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-- APPLICATiON AND CERTIFICATE FOR PAYMENT <br /> <br />Page 1 of 2 <br /> <br />TO (OWNER): City of Elk River - Pat Klaers <br /> <br />CONSTRUCTION <br />MANAGER: <br /> <br />Kraus-Anderson Construction <br />200 Grand Avenue <br />Saint Paul, MN S5102: <br /> <br />SECTION <br /> <br /> CONTRACTOR/SUPPLIER <br /> 1 Inc. <br /> 30mann Brothers, Inc. <br /> Excavatim Inc. <br /> ! 3 Contractors Inc. <br /> ? 4 F, Cook Construction Co. <br /> 1 Weather Proof. <br /> 23 St. Cloud Acoustics, Inc. <br /> 26 Steinbrecher Painting, inc. <br /> 27 Marsden Buildinc Maintenance <br /> Sales Inc. <br /> 31 Haldeman-Homme/Anderson Ladd <br /> 37' Haldeman-Hornme/Anderson [.add <br /> Haldeman-Homme/Anderson Ladd <br />41 Tri-State Fire <br />44 Direct Dk~ital Controls, Inc. <br />45 Collins Electrica[ Construction Co. <br /> Kraus-Anderson <br /> <br />PROJECT: Elk River Public Safety Facility <br /> <br />APPLICATION #: <br /> <br />13 <br /> <br />ARCHITECT: <br /> Tushie Montgomery <br /> <br />PERIOD FROM: <br />PER[OD TO: <br /> <br />8/1/O3 <br />8/31/03 <br /> <br />CONTRACTOR'S PROJECT #7713 <br /> <br />CONTRACT DATE <br /> <br />TOTAL: <br /> <br />PAYMENT DUE <br /> <br />S7,475.O( <br /> 2,375.00 <br />13,Z76.30 <br />1 <br /> 9,566.50 <br /> <br />7,381 <br />8, S13.89 <br /> <br /> 51 <br />1 <br /> 981.11 ARCHITECT'S CERTIFICATE FOR PAYMENT <br /> In accordance with the Contract Documents, based on <br /> 8.00 on-site observations and the data comprising the <br />19,000.00 above situation, the Architect certifies to the Owner <br /> that to the best of the Architect's knowledge, <br /> information and beIief the Work is in accordance with <br /> the Contract Documents, and the Contractors are <br /> entiUed to payment of the AMOUNT INDICATED. <br /> <br />17/By: <br /> <br />Amount Certified <br /> <br />.Date: <br /> <br />Tushie Montgomery And Associates <br /> <br /> <br />