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Contractor Name <br />Title <br />Contractor Names <br />Pay Estimate Summary Sheet <br />Estimate Number: 2 Partial <br />Project Number: 22-02 <br />Project Name: <br />Period Ending <br />Autumn Heights Street Reconstructions <br />October 31, 2022 <br />Contractor: GMH Asphalt Corporation <br />Address: 9180 Laketown Road, Chaska, MN 55318 <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 5 % <br />Percent Complete 90% <br />6 Deductions or Charges <br />7 Total Earned Less Retainage (Lines 4+5+6) <br />8 Previous Payment(s) <br />9 Payment Due (Lines 7-8) <br />10 Total Balance to Finish, Including Retainage (Lines 3-7) <br />897,894.48 <br />$ 897,894.48 <br />$ 804,459.60 <br />$ (40,222.98) <br />$ 764,236.62 <br />$ 190, 528.15 <br />$ 573,708.47 <br />$ 133,657.86 <br />Certification of Partial Payment <br />l 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 />(�Yl H fFi±cCo noon. <br />Print Name <br />Signature <br />//-f/ <br />Date <br />City of Ramsey Approval <br />Suture (Project Engineer) Date <br />0 <br />Signature (City Engineer) Date <br />Pay Estimate Page 1 of 3 <br />