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I hereby certify that all items antl amounts shown by this pay estimate are correct for the work completed to date. • CONTRACTOR: JAY BROS. INC. BY: TITLE: DATE: Based on the ENGINEER'S on-site inspections as an experienced and qualified design professional and on review of application for payment and the accompanying data and .schedules, the ENGINEER has determined, to the best of his knowledge and belief, that the quantitles shown by this estimate are correct and that, based on such inspections and review, that the work has progressed to the point indicated (subject to an evaluation of such work as a functioning Project upon Substantial Completion, to the results of any subsequent tests required by the Contract Documents, and to any qualifications stated in his recommendation), and that payment of the amount recommended is due Contractor(s); but by recommending any payment, the ENGINEER will not thereby be deemed to have reviewed the means, methotls, sequences, techniques, or proceetlures of construction or safety precautions or programs incident thereto or that the ENGINEER has made any examination to ascertain how or for what purpose any Contractor has usetl the monies paid on account of the Contract Price. or that title to any of the work, materials, or equipment has passed to the Owner tree and clear of any lein, olaims, security interests or encumbrances, or that the Contractor(s) have completed their work exactly in accordance with the Contract Documents. ENGINEER:HOWARD R. GREEN COMPANY '/,~/{y~ 1 TITLE: /"~~2~'_~i_vv «~'r'at'a'i. DATE: ~ /~ ~~ ~ SL Paul Regional Water Services BY: TITLE: DATE: Approved by Owner/Commission CITY OF FALCON HEIGHTS BY: TITLE: DATE: • O:\Praj182D9B61\0!)71 \Parllal Paymenfi\Pay 6t M.As f ,l ~ ` /~ ~~ /~ r PA6EE ~'!