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Contract Amounts <br />Original Contract $546,809.69 <br />Contract Changes $149,100.00 <br />Revised Contract $695,909.69 <br />Funds Encumbered <br />Original $546,809.69 <br />Additional N/A <br />Total $546,809.69 <br />Work Certified To Date <br />Base Bid Items $545,348.84 <br />Backsheet $0.00 <br />Change Order $199,753.20 <br />Supplemental Agreement $0.00 <br />Work Order $0.00 <br />Material On Hand $0.00 <br />Total $745,102.04 <br />Amount Paid This Final Pay Voucher $151,221.94 <br />R-012972-000 $119,965.09 $745,102.04 $0.00 $593,880.10 $151,221.94 $745,102.04 <br />Percent Retained: 0.0000% <br />Work Certified <br />This Pay Voucher <br />Work Certified <br />To Date <br />Less Amount <br />Retained <br />Less Previous <br />Payments <br />Amount Paid <br />This Pay Voucher <br />Total Amount <br />Paid To Date <br />I 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 Performed <br />in accordance with, and pursuant to, the terms of the Contract is as shown in this Final Voucher. <br />Approved By <br />Project Engineer <br />Date <br />Approved By North Valley, Inc. <br />Contractor <br />Date <br />CITY OF LINO LAKES <br />600 Town Center Parkway <br />Lino Lakes, MN 55014-1182 <br />Project R-012972-000 - 2019 Mill & Overlay Street Improvements <br />Final Pay Voucher No. 5 <br />Contractor: North Valley, Inc. <br />20015 Iguana Street NW <br />Nowthen, MN 55330 <br />Contract No. <br />Vendor No. <br />For Period: 10/10/2019 - 11/7/2019 <br />Warrant # __________ Date ___________ <br />Page 1 of 8Pay Voucher <br />Approved By <br />City of Lino Lakes <br />Date