Dept. of Trans.             PROGRESS              Serial No.    Contract No.
                                                  21-324-10-13  04-3Q3604
                    PROGRESS PAYMENT VOUCHER      %complete:    %time:
                                                    96%          100%

Location:                                         Federal Project:
04-SM-35-L21.7/L22.8                              NONE

Progress payment No. 005                     Payment period ending: 11-20-21
TEICHERT CONSTRUCTION
3500 AMERICAN RIVER DRIVE
SACRAMENTO CA 95864

Escrow No. 00000
                                           Total Estimate      This Estimate
 1. Contract Itms Without Mobil.               886,903.10           2,450.00
 2. a. Extra Work
    b. Adustment Comp.
 3. Materials on Hand
 4. Earned Subject to Retention                886,903.10           2,450.00
 5. Mobilization
 6. Total Work Completed        886,903.10
 7. Deductions
 8. a. Contract Retentions
    b. Unsatisfactory Retentions
    c. Reduction after 95% Comp.
 9. Total pay to Contractor                    886,903.10           2,450.00
10. Reduction Amt to Escrow
11. Payment to Escrow                 0.00
12. Net Pymt. this Estimate                                         2,450.00