Laserfiche WebLink
PROJECT PAY FORM <br />PARTIAL PAY ESTIMATE NO. <br />PERIOD OF ESTIMATE <br />TO <br />PROJECT OWNER: <br />1. Original Contract Amount <br />2. Net Change Order Sum <br />3. Revised Contract (1+2) <br />4. *Work Completed <br />5. *Stored Materials <br />6. Subtotal (4+5) <br />7. Retainage* <br />8. Previous Payments <br />9. Amount Due (6-7-8) <br />*Detailed Breakdown Attached <br />START DATE:ON SCHEDULE <br />SUBSTANTIAL COMPLETION: <br />FINAL COMPLETION: <br />ENGINEER'S CERTIFICATION:FOCUS Engineering, inc. <br />DATE <br />CONTRACTOR'S CERTIFICATION:CONTRACTOR <br />DATE <br />APPROVED BY OWNER:CITY OF LAKE ELMO, MINNESOTA <br />DATE DATE <br />BY <br />BY <br />YES <br />NO <br />The undersigned Contractor certifies that to the best of their <br />knowledge, information and belief the work covered by this payment <br />estimate has been completed in accordance with the contract <br />documents, that all amounts have been paid by the contractor for <br />work for which previous payment estimates was issued and <br />payments received from the owner, and that current payment shown <br />herein is now due. <br />The undersigned certifies that the work has been reviewed and to the <br />best of their knowledge and belief, the quantities shown in this <br />estimate are correct and the work has been performed in accordance <br />with the contract documents. <br />ENGINEER <br />BY <br />7/5/2022 <br />11/24/2022 <br />REVISED DAYS <br />REMAINING <br />142 <br />0 <br />0 <br />10/14/2022 <br />ORIGINAL DAYS <br />CONTRACT CHANGE ORDER SUMMARY PAY ESTIMATE SUMMARY <br />6 <br />1/31/202312/1/2022FROM <br />PARKVIEW-CARDINAL NBRHD STREET & UTILITY IMPROVEMENTS <br />PROJECT NO. 2020.121 <br />CITY OF LAKE ELMO <br />3800 LAVERNE AVENUE NORTH <br />LAKE ELMO, MN 55042 <br />ATTN: JACK GRIFFIN, CITY ENGINEER <br />CONTRACTOR: <br />T.A. SCHIFSKY & SONS, INC. <br />2370 HIGHWAY 36 EAST <br />NORTH ST. PAUL, MN 55109 <br />ATTN: JONATHAN HAGER <br />CONTRACT TIME <br />TOTALS $42,082.61 $0.00 $47,359.46 <br />NET CHANGE $42,082.61 <br />$132,081.365.0% <br />$2,462,186.41 <br />$49,852.07 <br />$2,641,627.23 <br />1 8/12/2022 $29,630.61 $3,351,605.81 <br />2 9/20/2022 $12,452.00 $2,591,775.17 <br />No.Approval <br />Date <br />Amount $3,309,523.20 <br />Additions Deductions $42,082.61 <br />FOCUS Engineering, inc.PROJECT PAYMENT FORM <br />1-31-23 <br />1/31/23