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CONTRACTOR'S PAY REQUEST DISTRIBUTION: <br />2022 CSAH 19 Watermain CONTRACTOR (1) <br />OWNER (1) <br />CITY OF ORONO, MN ENGINEER (1) <br />BMI PROJECT NO. 0C1.126638 BONDING CO. (1) <br />TOTAL AMOUNT BID PLUS APPROVED CHANGE ORDERS $981,850.46 <br />TOTAL, COMPLETED WORK TO DATE $947,374.37 <br />TOTAL, STORED MATERIALS TO DATE $0.00 <br />DEDUCTION FOR STORED MATERIALS USED IN WORK COMPLETED $0.00 <br />TOTAL, COMPLETED WORK & STORED MATERIALS $947,374.37 <br />RETAINED PERCENTAGE ( 0% ) $0.00 <br />TOTAL AMOUNT OF OTHER PAYMENTS OR (DEDUCTIONS) $0.00 <br />NET AMOUNT DUE TO CONTRACTOR TO DATE $947,374.37 <br />TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES $922,567.36 <br />PAY CONTRACTOR AS ESTIMATE NO.4 & FINAL $24,807.01 <br />Certificate for Partial Payment <br />I hereby certify that, to the best of my knowledge and belief, all items quantities and prices <br /> of work and material shown on this Estimate are correct and that all work has been <br />performed in full accordance with the terms and conditions of the Contract for this project <br />between the Owner and the undersigned Contractor, and as amended by any <br />authorized changes, and that the foregoing is a true and correct statement of the <br />contract amount for the period covered by this Estimate. <br />Contractor: Geislinger & Sons, Inc. <br />511 Central Ave S <br />PO Box 437 <br />Watkins, MN 55389 <br />By <br />Name Title <br />Date <br />CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT: <br />ENGINEER: BOLTON & MENK, INC., 2638 SHADOW LANE, SUITE 200, CHASKA, MN 55318 <br />By , PROJECT ENGINEER <br />Date <br />APPROVED FOR PAYMENT: <br />OWNER: <br />By <br />Name Title <br />And <br />Name Title <br />Project Manager <br />8/9/2023 <br />8/9/2023