K-3 - Pay Estimate 3 - Boomerang - Potter Creek Interceptor Project

PARTIAL PAYMENT ESTIMATE NUMBER 3 CONTRACTOR: Boomerang Corp. ADDRESS: 13225 Circle Dr, Suite A, PO Box 227 CITY, STATE, ZIP Anamosa, IA 52205 OWNER: CITY OF TIFFIN PROJECT: Potter Creek Interceptor Sewer Project HFC#21218.244 <table> <tr> <th>Date of Completion:</th> <th>Amount of Contract:</th> <th>Date of Estimate:</th> </tr> <tr> <td>Original: 9/1/2024</td> <td>Original: $1,067,837.60</td> <td>From: 17-Dec-23</td> </tr> <tr> <td>Revised:</td> <td>Revised: $1,073,277.40 (C.O. #1)</td> <td>To: 27-Feb-24</td> </tr> </table> <table> <tr> <th></th> <th>THIS PERIOD</th> <th>TOTAL TO DATE</th> </tr> <tr> <td>Amount Earned</td> <td>$375,848.00</td> <td>$1,110,539.40</td> </tr> <tr> <td>Add Material Stored On-Site</td> <td>$ -</td> <td>$ -</td> </tr> <tr> <td>Subtract Materials Installed On-Site</td> <td>$ -</td> <td>$ -</td> </tr> <tr> <td>Subtotal</td> <td>$375,848.00</td> <td>$1,110,539.40</td> </tr> <tr> <td>Retainage (5%)</td> <td>$18,792.40</td> <td>$55,526.97</td> </tr> <tr> <td>Previous Payments</td> <td></td> <td>$697,956.83</td> </tr> <tr> <td>Amount Due</td> <td>$357,055.60</td> <td>$357,055.60</td> </tr> </table> Estimated % of Job Complete Based on Amount Earned/Contract Amount only 104% This does not constitute work completed to date Is Contractor's Construction Progress on Schedule? YES X NO N/A I hereby certify that I have carefully inspected the work and as a result of my inspection and to the best of my knowledge and belief, the quantities shown in this estimate are correct and have not been shown in previous estimates and the work has been performed in accordance with the contract documents. HART-FREDERICK CONSULTANTS P.C. By: [signature] Title: Project Engineer Date: February 28, 2024 Approved by Owner's Representative: By: ________________________________ Title: ________________________________ (Additional signatures -- if required) By: ________________________________ Title: ________________________________