2016.03.21 CC Packet - Laserfiche WebLink

Home

A WSB &..ft ssociales, 11 CITY OF HUGO 14669 Fitzgerald Avenue North Hugo, MN 55038 Project 01687-58 - HUGO - 129th Street Bridge Improvements Pay Voucher No. 4 Contractor: Pember Companies, Inc. N4449 469th Street Menomonie, WI 54751 Contract Amounts Original Contract Contract Changes Revised Contract Work Certified To Date Base Bid Items Backsheet Change Order Supplemental Agreement Work Order Material On Hand Total Contract No. Vendor No. For Period: 12/1/2015 - 3/14/2016 Warrant # Date Funds Encumbered $616,090.97 Original $29,969.95 Additional $646,060.92 Total $585,402.84 $0.00 $0.00 $0.00 $29,969.95 $0.00 $615,372.79 $616,090.97 N/A $616,090.97 This is to certify that the items of work shown in this certificate of Pay Voucher have been actually furnished for the work comprising the above mentioned projects in accordance with the plans and specifications heretofore approved. Approved By Approved By Pember Companies, Inc. County/City/Project Engineer Contractor Date March 17, 2016 Date City of Hugo Date Page 1 Work Certified This Pay Voucher Work Certified To Date Less Amount Retained Less Previous Payments Amount Paid This Pay Voucher Total Amount Paid To Date 01687-58 $31,311.15 $615,372.79 $30,768.64 $554,858.56 $29,745.59 $584,604.15 Percent Retained: 5% Percent Complete: 95.25% Amount Paid This Pay Voucher $29,745.59 This is to certify that the items of work shown in this certificate of Pay Voucher have been actually furnished for the work comprising the above mentioned projects in accordance with the plans and specifications heretofore approved. Approved By Approved By Pember Companies, Inc. County/City/Project Engineer Contractor Date March 17, 2016 Date City of Hugo Date Page 1