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.APPLICATION AND CERTIFICATE FOR PAYMENT <br /> <br />TO (OWNER): City of Elk River o Pat Klaers <br /> <br />PROJECT: Elk <br /> <br />City Hall <br /> <br />CONSTRUCTION ARCHITECT: <br />MANAGER: Kraus-Anderson Construction Tushie <br /> ZOO Grand Avenue <br /> Saint Paul, MN 55102 <br /> <br />SECTION CONTRACTOR/SUPPLIER CURRENT PAYMENT DUE <br /> 1 George F. Cook Construction Co. 6,751.37 <br /> 9 Regal Contractors Inc. 66,500.00 <br /> 10 George F. Cook Construction Co. 2,852.85 <br /> 13 Roof Tech, Inc. 13,121.61 <br /> 15 Carciofini Caulking Company 936.70, <br /> 33 Schindler Elevator Corporation 3,838.00 <br /> 36 Weidner's Plumbing & Heating 41,334.50 <br /> <br /> 37 Direct Digital Controls, Inc. 2,188.00 <br /> 38 Reliance Electric 2_0,795.50 <br /> Kraus-Anderson Construction Co. 32,943.00 <br /> TOTAL: 191,2_61.53 <br /> <br />Page 1 of 2 <br /> <br />APPLICATION #: <br /> <br />PERIOD FROM: <br />PERIOD TO: <br /> <br />CONTRACTOR'S PROJECT #7751 <br />CONTRACT DATE <br /> <br /> accordance with the Contract Documents, based on <br />on-site observations and the data comprising the <br /> ~ove situation, the Architect certifies to the Owner <br />that to the best of the Architect's knowledge, <br />nformation and belief the Work is in accordance with <br />the Contract Documents, and the Contractors are <br />entitled to payment of the AMOUNT iNDICATED. <br /> <br /> 15 <br /> <br />10/1/O3 <br />10/31/03 <br /> <br />ARCHITECT'S CERTIFICATE FOR PAYMENT <br /> <br /> nount Certified <br /> <br /> ~3y: Date:_ <br /> Tushie Montgomery And Associates <br /> <br /> <br />