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<br />CONTRACTOR'S PAY REQUEST <br />NW SANITARY SEWER AND WATERMAIN EXTENSION <br />CITY OF RAMSEY <br />BMI PROJECT NO.: C12.35976 <br /> <br />DISTRIBUTION: <br />CONTRACTOR (1) <br />OWNER (1) <br />ENGINEER (1) <br />BONDING CO. (1) <br />$6,693,820.17 <br />$6,369,149.27 <br />$31,302.74 <br />$31,302.74 <br />$6,369,149.27 <br />$318,457.46 <br />$316,750.73 <br />$1,706.73 <br />$0.00 <br />$6,050,691.81 <br />$6,018,263.87 <br />$32,427.94 <br /> <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 />TOTAL RETAINED PERCENTAGE 5% <br />TOTAL AMOUNT RETAINED ON PREVIOUS ESTIMATES <br />PAY RETAINAGE ACOUNT AS ESTIMATE NO. 11 <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. 11 <br />Certificate for Partial Payment <br />I hereby certify that, to the best of my knowledge and 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 />By <br /> <br />LaTour Construction <br />1234 Country Road 8 Northwest <br />Maple lake, MN 55358 <br /> <br />~ <br /> <br />Contractor: <br /> <br /> <br />Name <br /> <br />bST.:&mA roe /;O/Y1 <br />Title <br /> <br />Date ,. / (J . 0 7 <br /> <br />CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT: <br />ENGINEER: B L TO NGINEERS, 7533 SUNWOOD DRIVE, RAMSEY, MN. <br /> <br />By <br />Just" <br /> <br /> <br />, PROJECT ENGINEER <br /> <br />Date 7- 7- 0 7 <br /> <br /> <br /> <br />And <br /> <br />Name <br /> <br />Title <br /> <br />Date <br /> <br />-92- <br />