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Pay Estimate Summary Sheet <br />Estimate Number: 1 Partial <br />Project Number: 21-03 <br />Project Name: Business Park 95 Street Reconstruction <br />Period Ending July 31, 2021 <br />Contractor: North Valley, Inc. <br />Address: 20015 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 $ 942,685.58 <br />4 Value of Work Completed $ 648,979.76 <br />Value of Work Remaining 293,705.82 <br />$ 942,685.58 <br />Percent Complete 69% <br />5 Retainage 5 % <br />6 Previous Payment(s) <br />7 Deductions or Charges <br />8 Total Retainage, Payments & Deductions (Lines 5+6+7) <br />Payment Due (Lines 4-8) <br />$ 32,448.99 <br />$ 32,448.99 <br />$ 616,530.77 <br />Certification of Partial Payment <br />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 contract amount for the period covered by this estimate. <br />\\.\\ oc2_\k \\sct,0 <br />Contractor Name <br />Title <br />ka\l\)( <br />Print Name <br />Signatu <br />L, <br />Date <br />City of Ramsey Approval <br />Signature (Project Engineer) <br />61617,02_t <br />Date <br />S gnature (City rigineer) -.-) Date <br />Pay Estimate Page 1 of 4 <br />