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PRe _--CT APPLICATION AND PROJECT,CERT[ <br />AIA DOCUMENT G722/CIvla (Instructions on reverse side) <br /> <br />;ATE FOR PAYMENT <br /> <br />PAGE ()NE OF PAGES <br /> <br />TO O\VNER: City of Elk River <br /> <br /> 13065 Orono Parkway <br /> Elk River, MN <br /> Loft Johnson <br />ATTF. NTION: <br /> <br />PROJ EC'F: <br /> <br />Northbound Liquors <br />19348 Evans Street NW <br />Elk River, MN 55330 <br /> <br />APPLICATION NO.: Distribution to: <br />PERIOD TO: 01 i--I OWNER <br />PItOJECT NOS.: 04/30/97 [] CONSTRUCTION <br /> MANAGER <br /> 3460 <br /> [] ARCttlTECT <br /> <br />PROJECT APPLICATION FOR PAYMENT <br />Applicatioc~ is made for Payment, as shown below, in connection with the f'roject. Project <br />Application Summary, AIA Document G723/Cbda, is attached. <br /> <br />I. TOTAL CONTRACT SUMS (Item A Totals) $ 858,412 <br />2. Total net changes by Change Orders $ 10~150 <br />(hem B 'liotals) 868,562 <br />3. TOTAL CONTRACT SUM TO DATE (Item C 'lbtals)$ <br /> <br />PROJECT CERTIFICATE FOR PAYMENT <br />· In accordance with the Contract Documents, based on on-site observations and tile data <br />comprising this Al)plication, tile Construction Manager and Architect certify to the Owner <br />that to tile best of their knowledge, Jrfformation arid belief the Work has progressed as <br />indicated, the quality of tile \X,brk is it'~ accordance with the Contract Documc,~ts, and <br />tile Cofltractors are entitled to payment of the AMOUNTS CERTIFIF. D. <br /> <br />4. TOTAL COMPLETED & STORED TO DATE s 38,674 <br />(hem F 'li)tals) <br />5. RETAINAGE (heat tl Totals) $ 1,933 <br />6. LESS PREVIOUS TOTAL PAYM~:NTS $ <br />(hem I 'lbtals) <br /> <br />TOTAL OF AMOUNTS CERTIFIED ................ $ <br /> Greystone Construction Company <br /> <br /> i <br />7. CURRENT PAYMENT DUE (hem J Totals) I s 36,741 <br /> <br />Thc undersigned Construction Manager certifies that to the best of tim Construction <br />M:magcr's knowledge, in/bt,nation and bclicf this Project Application for Pay,neat is an <br />accurate compilatioc~ of tile Contractors' Applications for Payment, attached hereto. <br />CONSTRUCTION MANAGER- : ~ Greystone Construction Company <br />By: Date: <br /> <br />36,741 <br /> <br />State of: MN <br />County of: Scott <br />Subscribcd0'Ind sworn to before <br />mc this da5' or May 1997 <br /> Debra K. Quinnell <br /> <br />Notary Public: ~'J/31/2000 <br />My Commission exp~rcs~ <br /> <br />~;,~ ,-- .,,: <br /> <br />This Certificate is not negotiable. Thc AMOUNTS CERTIFIED are payable only to thc <br />Contractors named in A1A Document G723/CMa, attached. Issuance, payment and accep- <br />tance, of payment arc without prejudice to any rights of the Owner or tile Contractors <br />under their Contracts. <br /> <br />AIA DOCUMENT G722/CM~'-* PROJECr APPLICATION AND PROJECT CERTIFICATE FOR PAYMENT * 1092 EDITION" AIAe <br />©1992 · TIlE ASIFRICAN INSTITU'FE OF ARCHITEeFS, 1735 NEW YORK AVENUE, N.W., WA.$111NGTON, D.C. 20006-5292 <br />WARNING: Unlicensed photocopying violates U.S. copydght laws and will sula~ect the violator to legal proaecullon. <br /> <br />G722/CMa-1992 <br /> <br />CONSTRUCTION /vlANAG E .~,~ 5/1/97 <br />By: ' ~&. [. Date: <br /> <br />ARCIIITECT: ~&Associates, Inc. <br />L~y: k.~l~ ',~'s}fi e~resid eat D:,te: ~~~- <br /> <br /> <br />