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CONTRACTOR'S PAY REQUEST <br />DISTRIBUTION: <br />NW SANITARY SEWER AND WATERMAIN EXTENSION <br />CITY OF RAMSEY <br />BMI PROJECT NO.: C12.35976 <br />CONTRACTOR (1) <br />OWNER (1) <br />ENGINEER (1) <br />BONDING CO. (1) <br />TOTAL AMOUNT BID PLUS APPROVED CHANGE ORDERS <br />$6,693,820.17 <br />TOTAL, COMPLETED - WORK TO DATE <br />$5,972,484.53 <br />TOTAL, STORED MATERIALS TO DATE <br />$31,302.74 <br />DEDUCTION FOR STORED MATERIALS USED IN WORK COMPLETED <br />$18,015.80 <br />TOTAL, COMPLETED WORK & STORED MATERIALS <br />$5,985,771.47 <br />TOTAL RETAINED PERCENTAGE (5 %) <br />$299,288.57 <br />TOTAL AMOUNT RETAINED ON PREVIOUS ESTIMATES <br />$236,532.51 <br />PAY RETAINAGE ACOUNT AS ESTIMATE NO. 6 <br />$62,756.06 <br />TOTAL AMOUNT OF OTHER PAYMENTS OR (DEDUCTIONS) <br />$0.00 <br />NET AMOUNT DUE TO CONTRACTOR TO DATE <br />$5,686,482.89 <br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES <br />$4,494,117.61 <br />PAY CONTRACTOR AS ESTIMATE NO. 6 <br />$1,192,365.28 <br />I hereby <br />of work <br />performed <br />between <br />authorized <br />contract <br />Certificate for Partial Payment . <br />certify that, to the best of my knowledge and belief, all items quantities and prices <br />and material shown on this Estimate are correct and that all work has been <br />in full accordance with the terms and conditions of the Contract for this project <br />the Owner and the undersigned Contractor, and as amended by any <br />changes, and that the foregoing is a true and correct statement of the <br />amount for the period covered by this Estimate. <br />Contractor: LaTour Construction <br />1234 Country Road 8 Northwest <br />Maple lake, MN 55358 <br />BY �....� Esrtr»l4TC,2 /. <br />Name Title <br />Date <br />CHECKED AND <br />ENGINEER: <br />By <br />APPROVED AS TO QUANTITIES AND AMOUNT: <br />pOLTON & MEN 9NC., ENGINEERS, 7333 SUNWOOD DRIVE, <br />. %� , PROJECT <br />RAMSEY, MN. <br />ENGINEER <br />Justin Femrite, PTE <br />Date �1- )3 <br />APPROVED FOR PAYMENT: <br />OWNER: City of Rams- . y <br />By ,f G - A:& /77/d& <br />Name Ti ate <br />And <br />Name Title Date <br />