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CONTRACTOR'S PAY REQUEST <br />NW SANITARY ,SEWER AND WATERMAIN EXTENSION <br />CITY OF RAMSEY <br />BMI PROJECT NO.: C12.35976 <br /> <br />TOTAL AM~)-t)NT BID PLUS APPROVED CHANGE ORDERS <br />TOTAL COMPLETED WORK TO DATE <br />TQTAL STORED MATERIALS TQ DATE <br />DEDUCTION FOR STORED MATERIALS USED IN WORK COMPLETED <br />T~OTAL, COMPLETED WORK & sTORED MATERIALS <br />TOTAL RETAINED PERCENTAGE (5%) <br />TOTAL AMOUNT RETAINED ON PREVIOUS ESTIMATES <br />PAY RE'FAINAGE ACOUNT AS ESTIMATE NO. 2 <br />TOTAL AMOUNT OF OTHER PAYMENTS OR (DEDUCTIONS) <br />NET AMOUN'J' DUE TO CONTRACTOR TO DATE <br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES <br />PAY CONTP, ACTOR AS ESTIfClATE NO. <br /> <br /> · Certificate for Pad:iai Payment .. <br /> <br />DISTRIBUTION: <br />CONTP, ACTOR (1) <br />OWNER (1) <br />~NGINE~R (1) <br />8OND~NG CO. (1) <br /> $6,693,820.1 ~- <br /> $919,599.26 <br /> $18,015.33 <br /> $o.o_o <br /> $937,614.5~9 <br /> $46,880.73 <br /> $15,560.03 <br /> $31,320,70 <br /> $0.00 <br /> $890,733.86 <br /> $295,640.48 <br /> $~95,093.38 <br /> <br />I hereby certify that, to the best of my knowledge and belief, all items quantities and prices <br />of work and material shown on this Estimate are correct and that all work has been <br />performed in Fuff accordance with the terms and conditions of the Contract for this project <br />bet!~,een the Owner and the undersigned Contractor, and as amended by any <br />authorized changes, and that the foregoing is a true and correct statement of the <br />contract amount for the period coveFed by this Estimate. <br /> <br />Contractor: LaTour Construction <br /> 1234 Country Road 8 Northwest <br /> Maple lake, MN 55358 <br /> <br /> Name Title <br /> <br /> NByE__R: BOFFO N~&~M E~ E NGINEE RS,~~._. 7333 SUNWOOD, PROJECT ENGINEERDRIVE' RAMSEY, MN. <br /> ~/~F~ t ~-~-/'-' re n r it e, P.E.~/' <br />Date - L <br /> <br />APPROVED FOR PAYMENT: <br />OWNER: City pf Rams.ey?~.~. <br /> <br />./ <br /> <br />Title <br /> <br />And <br /> <br />Name Title Date <br /> <br />-89- <br /> <br /> <br />