#08 - Well 2 PFAS WTP Pay Req 4 - Laserfiche WebLink

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PROJECT PAY FORM PARTIAL PAY ESTIMATE NO. PERIOD OF ESTIMATE TO PROJECT OWNER: CONTRACTOR: 1. Original Contract Amount 2. Net Change Order Sum 3. Revised Contract (1+2) 4. Work Completed* 5. Stored Materials* 6. Subtotal (4+5) 7. Retainage* 8. Previous Payments 9. Amount Due (6-7-8) *Detailed Breakdown Attached START DATE: ON SCHEDULE SUBSTANTIAL COMPLETION:X FINAL COMPLETION: ENGINEER'S CERTIFICATION:STANTEC DATE CONTRACTOR'S CERTIFICATION:CONTRACTOR DATE APPROVED BY OWNER:CITY OF LAKE ELMO, MINNESOTA DATE DATE No.Approval Date Amount $1,360,650.00 Additions Deductions $0.00 $1,060,077.72 $0.00 $1,360,650.00 $1,060,077.72 $0.00 $539,246.33 $53,003.895.0% CONTRACT TIME TOTALS $0.00 $0.00 $467,827.50 NET CHANGE $0.00 CONTRACT CHANGE ORDER SUMMARY PAY ESTIMATE SUMMARY 4 5/31/20255/1/2025FROM WELL NO. 2 PFAS WTP PROJECT NO. 2023.115; 173420153 CITY OF LAKE ELMO 3880 LAVERNE AVENUE NORTH LAKE ELMO, MN 55042 ATTN: CHAD ISAKSON, ASSISTANT CITY ENGINEER MAGNEY CONSTRUCTION, INC 1401 PARK ROAD CHANHASSEN, MN 55317 ATTN: PETER NORDANG, PROJECT MANAGER 1/22/2025 7/18/2025 REVISED DAYS REMAINING 177 0 48 5/30/2025 ORIGINAL DAYS BY BY YES NO The 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. ENGINEER BY CITY OF LAKE ELMO PROJECT PAYMENT FORM