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Pay Estimate Summary Sheet <br />Estimate Number: 3 Final <br />Project Number: 24-10 <br />Project Name: 2024 MSA Pavement Markings <br />Period Ending November 30, 2024 <br />Contractor: Sir Lines -A -Lot <br />Address: 7175 Cahill Road, Edina, MN 55303 <br />1 Original Contract Amount $ 46,151.95 <br />2 Change Order(s) No. Thru No. <br />3 Total Funds Encumbered $ 46,151.95 <br />4 Value of Work Completed $ 39,264.45 <br />5 Retainage 0 % $ <br />Percent Complete 85% <br />6 Deductions or Charges $ <br />7 Total Earned Less Retainage (Lines 4+5+6) $ 39,264.45 <br />8 Previous Payment(s) $ 35,314.01 <br />9 Payment Due (Lines 7-8) $ 3,950.44 <br />10 Total Balance to Finish, Including Retainage (Lines 3-7) $ 6,887.50 <br />Certificaiton of Final 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 amount for the Final Estimate, the provisions of M.S. 290.92 have been <br />complied with and that all claims against me by reason of the contract have been paid or satisfactorily secured. <br />Sir Lines -A -Lot LLC <br />Gina Goehrin <br />Contractor Name Print Name <br />Project Accountant Lead <br />Title <br />Sature <br />11-26-2024 <br />Date <br />City of Ramsey Approval <br />I I (26/z02.11 <br />Signure (Project Engineer) Date <br />Signature (City Engineer) ' Date <br />Pay Estimate Page 1 of 2 <br />