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Pay Estimate summary Sheet <br />Estimate Number: 4 Final <br />Project Number: 23-07 <br />Project Name: 2023 Neighborhood Pavemet Overlay Improvements <br />Period Ending November 30, 2023 <br />Contractor: North Valley Inc. <br />Address: 20015 Iguana Street NW Suite 100, Nowthen, MN 55330 <br />1 Original Contract Amount <br />$ <br />536,886.89 <br />2 Change Order(s) No. 1 Thru No. 1 <br />$ <br />60,583.56 <br />3 Total Funds Encumbered <br />$ <br />597,470.45 <br />4 Value of Work Completed <br />$ <br />573,503.63 <br />5 Retainage 0 % <br />$ <br />- <br />Percent Complete 100% <br />6 Deductions or Charges <br />$ <br />- <br />7 Total Earned Less Retainage (Lines 4+5+6) <br />$ <br />573,503.63 <br />8 Previous Payment(s) <br />$ <br />567, 768.59 <br />9 Payment Due (Lines 7-8) <br />$ <br />5,735.04 <br />10 Total Balance to Finish, Including Retainage (Lines 3-7) <br />$ <br />- <br />Certificaiton of Final Payment <br />l 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 />North Valley, Inc. <br />Contractor Name <br />President <br />Title <br />City of Ramsey Approval <br />ISignafure (Project Engineer) <br />Signature (City Engineer <br />El <br />Leslie A. Bloom <br />Print Name _ <br />Signature <br />December 5, 2023 <br />Date <br />I?, 11, / Z-'0 Z'3 <br />Date <br />'2, N Z- <br />Date <br />Pay Estimate Page 1 of 2 <br />