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Pay Estimate Summary Sheet <br />Estimate Number: 1 Partial <br />Project Number: 21-05 <br />Project Name: 2021 MSA Pavement Overlay improvements <br />Period Ending June 30, 2021 <br />Contractor: North Valley, Inc. <br />Address: 200'15 Iguana Street NW, Suite 100, Nowthen, MN 55330 <br />1 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 $ 193,926,49 <br />Percent Complete 6% <br />5 Retainage 5 % <br />6 Previous Payment(s) <br />7 Deductions or Charges <br />$ 206,395,58 <br />$ 206, 395.58 <br />12,469.09 <br />$ 623.45 <br />8 Total Retainage, Payments & Deductions (Lines 5+6+7) $ 623.45 <br />Payment Due (Lines 4-8) <br />$ 11, 845,64 <br />Certification of Partial 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 protect 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 contract amount for the period covered by this estimate. <br />North valley, <br />Brad Sdrrridttsuar <br />Contractor Name Print Name <br />P.c�sic�nt <br />Title igna ure <br />July 9, 2021 <br />Date <br />City of Ramsey Approval <br />Signature (Project Engineer) Date <br />`Signature (City Engineer Date <br />Pay Estimate Page 1 of 2 <br />