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v <br />Pay Estimate Summary Sheet <br />Estimate Number: 1 Partial <br />Project Number: 2,3-01 (S.A.P. 199-123-001) <br />Project Name: 161stAvenue Reconstruction <br />Period Ending May 31, 2023 <br />Contractor: Northern Lines Contracting, Inc. <br />m <br />Address: 11039 Lamont Avenue NE, Hanover, MN 55341 <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 />M� <br />Percent Complete 3% <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 />$ 1,2447237.29 <br />MMMMM� - <br />$ <br />1,244,237.29 <br />$ <br />403023.20 <br />$ <br />(21001.16) <br />38,022.04 <br />38pO22.04 <br />11206,215.25 <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 />Northern Lines Contractin <br />on <br />C <br />m <br />or <br />Ctractor Mme <br />IProiect Manaaer <br />Title <br />Print e <br />Sign ;A r e/ <br />Date <br />MMMMMW_.. <br />City of Ramsey Approval <br />6 �Fl�20Z3 <br />Sig ature (Project Engineer) Date <br />RA A�vL, 9 CI ( 3 1 -Le -L3 <br />Signature (City Engineer) Date - <br />Pay Estimate Page 1 of 3 <br />