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<br /> .- <br />. --------------------------------------------------------------------------------- <br /> --------------------------------------------------------------------------------- <br /> I hereby certify that all items and amounts shown by this pay estimate are <br /> correct for the work completed to date. <br /> CONTRACTOR: ", ''''&;:''/5'~ <br /> TITLE: ---V, f---(i-~-Sl. <br /> ------------------------------------ <br /> DATE: ,-2.7-8.2- <br /> ----------- ----- <br /> --------------------------------------------------------------------------------- <br /> --------------------------------------------------------------------------------- <br /> Based on the ENGINEER'S on-site inspections as an experienced and qualified <br /> design professional and on review of application for payment and the accompanying <br /> data and schedules, the ENGINEER has determined, to the best of his <br /> ~~owledge and belief, that the quantities shown by this estimate are correct <br /> and that, based on such inspections and review, that the work has progressed <br /> to the point indicated (subject to an evaluation of such work as a <br /> functioning Project upon Substantial Completion, to the results of any <br />. subsequent tests required by the Contract Documents, and to any qualifications <br /> stated in his recommendation), and that payment of the amount recommended is <br /> is due Contractor(s); but by recommending any payment, the ENGINEER will <br /> not thereby be deemed to have reviewed the means, methods, sequences, <br /> techniques, or proceedures of construction or safety precautions or programs incident <br /> incident thereto or that the ENGINEER has made any examination to ascertain <br /> how or for what purpose any Contractor has used the monies paid on account <br /> of the Contract Price, or that title to any of the work, materials, or <br /> equipment has passed to the Owner free and clear of any lein, claims, <br /> security interests or encumbrances, or that the Contractor(s) have completed <br /> their work exactly in accordance with the Contract Documents. <br /> ENGINEER: ", :::i~:l::d.:-- <br /> TITLE: ____ _~~~c~__~~~_______ <br /> DATE: f1-2/-1.;2... <br /> ------ ---------- <br /> --------------------------------------------------------------------------------- <br /> --------------------------------------------------------------------------------- <br /> Approved by Owner/Commission <br /> CITY OF ARDEN HILLS BY: <br /> ------------------------------------ <br /> TITLE: <br />. ------------------------------------ <br /> DATE: <br /> ------------------ <br /> ~~~~~~~~~=~====================================================================== <br />