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I hereby certify that all items and amounts shown by this pay estimate are <br />correct for the work completed to date. <br />CONTRACTOR: JAY BROS. INC. <br />BY: <br />TITLE: , <br />DATE: <br /> <br /> 3t Peul Regional WaterServlees <br /> BY: <br /> TITLE: <br /> DATE: <br /> <br /> Approved by Owner/Commlasbn <br /> CITY OF FALCON HEIGHTS <br /> BY: <br /> TRLE: <br /> DATE: <br />• <br /> o`~s~aeanoor rwmna PMA~sww ea az <br />GAGE4 <br />q • <br />~, („~C7 <br />~ - ~~-03 <br />Based on the ENGINEER'S on-site Inspections as an experienced and qualified design <br />professbnal and on review of application for payment and the accompanying data and <br />schedules, the ENGINEER has tletermined, to the bast of his knowledge and belief, <br />that Me quantities shown by thb estimate are correct and that, based on such inspections <br />and review, that the work has progressed to the point intl~ated (subject to an evaluatbn <br />of such work as a Tuncdoning Protect upon Substantial Completion, to the results of any <br />subsequent tests required by the Contract Documents, and to any qualffxmtbns stated in <br />his recommendation); and that payment of the amount recommended Is due Contractor(s); <br />but by recommending any payment, the ENGINEER will not thereby be deemed to have <br />reviewed the means, methods, sequences, techniques, or proceedures oT construction <br />or safety precautions or programs incident thereto or that the ENGINEER has made any <br />examination to ascertain how or for what purpose any Contractor has used the monies <br />pakl on account of the Contract Price, or that title to any of the work, materials, or equipment <br />has passed to the Owner free and clear of any leln, claims, security Interests or encumbrances, <br />or that the Contmctor(s) have completed their work exactly In accordance wRh the Contrail <br />Documents. <br />ENGINEER: HOWARD R. GREEN COMPANY <br />BY: ~ / , <br />TITLE: /^"~ ~Li~~ o~w~ <br />DATE: GX I ~Vty o3 <br /> <br />_! ~~ ~~ <br />~a <br />