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Pay Estimate Summary Sheet <br />Estimate Number: 2 <br />Partial <br />Project Number: 25-09 <br />Project Name: <br />Period Ending <br />Contractor: <br />Address: <br />2025 Crack Seal Improvements <br />May 31, 2025 <br />FlowSeal Surface Maltenance, Inc. <br />19384 Seymour Street NW, Elk River, MN 55330 <br />1 Original Contract Amount <br />202: Change Order(s) No. Thru No. <br />3 Total Funds Encumbered <br />4 Value of Work Completed <br />5 Retainage 5 % <br />Percent Complete 70% <br />$ 154,404.70 <br />0 0 <br />6 Deductions or Charges <br />7 Total Earned Less Retainage (Lines 4+5+6) <br />8 Previous Payment(s) <br />9 Payment Due (Lines 7-8) <br />10 Total Balance to Finish, Including Retainage (Lines 3-7) <br />$ 154,404.70 <br />$ 107,450.00 <br />$ (5,372.50) <br />$ 102, 077.50 <br />$ 55,717.50 <br />$ 46,360.00 <br />$ 52,327.20 <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 />is 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 />e foregoing is a true and correct statement of the contract amount for the period covered by this estimate. <br />Contractor Name rint Name <br />( s_thew( <br />Tile <br />Signatur <br />Date' <br />City of Ramsey Approval <br />Signa a (Project Engineer) <br />Signature (City Engineer) <br />S 130/Zv25 <br />Date <br />Date <br />Pay Estimate Page 1 of 2 <br />