.00 <br />$0.00 <br />$464,361.98 <br />$23,218.10 <br />$0.00 <br />$441,143.88 <br />$262,305.67 <br />$178,838.21 <br />7)1 .x <br />Title <br />CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT: <br />ENGINEER: BOLTOI1 & MENK, INC., 7 3 Sunod Drive NW, Suite 206, Ramsey, MN 55303 <br />, PROJECT ENGINEER <br />Date 10/9/2020 <br />APPROVED FOR PAYMENT: <br />OWNER: CITY OF RAMSEY <br />p-� <br />By <br />And 1::?" <br />A14,4405E ry <br />Name <br />z TEce7F /6/1 ybazo <br />Namefiitle <br />Date <br />