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PROJECT APPLICATION AND PROJECT.CERTIF,,.;ATE FOR PAYMENT <br /> <br />AIA DOCUMENT G722/CMa (Instructions on reverse side) <br /> <br />PAGE ()NE OF PAGE,"; <br /> <br />TO OWNEl~ity of Elk River <br /> <br /> 13065 Orono Parkway <br /> <br /> Elk River, MN <br /> Loft Johnson <br />ATTENTION: <br /> <br />PROJECT: <br /> <br />Northbound Liquors <br /> <br />1934'8 Evans Street NW <br />Elk River, MN 55330 <br /> <br />APPLICATION NO,: Distribution to: <br /> 04 [] OWNER <br />PERIOD TO: <br />PROJECT NOS.: 07/31/97 [] 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 />Applicatior~ Summary, A1A Document G723/CMa, is attached. <br /> <br />1. TOTAL CONTRACT SUMS (Item A Totals) $ 836,211 <br /> <br />2. Total net changes by Change Orders $. 25,633 <br />(Item 13 Totals) 861,844 <br />3. TOTAL CONTRACT SUM TO DATE (Item C Totals) $ <br /> <br />4. TOTAL COMPLETED & STORED TO DATE <br /> (Item F Totals) <br /> <br />5. RETAINAGE (Item H Totals) <br /> <br />6. LESS PREVIOUS TOTAL PAYMENTS <br /> (item I Totals) <br />7. CURRENT PAYMENT DUE (Item J Totals) <br /> <br />468,640 <br /> <br />23,431 <br />286,240 <br /> <br />The undersigned Construction Manager certifies that to the best of the Construction <br />Manager's knowledge, informauon and belief this Project Application for Payment is an <br />accurate compilation of the Contractors' Applications for Payment attached hereto. <br /> <br />CONSTRUCTION MANAGER: ,...T..,, Greystone Construction Company <br />By: Date: <br /> <br />State of: <br /> <br />PROJECT CERTIFICATE FOR PAYMENT <br />In accordance with the Contract Documents, based on on-site observations and tile data <br />comprising this Application, the Construction Manager aqd Architect certify to tile Owner <br />that to the best of their knowledge, informatioP~ 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 />158,969 <br /> <br />TOTAL OF AMOUNTS CERTIFIED ................ $ <br /> (Jreystone Construction Company <br /> <br />CONSTRUCTION MANAG E1T'~ <br /> <br /> Tushie-Montgomery & AsSociates, Inc. <br /> <br />8/1/97 <br /> <br />ARCHITECT: <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 /> <br />uOtyof: Scott _.__::_.::...____::_%._%_:_%_:__:_~_.___~__._~-- tance of payment are without prejudice to any rights of the Owner or the Contractors <br />.t'ascr. ibeld and sworn.to bX)~st 199y~ DEBRA K. OUINNELL i under their Contracts. <br /> <br />file tilts Clay Ot <br /> Debra K. Qui~~:) My CO~I~ISSION EXPIRES J ' <br /> 1/31/2000 ~~ARY 31,'20~ <br />Notary Public: ~ <br /> <br /> A A'DOCUMENT G~NCM~ PROJECT APPLICATIO~AND PROJECT C[~TIFICAT~ FO~AYMENT 199. [DITION A <br /> ., ~ 992 · THE AMERICAN NSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE N.~ WASHINGTON, D.C. 20006-5292 <br /> ~ WARNING; Unllcen~ phot~o~lng vlolate~ U,S, cowflghl Im and will JubJ~t the violator to I~al pmmutlon, ~722/C~-1~g2 <br /> <br /> <br />