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Estimate Number: 3 <br />Pay Estimate Summary Sheet <br />Final <br />Project Number: 25-09 <br />Project Name: <br />Period Ending <br />Contractor: <br />Address: <br />2025 Crack Seal Improvements <br />June 30, 2025 <br />FlowSeal Surface Maitenance, Inc. <br />19384 Seymour Street NW, Elk River, MN 55330 <br />1 Original Contract Amount $ 154,404.70 <br />202E Change Order(s) <br />3 Total Funds Encumbered <br />4 Value of Work Completed <br />No. Thru No. 0 <br />0 <br />$ 154,404.70 <br />$ 111,187.50 <br />5 Retainage 0 % $ <br />Percent Complete 100% <br />6 Deductions or Charges $ 7,213.53 <br />7 Total Earned Less Retainage (Lines 4+5+6) $ 118,401.03 <br />8 Previous Payment(s) $ 102,077.50 <br />9 Payment Due (Lines 7-8) $ 16,323.53 <br />10 Total Balance to Finish, Including Retainage (Lines 3-7) $ <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 />kto-ca/ r-fi-Tec-e 4a4a,41e <br />Contractor Name <br />of <br />Title <br />Print Name <br />L <br />%'!i <br />I/ P <br />Signatu, <br />Date <br />City of Ramsey Approval <br />„</e <br />Sig r ature (Project Engineer) <br />Signature (City Engineer <br />/�('Zo2S <br />Date <br />7 /l 4- (zo <br />Date <br />:m <br />Pay Estimate Page 1 of 2 <br />