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CONTRACTOR'S PAY REQUEST <br />DISTRIBUTION: <br />EASTERN AREA TRAIL AND MOBILITY IMPROVEMENTS <br />CONTRACTOR (1) <br />CITY OF ELK RIVER <br />OWNER (1) <br />SP 204-090-003; MINN. PROJ. NO. TA 7115 (269) <br />ENGINEER (1) <br />BMI PROJECT NO. N15.108488 <br />BONDING CO. (1) <br />TOTAL AMOUNT BID PLUS APPROVED CHANGE ORDERS <br />$529,645.30 <br />TOTAL, COMPLETED WORK TO DATE <br />$434,139.15 <br />TOTAL, STORED MATERIALS TO DATE <br />$0.00 <br />DEDUCTION FOR STORED MATERIALS USED IN WORK COMPLETED <br />$0.00 <br />TOTAL, COMPLETED WORK & STORED MATERIALS <br />$434,139.15 <br />RETAINED PERCENTAGE ( 5%) <br />$21,706.96 <br />TOTAL AMOUNT OF OTHER PAYMENTS OR (DEDUCTIONS) <br />$0.00 <br />NET AMOUNT DUE TO CONTRACTOR TO DATE <br />$412,432.19 <br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES <br />$207,243.93 <br />PAY CONTRACTOR AS ESTIMATE NO. 2 <br />$205,188.26 <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: U.S. Sitework <br />11 183rd Circle NW, Suite B <br />iver, MN 55330 <br />By �re,o .f to/'7 <br />Name Title <br />Date <br />CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT: <br />ENGINEER: BOLTONIMENK, INC., 7533 SUNWOOD DRIVE, SUITE 206, RAMSEY, MN 55303 <br />By B 1 PROJECT MANAGER <br />, <br />CODY HOLMES, P.E. <br />Date <br />APPROVED FOR PAYMENT: <br />OWNER: CITY OF ELK RIVER, MN <br />By <br />Name Title Date <br />And <br />Name Title Date <br />