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APPLICATION AND CERTIFICATION FOR PAYMENT
<br />40 OWNER Cily o£Etk River PROJECT: Elk River Ice Arena
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<br />/ll/t DOCUMENT G702
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<br />APPLICATION NO: 9
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<br />PAGE ONE OF
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<br /> 2 PAGES
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<br />Disuibution to:
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<br />13065 Orono Parkway
<br />Elk River, Mimlesota 55330
<br />
<br />Expansion.
<br />Elk River, Minnesota
<br />
<br />FROM CONTRACTOR: VIA ARCHITECT: RSP Architecls, Ltd.
<br /> M. A. Monenson Compa.y 120 First Avenue North
<br /> 700 Meadow Laqe Norfl~ Minneapolis, MN 55401
<br /> Golden Valley, Minnesota 55422
<br />CONTRACT FOR: Comtruclion Manageme,tt
<br />
<br />PERIOD TO: I/31197
<br />
<br />PROJECT NO: 951019
<br />CONTRACT DATE May, 1996
<br />
<br /> {--'~OWNER
<br />. [--~ ARCI-IITECT
<br /> lCO T CTO
<br />
<br />CONTRACTOR'S APPLICATION FOR PAYMENT
<br />Applicalion is made lb! paymenl, as shov,'n below, iu oom~-ctiou with Ibc Coneracl.
<br />Conlinuali,m Sheet, AIA Documcnl G703, is attached.
<br />
<br />I. ORIGINAL CONTRACT SUM
<br />2. Nel change by Change Orders
<br />3. CON'FPo'~CT SUM TO DATE (Line I · 2)
<br />4. I'OTAL COMPL£TED & STORED TO
<br /> DATE (Column G on G703)
<br />5. REFAINAGE:
<br /> a, ~ % of Completed Work
<br /> (Colunm D + E ou G703)
<br /> b. *,4 Of Stored Material
<br /> (Column F on G703)
<br /> ]',Iai Retainage (Lines ~a v 5b or
<br /> lolal in Column I of GT03}
<br />6. IOTAL EARNED LESS RETAINAGE
<br /> (I,i~Je l Leg Line $ l'oeal)
<br />?. LESS PREVIOUS CERI'IFICATES FOR
<br /> PAYMI:,N[ (Linc 6 £rom prim Certilicol~)
<br />g. CURRENT PAYMENT DUE
<br />
<br />$ 2,288,20~.01!
<br />
<br />$ 164,827.00
<br />
<br />$ 2,4-53,031.00
<br />
<br />$ 2,416,608.00
<br />
<br />50:412.00
<br />
<br />$ 50.412.00
<br />
<br />$ 2,366.196.00
<br />
<br />9. IIAI.ANCE IO FINISil, INCLUDING RETAINAGE $ 86,835.00
<br /> (I.i,J¢) less Line 6)
<br />
<br />$ 2,2]],937.00
<br />
<br />CIiANGEORDER SIJMMARY ADDI'rI~J~S "' D'~DUCTION~,
<br />l'c,tal chan~es approved
<br />in previous mo,~ths by Owner $145,296.00
<br />Total a?p~oved this Month $19,531.00
<br />?'OTALS $164,827.00 $c).00:
<br />C!t3 ,OES by Ci, ,,ge
<br />
<br />Thc undersigned Contraclor oertifies thai lo thc besl of' the Contractor's knowledge,
<br />infornmtiun and belief thc Work covered by this Application fo{ Payment has been
<br />c. ompleled in acco{danee with the Coutracl Document% that all amounts have been paid by
<br />fife Contraclor l't~r Work fo{ which previous Certificates for Payme~t were issued and
<br />payments ~ived fi-om the Oyster, and that eurrenl payment shm~vn herein is now dm:.
<br />
<br />CON TRACTOR:
<br />
<br />M. A. Meaensou Company
<br />
<br />By: Date: Feb~uao' I O, 1997
<br />
<br />Slate oI': Minnesola Courtt)' of: Henncpin
<br />Subscribed and swore to before me this 10th day of Fcbruao', 1997
<br />NoraD, Pub[ic:
<br />'My Conmdsaion expires: Janus./3 l, 2DfRI
<br />
<br />'ARCHITECT'S C ERTIFIC'ATi "'J::OR PAYMENT
<br />In accordance with Iht Conttacl Docu,ucnts, ba. sed on .on-site obs~rvatlmts ~md Ihe data
<br />~omprising thc applicalion, the Ar~hitecl oertifies to the Owner thai (o thc bcsl of the
<br />Architect's knowledge, inlbm~ation and beJ{el'flte Work h~ progressed as indicated,
<br />rite quality of the Work is in aceordance with the Contract Docume~ts, and the Contrac~o~
<br />is en6tled to paymen! of the AMOUNT CERTIFIED.
<br />
<br />AMOUNT CERTIFIED ...........
<br />
<br />(d/tctctt explanathm if amount cer#.fied differ,'Jbom the amount applied, btieial all,figures on this
<br />· 4Fplication a.d ondce Continuation greet thai are clutnged to conform with the amount certified.}
<br /> ARCHITECI':
<br />
<br />By: Date:
<br />
<br />This Ce~iEea~e is not neg~tiable. The AMOUNT CERTIFIED is payable 0~dy to
<br />LJontractor nan)ed here,ri, lssu~, pay~nt ~d acccp~cc el parent ~ w,thout
<br />p~iudi~ to any d~ of the O~n~r or C~trac~r under this ~ni~cl.
<br />
<br />AiA LKX~IJWAEN{ GLO:)' APPLICAIlOfq AND CERnFICA{IOI~ ~:OR PAYM£Nr · Ig~2'EOfTION-/,iA -OIF~92 THe ^MERICAI'4 INSn {IJIE ix= ARCHIIEC'I'$. 1735 NEW ~ORKAVE. N
<br />Users may obtain validation o! this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee,
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