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2020 Goodview Avenue <br />Improvements Project Pay Voucher 1 <br />Page 1 of 4 <br />Client: City of Hugo Contractor:T. A. Schifsky & Sons, Inc. <br />14669 Fitzgerald Avenue North 2370 East Hwy. 36 <br />Hugo, MN 55038 North St. Paul, MN 55109 <br />Contract Amount Funds Encumbered <br />Original Contract $773,545.01 Original $773,545.01 <br />Contract Changes $0.00 Additional N/A <br />Revised Contract $773,545.01 Total $773,545.01 <br />Work Certified To Date <br />Base Bid Items $257,884.01 <br />Contract Changes $ <br />Material On Hand $0.00 <br />Total $257,884.01 <br />Work Certified <br />This Voucher <br />Work Certified To <br />Date <br />Less Amount <br />Retained <br />Less Previous <br />Payments <br />Amount Paid This <br />Voucher <br />Total Amount <br />Paid To Date <br />$257,884.01 $257,884.01 $12,894.20 $0.00 $244,989.81 $244,989.81 <br />Percent: Retained: 5% Percent Complete: 33.34% <br />This is to certify that the items of work shown in this Pay Voucher have been actually furnished for the work comprising the above- <br />mentioned project in accordance with the plans and specifications heretofore approved. <br />Approved By WSB Approved By T. A. Schifsky & Sons, Inc. <br />County/City/Project Engineer Contractor <br />Date Date <br />Approved By City of Hugo <br />Date <br />WSB Project No.: 014873-000 <br />Client Project No.: <br />State Project No.: 224-103-001 <br />Federal Project No.: <br />9/15/202009/16/2020