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Pay Voucher <br />Pagel of 7 <br />CITY OF LINO LAKES <br />600 Town Center Parkway <br />Lino Lakes, MN 55014-1182 <br />Project R-011539-000 - 2018 Mill and Overlay Project <br />Final Pay Voucher No. 5 <br />Contractor: T. A. Schifsky & Sons, Inc. <br />2370 East Hwy. 36 <br />North St. Paul, MN 55109 <br />Contract Amounts <br />Original Contract $412,950.83 <br />Contract Changes $101,851.06 <br />Revised Contract $514,801.89 <br />Work Certified To Date <br />Base Bid Items $382,476A3 <br />Backsheet $0.00 <br />Change Order $110,441.66 <br />Supplemental Agreement $0.00 <br />Work Order $0.00 <br />Material On Hand $0.00 <br />Total $492,918.09 <br />Contract No. <br />Vendor No. <br />For Period: 8/24/201,8-10/3112018 <br />Warrant # Date <br />Funds Encumbered <br />Original $412,950.83 <br />Additional N/A <br />Total 1 $412,950.83 <br />Work Certified <br />Work <br />Less <br />Less <br />Amount Paid <br />Total <br />This Pay <br />Certified <br />Amount <br />Previous <br />This Pay <br />Amount <br />Voucher <br />To Date <br />Retained <br />Payments <br />Voucher <br />Paid To Date <br />R-011639- <br />000 <br />$9,700.77 <br />$492,918.09 <br />$0.00 <br />$469,056.46 <br />$33,861.64 <br />$492,918.09 <br />Percent Retained: 0.0000% <br />Amount Paid This Final <br />Pay Voucher <br />$33,861.64 <br />hereby certify that a Final Examination has been made of the noted Contract, that the Contract has been completed, <br />that the entire amount of Work Shown in this Final Voucher has been performed and the Total Value of the Work <br />Performed <br />in accordance with, and pursuant to, the terms of the Contract is as shown in this Final Voucher. <br />Approved By Approved By T. A. Schifsky & Sons, Inc. <br />Project Engineer c Contractor v <br />k\_ zv%Lc /1-7 - 2018 <br />Date % & Date <br />Approved By <br />City of Lino Lakes <br />Date. <br />