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• <br />• <br />WSB <br />• & Ascoc7G7res, Inc. <br />Owner: City of Lino Lakes <br />600 Town Center Parkway <br />Lino Lakes, MN 55014 -1182 <br />For Period: 8/4/2012 to 9/26/2012 <br />Contractor: Pearson Bros., Inc. <br />11079 Lamont Avenue NE <br />Hanover, MN 55341 -4063 <br />Pay Voucher <br />LINO - 2012 Sealcoat Project <br />Client Contract No.: <br />Project No.: 02029 -20 <br />Client Project No.: <br />Date: 9/26/2012 <br />Request No.: 2 & FINAL <br />Project Summary <br />1 <br />Original Contract Amount <br />$255,999.75 <br />2 <br />Contract Changes - Addition <br />$5,314.60 <br />3 <br />Contract Changes - Deduction <br />$0.00 <br />4 <br />Revised Contract Amount <br />$261,314.35 <br />5 <br />Value Completed to Date <br />$261,314.35 <br />6 <br />Material on Hand <br />$0.00 <br />7 <br />Amount Earned <br />$261,314.35 <br />8 <br />Less Retainage <br />$0.00 <br />9 <br />Subtotal <br />$261,314.35 <br />10 <br />Less Amount Paid Previously <br />$248,248.63 <br />11 <br />Liquidated Damages <br />$0.00 <br />12 <br />AMOUNT DUE THIS PAY VOUCHER NO. 2 & FINAL <br />$13,065.72 <br />1 HEREBY CERTIFY THAT A FINAL EXAMINATION HAS BEEN MADE OF THE ABOVE NOTED CONTRACT, THAT <br />THE CONTRACT HAS BEEN COMPLETED, THAT THE ENTIRE AMOUNT OF WORK SHOWN IN THE FINAL <br />VOUCHER HAS BEEN PERFORMED AND THE TOTAL VALUE OF THE WORK PERFORMED IN ACCORDANCE <br />WITH, AND PURSUANT TO, THE TERMS OF THE CONTRACT IS AS SHOWN IN THIS FINAL VOUCHER. <br />Recommended for Approval by: <br />WSB 8_. ssociates, Inc. <br />roved by Contracto : <br />Pears n Bros., Inc. <br />7 V COLk <br />Specified Contract Completion Date: <br />Comment: <br />Construction Observer: <br />roved by Owner: <br />ity f Lino Lakes <br />Date: <br />Page 1 <br />