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Contractor's Application for Payment <br /> Owner: City of Ramsey Owner's Project No.: 23-19 <br /> Engineer: Bolton&Menk, Inc. Engineer's Project No.:a ORI.130893&OR1.134180 <br /> Contractor., -Douglas-Kerr Underground Agency's Project No.: <br /> Project: The COR Intrastructure Improvements <br /> Contract: <br /> Application No.: 7 Application Date: 11/13/2024 <br /> Application Period: From 10/1/2024 to 10/31/2024 <br /> 1. Original Contract Price $ 2,973,047.22 <br /> 2. Net change by Change Orders $ (6.,447.46) <br /> 3. Current Contract Price(Line 1+Line 23 $ 2.,966,599.76 <br /> 4. Total Work completed and materials stored to date <br /> (Sum of Column G Lump Sum Total and Column J Unit Price Total) 2,,917,307.61 <br /> S. Retainage <br /> a. 1% X $ 2,,917,,307.61 Work Completed $ 29.,173.08 <br /> b. X $ Stored Materials $ <br /> c. Total Retainage(Line 5.a+Line 5.b) $ 29,,173.08 <br /> 6. Amount eligible to date(Line 4-Line 5.c) $ 2,888,134.53 <br /> 7, Less previous payments $ 2,751,986.©6 <br /> 8. Amount due this application $ 136,148,47 <br /> 9. Balance to finish,including retainage(Line 3-Line 4) 49,292.15 <br /> Contractor's Certification <br /> The undersigned Contractor certifies,to the best of its knowledge,the following: <br /> (1)All previous progress payments received from Owner on account of Work done under the Contract have been applied on <br /> account to discharge Contractor's legitimate obligations incurred in connection with the Work covered by prior Applications for <br /> Payment; <br /> (2)Title to all Work,materials and equipment incorporated in said Work,or otherwise listed in or covered by this Application for <br /> Payment,will pass to Owner at time of payment free and clear of all liens,security interests,and encumbrances(except such as <br /> are covered by a bond acceptable to Owner indemnifying Owner against any such liens,security interest,or encumbrances);and <br /> (3)All the Work covered by this Application for Payment is in accordance with the Contract Documents and is not defective. <br /> Contractor: -Douglas-Kerr Underground,ILLC <br /> Signature: Date: <br /> Name: Title: <br /> Recommended by Engineer Approved by Owner <br /> By: By: <br /> Name: Zach Ling[,Pt Name: ILA3� <br /> Title: Project Manager Title: <br /> Date: 11/13/2024 Date: k -4 4-- <br /> EJCDC C-620 Contractor's Application for Payment <br /> (c)2018 National Society of Professional Engineers for EJCDC. All rights reserved. <br />