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WSB <br />CITY OF HUGO <br />14669 Fitzgerald Avenue North <br />Hugo, MN 55038 <br />Project 01904-871 - 147th Street North Sidewalk Extension <br />Pay Voucher No. 1 <br />Contract No. <br />Vendor No. <br />For Period: 5/10/2017 - 7/28/2017 <br />Warrant # Date <br />Funds Encumbered <br />Original $87,997.80 <br />Additional N/A <br />Total $87,997.80 <br />Work Certified <br />This Pay Voucher <br />Contractor: Arnt Construction Company <br />2190 Phelps Road <br />Amount Paid <br />This Pay Voucher <br />Hugo, MN 55038 <br />01904-47 <br />Contract Amounts <br />$67,079.60 <br />Original Contract <br />$87,997.80 <br />Contract Changes <br />$0.00 <br />Revised Contract <br />$87,997.80 <br />Work Certified To Date <br />Base Bid Items <br />$67,079.60 <br />Backsheet <br />$0.00 <br />Change Order <br />$0.00 <br />Supplemental Agreement <br />$0.00 <br />Work Order <br />$0.00 <br />Material On Hand <br />$0.00 <br />Total <br />$67,079.60 <br />Contract No. <br />Vendor No. <br />For Period: 5/10/2017 - 7/28/2017 <br />Warrant # Date <br />Funds Encumbered <br />Original $87,997.80 <br />Additional N/A <br />Total $87,997.80 <br />This is to certify that the items of work shown in this certificate of Pay Voucher have been actually furnished for <br />the work comprising the above mentioned projects in accordance with the plans and specifications heretofore approved. <br />Approved By Approved By Arnt Construction Company <br />County/City/Project Engineer <br />ust 2, 2017 <br />Date <br />City of Hugo <br />Date <br />Contractor <br />Date <br />Page 1 <br />Work Certified <br />This Pay Voucher <br />Work Certified <br />To Date <br />Less Amount Less Previous <br />Retained Payments <br />Amount Paid <br />This Pay Voucher <br />Total Amount <br />Paid To Date <br />01904-47 <br />$67,079.60 <br />$67,079.60 <br />$3,353.98 $0.00 <br />$63,725.62 <br />$63,725.62 <br />Percent Retained: 5% <br />Percent Complete: 76.2287% <br />Amount Paid This Pay Voucher <br />$63,725.62 <br />This is to certify that the items of work shown in this certificate of Pay Voucher have been actually furnished for <br />the work comprising the above mentioned projects in accordance with the plans and specifications heretofore approved. <br />Approved By Approved By Arnt Construction Company <br />County/City/Project Engineer <br />ust 2, 2017 <br />Date <br />City of Hugo <br />Date <br />Contractor <br />Date <br />Page 1 <br />