Laserfiche WebLink
Date: <br />Approved for Payment: <br />T.A. Schifsky & Sons, Inc.Signature Date <br />2370 East Hwy 36 <br />North St. Paul, MN 55109 <br />Name and Title <br />Checked and Approved as to <br />Quantities and Amount:Signature Date <br />Bolton & Menk, Inc. <br />2035 County Road D East <br />Maplewood, MN 55109 Name and Title <br />Approved for Payment: <br />City of Little Canada <br />Name Date <br />7/30/2021 <br />CONTRACTOR'S PAY REQUEST Pay Request No. 2 <br />2021 Street Improvements <br />City of Little Canada, MN For Period Ending:7/29/2021 <br />Revised Contract Amount $593,729.91 <br />Completed Work to Date $420,755.32 <br />BMI Project No. 0N1.122720 <br />Original Contract Amount $593,729.91 <br />Approved Change Orders $0.00 <br />Deduction $0.00 <br />Stored Materials on Hand $0.00 <br />Sub-Total $420,755.32 <br />Retained Percentage 5%($21,037.77) <br />Liquidated Damages $0.00 <br />Total $399,717.55 <br />Total Amount Paid on Previous Estimates $237,882.30 <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 />Title <br />Amount Due Contractor This Pay Request $161,835.25 <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 />DocuSign Envelope ID: 0A42E05B-14D3-41D4-9A93-B085E9254C6F <br />Jonathan Hager <br />July 31, 2021 <br />VP <br />Eric Seaburg <br />August 1, 2021 <br />PM <br />Public Works Director August 2, 2021Bill Dircks