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Pay Estimate Summary Sheet <br />Estimate Number: <br />Project Number: <br />Project Name: <br />Period Ending <br />Contractor: <br />Address: <br />1 Partial <br />26-06 <br />Riverside West Street Reconstructions <br />October 5, 2026 <br />North Valley, Inc. <br />20015 Iguana Street NW, Nowthen, MN 55330 <br />1 Original Contract Amount <br />2 Change Order(s) No. Thru No. <br />3 Total Funds Encumbered <br />4 Value of Work Completed <br />5 Retainage 5 % <br />Percent Complete 101 <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 />$ 327,246.47 <br />$ 327,246.47 <br />$ 328,984.64 <br />$ (16,449.23) <br />$ 312, 535.41 <br />$ 312,535.41 <br />$ 16,449.23 <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 />Aig nf Irk deo c_ <br />Contractor Name <br />P/1/ <br />Title <br />City of Ramsey Approval <br />Sigp(ature (Project Engineer) <br />Signature (City Engineer) <br />/#rr Ezf!x-s <br />Print Na e <br />Signature <br />D//q/Z.� <br />Date <br />107/11/2-04 <br />Date <br />lo/19/202.6 <br />Date <br />Pay Estimate Page 1 of 3 <br />