Laserfiche WebLink
<br />. <br /> <br />CONTRACTOR'S PAY REQUEST <br />NW SANITA~Y SEWER AND WATERMAIN EXTENSION <br />CITY OF RAMSEY <br />BMI PROJECT NO.: C12.35976 <br /> <br />DISTRIBUTION: <br />CONTRACTOR (1) <br />OWNER (1) <br />ENGINEER (1) <br />BONDING CO. (1) <br />$6,693,820.17 <br />$3,667,238.04 <br />$18,015.80 <br />$18,015.80 <br />$3,667,238.04 <br />$183,361.90 <br />$123,467.20 <br />$59,894.70 <br />$0.00 <br />$3,483,876.14 <br />$2,345,876.89 <br />$1,137,999.25 <br /> <br />TOTAL AMOUNT BID PLUS APPROVED CHANGE ORDERS <br />TOTAL, COMPLETED"WORK TO DATE <br />TOTAL, STORED MATERIALS TO DATE <br />DEDUCTION FOR STORED MATERIALS USED IN WORK COMPLETED <br />TOTAL, COMPLETED WORK & STORED MATERIALS <br />TOTAL RETAINED PERCENTAGE 5% <br />TOTAL AMOUNT'RETAINED ON PREVIOUS ESTIMATES <br />PAY RETAINAGE ACOUNT AS ESTIMATE NO. 4 <br />TOTAL AMOUNT OF OTHER PAYMENTS OR DEDUCTIONS <br />NET AMOUNT DUE TO CONTRACTOR TO DATE <br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES <br />PAY CONTRACTOR AS ESTIMATE NO. 4 <br /> <br />Certificate for Partial Payment . <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 full accordance with the terms and conditions of the Contract for this project <br />between 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 covered by this Estimate. <br /> <br />.. <br /> <br />Contractor: <br /> <br />LaTour Construction <br />. . .1234 Country Road 8 Northwest <br />Maple lake. MN 55358 ' <br /> <br />By <br /> <br />a <br /> <br /> <br />Name <br /> <br />Title <br /> <br />Date- 12. - 06 <br /> <br />CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT: <br />ENGINEER: BO TON & MENK, ., ENGINEERS, 7333 SUNWOOD DRIVE, RAMSEY, MN. <br /> <br /> <br />, PROJECT ENGINEER <br /> <br />Date 7- f{)-Ob <br /> <br /> <br /> <br />. By pW <br /> Name Title <br /> And <br /> Name Title Date <br /> -197- <br />