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Pay Estimate Summary Sheet <br />Estimate Number: 1 Partial <br />Project Number: 23-09 <br />Project Name: 2023 Pavement Rejuvenation Improvements <br />Period Ending July 31, 2023 <br />Contractor: Corrective Asphalt Materials, LLC <br />Address: 300 Daniel Boone Trail, South Roxana, IL 62087 <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 />Retainage b % <br />Percent Complete 100% <br />93,710.60 <br />$ 93,710.60 <br />$ 109,245.93 <br />$ (5,462.30) <br />6 Deductions or Charges $ <br />7 Total Earned Less Retainage (Lines 4+5+6) $ 103, 783.63 <br />8 Previous Payment(s) $ ,. <br />9 Payment Due (Lines 7-8) 103,783.63 <br />10 Total Balance to Finish, Including Retainage (Lines 3-7) $ .. <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 far 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 />i'VCCetve. '/4, <br />Contractor Name <br />meco1/4.\ (34) r <br />Title <br />:SeW Krill <br />Print Name <br />Signature <br />‘2s <br />Date <br />City of Ramsey Approval <br />Sigryature (Project Engineer) Date <br />�to L2a'Z.� <br />Signature (City Engineer) Date <br />Pay Estimate Page 1 of 2 <br />