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PROJECT PAY FORMPARTIAL PAY ESTIMATE NO.PERIOD OF ESTIMATETOPROJECT OWNER: CONTRACTOR:1. Original Contract Amount2. Net Change Order Sum3. Revised Contract (1+2)4. *Work Completed5. *Stored Materials6. Subtotal (4+5)7. Retainage*8. Previous Payments9. Amount Due (6-7-8)*Detailed Breakdown AttachedSTART DATE:ON SCHEDULEMILESTONE 1 (EQ. DELIVERED)MILESTONE 2 (MEDIA INSTALL)SUBSTANTIAL COMPLETION:XFINAL COMPLETION:ENGINEER'S CERTIFICATION:DATECONTRACTOR'S CERTIFICATION:CONTRACTORDATEAPPROVED BY OWNER:CITY OF LAKE ELMO, MINNESOTADATE DATENo.Approval DateAmount$660,970.71Additions Deductions $0.00$433,033.48$660,970.71$433,033.48$0.00$317,688.26$21,651.675.0%CONTRACT TIMETOTALS $0.00 $0.00$93,693.55NET CHANGE $0.00CONTRACT CHANGE ORDER SUMMARY PAY ESTIMATE SUMMARY25/8/202512/18/2024FROMWELL 2 PFAS REMOVAL EQUIPMENTPROJECT NO. 2023.115CITY OF LAKE ELMO3880 LAVERNE AVENUE NORTHLAKE ELMO, MN 55042ATTN: JACK GRIFFIN, CITY ENGINEERAQUEOUS Vets, LLC16761 CLEAR CREEK ROADREDDING, CA 96001ATTN: LINDSIE HABEN, PROJECT/COST ACCOUNTANT11/18/20248/1/2025REVISED DAYS25604/30/2025ORIGINAL DAYS5/16/20255/30/2025REMAINING22BYYESNOThe undersigned Contractor certifies that to the best of their knowledge, information and belief the work covered by this payment estimate has been completed in accordance with the contract documents, that all amounts have been paid by the contractor for work for which previous payment estimates was issued and payments received from the owner, and that current payment shown herein is now due.The undersigned certifies that the work has been reviewed and to the best of their knowledge and belief, the quantities shown in this estimate are correct and the work has been performed in accordance with the contract documents.ENGINEERBYFOCUS Engineering, inc.PROJECT PAYMENT FORM