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'PROJECT APPLICATION AND PROJECT,CERTIFICATE FOR PAYMENT <br /> AIA DOCUMENT G722/CMa (instructions on reverse side) <br /> <br />PAGE ()NE OF PAGES <br /> <br />TO <br /> OWN E~:lty of Elk River <br /> <br /> 13065 Orono Parkway <br /> <br /> Elk River, MN <br /> Lori Johnson <br />ATTENTION: <br /> <br />PROJECT: <br /> <br />Northbound Liquors <br />19348 Evans Street NW <br />Elk River, MN 55330 <br /> <br />APPLICATION NO.: Distribution to: <br />PERIOD TO: 02 [] OWNER <br />PROJECT NOS.: 05/30/97 [] CONSTRUCTION <br /> 3460 MANAGER <br /> [] ARCHITECT <br /> <br />PROJECT APPLICATION FOR PAYMENT <br />Application is made for Payment, as shown below, in connection with the Project. Project <br />Application Sum,'nary, AIA Document G723/CMa, is attached. <br /> <br />l. TOTAL CONTRACT SUMS (Item A Totals) $ 858,412 <br />2. Total net changes by Change Orders $ 10,150 <br />(hem B Totals) 868,562 <br />3. TOTAL CONTRACT SUM TO DATE (Item C Totals)$ <br /> <br />4, TOTAL COMPLETED & STORED TO DATE $ 121,187 <br />(Item F Totals) <br />5. RETAINAGE (Item H Totals) $ 6,059 <br /> 36,741 <br />6. LESS PREVIOUS TOTAL PAYMENTS <br />(Item I Totals) <br />7. CURRENT PAYMENT DUE (Item J Totals) <br /> <br />The undersigned Construction Manager certifies that to the best of the Construction <br />Manager's knowledge, information and belief this Project Application for Payment is an <br />accurate compilation of the Contractors' Applications for Payment, attached hereto. <br /> Greystone Construction Company <br />CONSTRUCTION MANAGER: <br />  6/3/97 <br />By: ~ Date: <br />State of: MN <br />County of: Scott <br />Subscrib~ and sworn to be, fore <br />mc this day oi~une 1997 <br /> Debra K. Quinnell <br /> 1/31/2000 <br /> Notary Public: <br />My Commissinn expires: <br /> <br />PROJECT CERTIFICATE FOR PAYMENT <br />In accordance with the Contract Documents, based on on-site observations and the data <br />comprising this Application, the Construction Manager and Architect certify to the Owner <br />that to the best of their knowledge, information and belief the Work has progressed as <br />indicated, the quality of the Work is in accordance with the Contract Documents, and <br />the Contractors are entitled to payment of the AMOUNTS CERTIFIED. <br /> <br /> 78,387 <br /> <br />TOTAL OF AMOUNTS CERTIFIED ................ $ <br /> Greystone Construction Company <br /> <br />CONSTRUCTION <br /> MANA~_~ ~ _ <br /> 6/3/97 <br /> <br /> T~tgomery & Associates, Inc. <br />ARCHITECT/ ' <br /> /~'~"~q-u~, President . /e~. q -t~ <br />By: ~ b ~ Date: '~' ~' <br /> <br />This Certificate is not negotiable. The AMOUNTS CERTIFIED are payable only to the <br />Contractors named in AIA Document G723/CMa, attached. Issuance, payment and accep- <br />tance of payment are without prejudice to any rights of the Owner or the Contractors <br />under their Contracts. <br /> <br />AIA DOCUMENT G722/CMa ,, PROJECT APPLICATION AND PROJECT CERTIFICATE FOR PAYMENT · 1992 EDITION * AIA® <br />©1992 * TIlE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006-5292 <br />WARNING: Unlicensed photocopying violates U.S. copyflght law~ ,,nd will subject the vlolato[ to legal prosecution. <br /> <br />G722/CMa-1992 <br /> <br /> <br />