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Pay Estimate Summary Sheet <br />Estimate Number: <br />Project Number: <br />Project Name: <br />Period Ending <br />Contractor: <br />1 <br />Partial <br />26-53 <br />2026 Skim Patching <br />January 0, 1900 <br />North Valley, Inc. <br />Address: 20015 Iguana St NW Suite 100, Nowthen, IVN 55330 <br />1 <br />2 <br />3 <br />4 <br />5 <br />Original Contract Amount <br />Change Order(s) No. Thru No. <br />Total Funds Encumbered <br />Value of Work Completed <br />Retainage 5 <br />0/0 <br />Percent Complete 59% <br />$ 243,173.74 <br />0 0 <br />6 Deductions or Charges <br />7 Total Eamed 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 />$ 243,173.74 <br />$ 143,015.92 <br />$ (7,150.80) <br />$ 135,865.12 <br />$ <br />$ 135,865.12 <br />$ 107,308.62 <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 />ontractor Name <br />Cd'Pfic(.r <br />le <br />Tk--,e(tua7 <br />rint <br />gnature <br />Date <br />(61)(-L._ <br />City of Ramsey Approval <br />Signature (Project Engineer) Date <br />Signature (City) Direcfor of Public Works Date <br />Pay Estimate Page 1 of 1 <br />