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Pay Estimate Summary Sheet <br />Estimate Number: 1 Partial <br />Project Number: 25-09 <br />Project Name: 2025 Crack Seal Improvements <br />Period Ending May 3, 2025 <br />Contractor: FlowSeal Surface Maitenance, Inc. <br />Address: 19384 Seymour Street NW, Elk River, MN 55330 <br />1 Original Contract Amount $ 154,404.70 <br />202; Change Order(s) No. Thru No. 0 0 <br />3 Total Funds Encumbered $ 154,404.70 <br />4 Value of Work Completed $ 58,650.00 <br />5 Retainage 5 % $ (2,932.50) <br />Percent Complete 38% <br />6 Deductions or Charges <br />7 Total Earned Less Retainage (Lines 4+5+6) $ 55,717.50 <br />8 Previous Payment(s) $ <br />9 Payment Due (Lines 7-8) $ 55,717.50 <br />10 Total Balance to Finish, Including Retainage (Lines 3-7) $ 98,687.20 <br />Certification of Partial 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 contract amount for the period covered by this estimate. <br />r I oi,J <br />Contractor Name Print Name <br />io re v`14C(1 <br />l S(/Ir1 [ r <br />Title Signature <br />u; 5 Icr�ts )c <br />Date <br />City of Ramsey Approval <br />S /131 2_025- <br />Sature (Project Engineer) Date <br />Signature (City Engineer) <br />_((41��Z <br />Date <br />Pay Estimate Page 1 of 2 <br />