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Pay Estimate Summary Sheet <br />Estimate Number: 4 Partial <br />Project Number: 25-07 <br />Project Narne: 2025 Neighborhood Pavement Overlay Improvements <br />Period Ending September 30, 2025 <br />Contractor: North Valley, Inc. <br />Address: 20015 Iguana Street NW, Ncwthen, MN 55330 <br />1 Original Contract Amount <br />2 Change Order(s) No. 1 Thru No. 1 <br />3 Total Funds Encumbered <br />4 Value of Work Completed <br />5 Retainage 1 % <br />Percent Complete 107% <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 />$ 1,198,056.75 <br />$ 26,301.62 <br />$ 1,224,358.37 <br />$ 1,314,890.71 <br />$ (13,148.91) <br />$ 1,301,741.80 <br />$ 1,276,386.16 <br />$ 25,355.64 <br />$ 13,148.91 <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 correel 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 />IIrL,Lnf IJntGc 'r- <br />Contractor Name <br />Title <br />City of Ramsey Approval <br />IS' g ature (Project Engineer) <br />M +urt C.•-�- 7 <br />Signature (City Engineer) <br />Print N me <br />Signature <br />Date <br />Date <br />Date <br />Pay Estimate Page 1 of 3 <br />