Dept. of Trans. PROGRESS Serial No. Contract No. 12-355-15-27 01-0C2604 PROGRESS PAYMENT VOUCHER %complete: %time: Location: 80% 30% 01-DN-101-17.5 Federal Project: NONE Progress payment No. 04 Payment period ending: 12-19-12 HEMMINGSEN CONTRACTING, INC. P.O. BOX 215 CRESCENT CITY, CA 95531 Escrow No. 00000 Total Estimate This Estimate 1. Contract Itms Without Mobil. 2,625.00 0.00 2.a. Extra Work 242,603.18 27,025.42 b. Adjustment Comp. 3. Materials on Hand 4. Earned Subject to Retention 245,228.18 27,025.42 5. Mobilization 6. Total Work Completed 245,228.18 7. Deductions 0.00 5,000.00 8. a.Contract Retentions b. Unsatisfactory Prog. c. Reduction after 95% Comp. 9. Total pay to Contractor 245,228.18 32,025.42 10. Reduction Amt to Escrow 11. Payment to Escrow 0.00 12. Net Pymt. this Estimate 32,025.42