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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 />4 Partial <br />26-07 <br />Section 01 Unplatted <br />September 30, 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 1 % <br />Percent Complete 83% <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 />$ 1,189,848.87 <br />$ 1,189,848.87 <br />$ 987,246.62 <br />$ (9,872.47) <br />$ 977,374.15 <br />$ 970,235.62 <br />$ 7,138.53 <br />$ 212,474.72 <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 />b Ct("i7� (.i'tte-t 't' ..: s ( <br />Ea,* —s <br />Contractor Name Print N <br />Title <br />City of Ramsey Approval <br />Sighature Project Engineer) <br />Signature <br />/c4v/z4 <br />Date <br />I0(I'- f Zc zi <br />Date <br />to /(9/2o26 <br />Signature (City Engineer) Date <br />Pay Estimate Page 1 of 3 <br />