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4.3 SR 08-15-2022
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4.3 SR 08-15-2022
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8/12/2022 8:34:05 AM
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CONTRACTOR'S PAY RE UEST NO 8 DISTRIBUTION: <br />WINDSOR PARK 3RD ADDITION SEWER EXTENSION CONTRACTOR (1) <br />CITY OF ELK RIVER, MN OWNER (1) <br />BMI PROJECT NO. R19.122405 ENGINEER (1) <br />BONDING C0. (1) <br />TOTAL AMOUNT BID PLUS APPROVED CHANGE ORDERS $1,094,582.00 <br />TOTAL, COMPLETED WORK TO DATE $1,083,063.18 <br />TOTAL, STORED MATERIALS TO DATE $68,164.93 <br />DEDUCTION FOR STORED MATERIALS USED IN WORK COMPLETED $68,164.93 <br />TOTAL, COMPLETED WORK & STORED MATERIALS $1,083,063.18 <br />RETAINED PERCENTAGE ( 1% ) $10,830.63 <br />TOTAL AMOUNT OF OTHER PAYMENTS OR (DEDUCTIONS) $0.00 <br />NET AMOUNT DUE TO CONTRACTOR TO DATE $1,072,232.55 <br />70TAL AMOUNT PAID ON PREVIOUS ESTIMATES $1,027,029.02 <br />PAY CONTRACTOR AS ESTIMATE N0. 8 $45,203.53 <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: G.F.Jedlicki Inc. <br />2471 Galpin Court, Suite 110 <br />Chanhassen, MN 55317 <br />B �� !� ��.��; ��� <br />y r/� <br />Name Title <br />Date �� � � � � <br />CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT: <br />ENGINEER: BOLTON & MENK, INC., 7533 SUNWOOD DRIVE NW #206, RAMSEY, MN 55330. <br />BY �o.-�. , PROJECT MANAGER <br />Date 5/25/2022 <br />APPROVED FOR PAYMENT: <br />OWNER: CITY OF ELK RIVER <br />Chief 8/10/2022 <br />Name Title Date <br />And <br />Name Title Date <br />Code: 406-4-8080-4530 <br />
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