Laserfiche WebLink
Pay Estimate Summary Sheet <br />Estimate Number: 1 Partial <br />Project Number: 21-02 <br />Project Name: Tiger Street Reconstruction <br />Period Ending August 31, 2021 <br />Contractor: North Valley, Inc. <br />Address: 20015 Iguana Street NW, Suite 100 Nowthen, MN 55330 <br />1 Original Contract Amount $ 224, 552.19 <br />2 Change Order(s) No. I Thru No. 1 $ 41,039.00 <br />3 Total Funds Encumbered $ 265,591,19 <br />4 Value of Work Completed $ 225,775.30 <br />Value of Work Remaining $ 39,815.89 <br />Percent Complete 85% <br />5 Retainage 5 % $ 11,288.77 <br />6 Previous Payment(s) $ <br />7 Deductions or Charges <br />8 Total Retainage, Payments & Deductions (Lines 5+6+7) $ 11,288.77 <br />Payment Due (Lines 4-8) $ 214,486.53 <br />Certification of Partial Payment <br />I hereby certify that, to the best of my knowledge and belief, all items, quantities and paces 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 />hoCZA \\CApi <br />Contractor Name �) LA,4e Q, <br />Print Name <br />Title Signature <br />-E:""Nral\ I 5 <br />Date <br />City of Ramsey Approval <br />Signature (Project Engineer) <br />Date <br />1 <br />Signature (City Engineer) Date <br />Pay Estimate Page 1 of 2 <br />