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Estimate Number: <br />Project Number: <br />Project Name: <br />Period Ending <br />Contractor: <br />Address: <br />Pay Estimate Summary Sheet <br />2 Partial <br />22-01 (S.A.P. 199-105-006 & 199-111-003) <br />Sunwood Drive & Waco Street Reconstruction <br />September 30, 2022 <br />Novco, Inc. <br />11090 173rd Avenue, Elk River, 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 />5 Retainage 'i % <br />Percent Complete 107% <br />6 Deductions or Charges <br />7 Total Earned Less Retainage (Lines 4+5+6) <br />8 Previous Payment(s) <br />3 Payment Due (Lines 7-a) <br />10 Total Balance to Finish, Including Retainage (Lines 3-7) <br />$ 560,896, 85 <br />560,896.85 <br />602,558.55 <br />(6,025.59) <br />(6,024.30) <br />590,508.66 <br />352,934.31 <br />237,574.35 <br />6,025.59 <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 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 />dove.A) 1^61(1‘.1(' <br />Contractor Name Print Name <br />Title <br />Signa ure <br />Qll3/ <br />Date <br />City of Ramsey Approval <br />Signature (Project Engineer) 1 Date <br />3 zzL---- <br />(a� <br />4(zz_ <br />Signature (City Engineer) ` Date <br />Pay Estimate Page I of 2 <br />