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Attachment B <br /> CONTRACTOR'S PAY REQUEST QD <br /> BOOLTONDISTRIBUTION: <br /> 2022 SNELLING AVENUE NORTH STREET& UTILITY & MEN K <br /> IMPROVEMENTS CONTRACTOR(1) <br /> Real People.Real Solutions. OWNER(1) <br /> CITY OF ARDEN HILLS - PW-20-0100 ENGINEER(1) <br /> BMI PROJECT NO. OT1.124965 <br /> TOTAL AMOUNT BID PLUS APPROVED CHANGE ORDERS $1,277,585.49 <br /> TOTAL, COMPLETED WORK TO DATE $1,124,899.45 <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 $1,124,899.45 <br /> RETAINED PERCENTAGE ( 5.0% ) $56,244.97 <br /> TOTAL AMOUNT OF OTHER PAYMENTS OR (DEDUCTIONS) $0.00 <br /> NET AMOUNT DUE TO CONTRACTOR TO DATE $1,068,654.48 <br /> TOTAL AMOUNT PAID ON PREVIOUS ESTIMATES $738,978.16 <br /> PAY CONTRACTOR AS ESTIMATE NO. $329,676.32 <br /> CERTIFICATE FOR PARTIAL PAYMENT <br /> I hereby certify that, to the best of my knowledge and belief, all items quantities and prices of work and material <br /> shown on this Estimate are correct and that all work has been performed in full accordance with the terms and <br /> conditions of the Contract for this project between the Owner and the undersigned Contractor, and as amended by <br /> any authorized changes, and that the foregoing is a true and correct statement of the contract amount for the period <br /> covered by this Estimate. <br /> Contractor: T. A. Schifsky& Sons, Inc. <br /> 2370 E. Hwy 36 <br /> North St. Paul, MN 55109 <br /> By VP of Operations <br /> Name Title <br /> Date August 9, 2022 <br /> CHECKED AND APPROVED AS TO QUANTITIES AND AMOUNT: <br /> ENGINEER: BOLTON & MENK, INC., 12224 NICOLLET AVE, BURNSVILLE, MN 55337 <br /> By CONSULTING ENGINEER <br /> Date 08/09/2022 <br /> APPROVED FOR PAYMENT: <br /> OWNER: <br /> By <br /> Name Title Date <br /> And <br /> Name Title Date <br />