Laserfiche WebLink
PROJECT APPLICATION AND PROJECT,CERTIFICATE FOR PAYMENT <br /> <br />DOCUMENT G7221CMa <br /> <br />TO <br /> OWNE,~i~,D. 0fElk River <br /> 13065 Or0no Parkway <br /> E]k River, MN <br /> Loft Johnson <br />ATTENTION: <br /> <br />.Northbound Liquors <br /> 1934'8 Evans Street NW <br />Elk River, MN .55330 <br /> <br />APPLICATION NO.: Distribution (o:. <br />PERIOD TO: 07 C] OWNER <br />PROJECT NOS.: 10/31/97 f'l CONSTRUCTION <br /> MANAGER <br /> 3460 <br /> O ARCHITECT <br /> <br />O <br /> <br />I- <br /> <br />Z <br />O <br />O <br /> <br />bJ <br />Z <br />O <br />I- <br /> <br />>- <br />Ltl <br /> <br />O <br /> <br />O <br />LL <br /> <br />PROJECT APPLICATION FOR PAYMENT <br />AppliCation is made for P~yment, a.~ .$how~ below, in connection with thc Project. ProlccL <br />Application Summary, AIR Doc'umeat G7Z31CMa, ts 2ttached. <br /> <br />I. TOTAL CONTRACT SUMS (Item A Toula) f , 95R:378 <br />2. Total net changes by Change OrdOra l.. $2,117 <br /> (Item n Touts) 1,010,495 <br />3. TOTAL CONTRACT SUM TO DATE (llcm C To(als)l <br /> <br />4. TOTAL COMPLETED & STORED TO DATE <br /> (Item F Tar4.9 <br />5. RETAINAGE (Item H Totals-) <br /> <br />~. LESS PREVIOUS TOTAL PAYMENTS <br /> (hem (Totals) <br />7. CURRENT PAYMENT DUE (l~em J Torah) <br /> <br /> 991'_.511 <br /> <br />J 1,4,,40ff .,, <br />j . 870,307 <br /> <br />I t 106r79S ] <br /> <br />Thc undcrsisned Construction Man,Set certifies that to the best of Ibc Construction <br />Manager's kflow~dge, Informat~n ~nd belief Ih~ Project Appltcatlon for ~ymenl is ~n <br />actuate compilation o( ~he Commc~ors' Appli~tions for ~ymcnl, almched hcre(~ <br />CONSTRUCTION MANAGER~ Om)~lone Cons/mclion ~mp~y <br /> <br />By: ...... ' ~ ~- Dile: <br /> <br />Sma of: <br />County of: Scoff <br /> <br />Post-ir' Fax Note 7671 Date, <br />To /..O~' ~ dO~$O~/ From <br />Fax J Fa ~ <br /> <br />PROJECT CERTIFICATE FOR PAYMENT <br />In accordance with the Contract Documents. based on on.slit obseo,~tion& an,,[ Iht dat~ <br />comprbin8 this ApplicaLion. Ihs Construction M~n'~gcr and ^reAl,cc( cerdf.v tu Iht Owner <br />that to the best of their knowlcdsc, lnform~6on ~nd belief thc Work has progrcs~d ~s <br />indicated, ~he qunllty of the ~brk is In accordznce with thc Comracl Documents. and <br />the Comr3ctors are en6ttcd to pnymcnt of thc AMOUNTS CERTIFIED. <br /> <br />i06,795 <br /> <br />TOTAL OF AMOUNTS CERTIFIED ................ <br /> Greystone Construction Company <br />CONSTRUCTION biAN. _t~la~J~ ] 1/6,~ <br /> <br /> Tushle-Mont~ome~ & ^s~ociates, Inc. <br />~ RCHIT£CT: <br /> <br />Commctom named in AIA D~umcnr G~3/CMa, at~ch~. Issuance. paymcm and acccp- <br />~ncc o~ ~ymcm are wilhom prejudice ID any rishts of thc Owner or <br />under ~hcir Coronets.. <br /> <br />)R PAYM[NT * 15}92 EDITION · AIA~ <br />.N.~.. WASHINGTON, D.C 20(XI6-S,192 <br />~t ~ ~e~at~ ~e I~al p~utl~ <br /> <br />O7221CMa-1992 <br /> <br /> <br />