Dept. of Trans. PROGRESS Serial No. Contract No. 10-263-10-20 04-1E4604 PROGRESS PAYMENT VOUCHER %complete: %time: Location: 9% 4% 04-CC-4-R10.3/R13.5 Federal Project: 04-CC-24-R2.3/R8.9 NONE 04-CC-80-2.0/10.7 Progress payment No. 01 Payment period ending: 09-20-10 DEBRUIN CONSTRUCTION INC P O BOX 1355 FRENCH CAMP CA 95321 Escrow No. 00000 Total Estimate This Estimate 1. Contract Itms Without Mobil. 25,470.00 25,470.00 2.a. Extra Work b. Adjustment Comp. 3. Materials on Hand 4. Earned Subject to Retention 25,470.00 25,470.00 5. Mobilization 20,000.00 20,000.00 6. Total Work Completed 45,470.00 7. Deductions 8. a.Contract Retentions b. Unsatisfactory Prog. c. Reduction after 95% Comp. 9. Total pay to Contractor 45,470.00 45,470.00 10. Reduction Amt to Escrow 11. Payment to Escrow 0.00 12. Net Pymt. this Estimate 45,470.00