Laserfiche WebLink
Pay Estimate Summary Sheet <br /> Estimate Number: 5 Final <br /> Project Number: 71-05 <br /> Project Name: 2021 MSA Pavement Overlay Improvements <br /> Period Ending December 31,2021 <br /> Contractor: North Valley, Inc. <br /> Address: 20015 Iguana Street NW, Suite 100, Nowthen, MN 55330 <br /> 1 Original Contract Amount $ 206,395.58 <br /> 2 Change Order(s) No. Thru No. <br /> 3 Total Funds Encumbered $ 206,395.58 <br /> 4 Value of Work Completed $ 175,529.67 <br /> Value of Work Remaining $ <br /> Percent Complete 100% <br /> f <br /> i <br /> 5 Retainage 0 % $ .- <br /> j. <br /> 6 Previous Payment(s) $ 166753.19 s <br /> a <br /> 7 Deductions or Charges <br /> i <br /> 1'. <br /> 8 Total Retainage, Payments & Deductions (Lines 5+6+7) $ 166,753.19 <br /> I <br /> r <br /> I <br /> Payment Due (Lines 4-8) $ 8,776.48 <br /> Certificaiton of Final,Payment s <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 /> Ncrffi Va-EYr IM- IeSI ie A. Blom <br /> Contractor Name Print Name <br /> President <br /> Title Signature <br /> �z <br /> JJwMar r 14, 2022 <br /> bate <br /> } <br /> City of Ramsey Approval <br /> 7 c�Z <br /> Signatbre (Project"Engineer) Date <br /> r <br /> ;f. <br /> Signature (City Engineer) Date <br /> Pay Estimate Page 1 of 2 <br />