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<br />TOTAL AMOUNT BID PLUS APPROVED CHANGE ORDERS <br />TOTAL, COMPLETED WORK TO DATE <br />TOTAL, STORED MATERIALS TO DATE <br />DEDUCTION FOR STORED MATERIALS USED IN WORK COMPLETED <br />TOTAL, COMPLETED WORK & STORED MATERIALS <br />RETAINED PERCENTAGI 5% <br />TOTAL AMOUNT OF OTHER PAYMENTS OR DEDUCTIONS <br />NET AMOUNT DUE TO CONTRACTOR TO DATE <br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES <br />PAY CONTRACTOR AS ESTIMATE NO. 1 <br />Certificate for Partial Payment <br />I hereby certify that, to the best of mY,k.nowledgeand'belief, all items quantities and prices <br />of work and material shown on this Estimate are correct and that all work has been <br />performed in full accordance with the terms and conditions of the Contract for this project <br />between the Owner and the undersigned Contractor, and as amended by any <br />authorized changes, and that the foregoing is a true and correct statement of the <br />contract amount for the period covered by this Estimate. <br /> <br />DISTRIBUTION: <br />CONTRACTOR (1) <br />OWNER (1) <br />ENGINEER (1) <br />BONDING CO. (1) <br />$287,496.29 <br />$280,031.66 <br />$0.00 <br />$0.00 <br />$280,031.66 <br />$14,001.58 <br />$0.00 <br />$266,030.08 <br />$0.00 <br />$266,030.08 <br /> <br />CONTRACTOR'S PAY REQUEST <br />BUNKER LAKE BOULEVARD WATERMAIN IMPROVEMENTS - 2006 <br />CITY OF RAMSEY <br />8MI PROJECT NO.: R13.38496 <br /> <br />By <br /> <br /> <br />Northwest Asphalt Inc. <br />1451 Stagecoach Road <br />Shakopee, MN 55379 <br /> <br />Contractor: <br /> <br /> <br />0..... -lYe f{~/ <br />Title <br /> <br />Name <br /> <br />Date I Iii 0 <br /> <br />CHECKED ANt> APPROVED AS TO QUANTITIES AND AMOUNT: <br />ENGINEER: B?}- TON ~/7" ENGINEERS, !533 SUNWOOD DRIVE SUITE 206; RAMSEY, MN. <br /> <br />By II, ./ / ~ , PROJECT ENGINEER . <br />Justi emrite, P <br /> <br /> <br />Date <br /> <br />APPROVED FOR PAYMENT: <br />OWNER: City of Rams <br />~ <br /> <br /> <br /> <br /> <br />By <br /> <br />And <br /> <br />Name <br /> <br />Title <br /> <br />Date <br /> <br />-111- <br />