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CITY OF HUGO <br />14669 Fitzgerald Avenue North <br />Hugo, MN 55038 <br />Project R-013127-000 - Waters Edge Storm Reuse - Phase 2 <br />Pay Voucher No. 1 <br />Contractor: Peterson Companies, Inc City Project No. NA <br />8326 Wyoming Trail For Period: 10/07/2019 - 11/29/2019 <br />Chisago City, MN 55013 <br />Contract Amountsi <br />Contract Chi <br />Revised Co <br />Work Certified to <br />Base Bid <br />Back <br />Changes <br />Supplemental Agree <br />Work <br />Material on <br />$ 610.000.00 <br />$ 610,000.00 <br />$ 176,644.50 <br />0 <br />0 <br />0 <br />0 <br />0 <br />$ 176,644.50 <br />Work Certified Work Certified Less Amount Less Previous Amount Paid This Total Amount <br />This Pay Voucher to Date Retained Payments Pay Voucher Paid to Date <br />176,644.50 $ 176,644.60 $ 8,832.23 0 $ 167,812.27 $ 167,812.27 <br />Percent retained 5%, <br />i <br />Amount Paid This Pay Voucher $ 167,812.27 <br />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 1 <br />mentioned projects in accordance with the plans and specifications heretofore approved. <br />i <br />Approved By: W/fSB Ap ov By: Peterson Companies, Inc <br />4 - <br />Project Engineer Contractor <br />December 10, 2019 12&1 I� <br />Date Date <br />Approved By: City of Hugo <br />City of Hugo <br />Date <br />K:1013127-OOOV1dmin1Conslrucflon Admin%Pay Vouchers) <br />Page 1 of 2 013127-000 PVf 120519VO 1 Cover <br />