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CONTRACTOR'S R CAPITULATION <br />Well House No. 4 <br />CITY OF Ramsey <br />BMI PROJECT NO.: M21.37017 <br />TOTAL WORK COMPLETED WELL HOUSE NO.4 $57,394.00 <br />TOTAL WORK COMPLETED TO DATE <br />$ , $2 <br />RETAINED PERCENTAGE 5% $28 $0.00 <br />.70 <br />TOTAL AMOUNT OF OTHER PAYMENTS OR DEDUCTIONS $0 <br />NET AMOUNT DUE TO CONTRACTOR TO DATE $54,524.30 <br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES .00 <br />PAY CONTRACTOR PER ESTIMATE NO. 1 $54,52244.30 <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 />Contractor: Rice Lake Construction Group <br />P.O. add, <br />D M <br />ie o MN 56444 <br />B 2 �J`0" pct � �4� y Title <br />Date <br />CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT: <br />ENGINEER: F LTON NK, INC., ENGINEERS, 7533 SUNWOOD DRIVE, SUITE 206 <br />A S <br />By , PROJECT ENGINEER <br />Paul %affert, .E. <br />Date 0 <br />APPROVED FOR PAYMENT: <br />OWNER: City of Ramsey <br />By <br />Name <br />v <br />—77— <br />