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Estimate Number: <br />Project Number: <br />Project Name: <br />Period Ending <br />Pay Estimate Summary Sheet <br />3 Partial <br />22-06 <br />Wood Pond Hills 2nd - 5th Street Reconstructions <br />October 31, 2022 <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) <br />3 Total Funds Encumbered <br />4 Value of Work Completed <br />5 Retainage 5 % <br />Percent Complete 97% <br />No. Thru No. <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 />568,135.15 <br />$ 568,135.15 <br />$ 551, 652, 62 <br />$ (27,582.63) <br />$ 524,069.99 <br />$ 414,352.17 <br />$ 109,717.82 <br />$ 44, 065,16 <br />Certification of Partial Payment <br />1 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 />NO \,\N\ --.4\( - <br />Contractor Name <br />ot,en+ <br />Leatir <br />Print Name <br />Title Signature <br />i0!\iei(Y\ CI. 3„), <br />K----e\poyy) <br />Date <br />City of Ramsey Approval <br />Signs ure (Project Engineer) Date <br />Signature (City Engineer) _.,.� Date <br />Pay Estimate Page 1 of 2 <br />