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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 PERCENT AG! 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. 3 - Final <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 />REMOVED <br /> <br />DISTRIBUTION: <br />CONTRACTOR (1) <br />OWNER (1) <br />ENGINEER (1) <br />BONDING CO. (1) <br />$287,496.29 <br />$302,680.88 <br />$0.00 <br />$0.00 <br />$302,680.88 <br />$0.00 <br />$0.00 <br />$302,680.88 <br />$275,965.91 <br />$26,714.97 <br /> <br />CONTRACTOR'S PAY REQUEST <br />BUNKER LAKE BOULEVARD WATERMAIN IMPROVEMENTS - 2006 <br />CITY OF RAMSEY <br />BMI PROJECT NO.: R13.38496 <br /> <br />By <br /> <br /> <br />(!Fu. <br />Title <br /> <br />Contractor: <br /> <br />Date <br /> <br />CHECKED AND APR OVED AS TO QUANTITIES AND AMOUNT: <br />ENGINEER: BOLT N & MENK, I~GINEERS, 7533 SUNWOOD DRIVE SUITE 206, RAMSEY, MN. <br />~/ . . <br />.~. <br />. ,. , PROJECT ENGINEER <br /> <br /> <br />Date <br /> <br /> <br />tJ/(,1,1 Ie t <br />Title <br /> <br /> <br />And <br /> <br />Title <br /> <br />Date <br /> <br />Name <br /> <br />-95- <br />