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APPLICATION AND CERTIFICATE FOR PAYMENT Page 1 of 2 <br /> <br />TO (OWNER): City of Elk River- Pat Klaers <br /> <br />PROJECT: Elk River Public Safety Facility APPLICATION #: <br /> <br />16 <br /> <br />CONSTRUCTION <br />MANAGER: <br /> <br />Kraus-Anderson Construction <br />200 Grand Avenue <br />Saint Paul, MN 55102 <br /> <br />ARCHITECT: <br /> Tushie Montgomery <br /> <br />PERIOD FROM: <br />PERIOD TO: <br /> <br /> 11/1/O3 <br />11/30/03 <br /> <br />CONTRACTOR'S PROJECT #7713 <br /> <br />CONTRACT DATE <br /> <br />SECTION CONTRACTOR/SUPPLIER CURRENT PAYMENT DUE <br /> lZ Western Steel Erection, Inc. 5,625.00 <br /> 28 Bartley Sales Co. Inc. 5,375.00 <br /> 40 Northern Air Corporation 5,666.04 <br /> 43 Sentra-Sota Sheet Metal, Inc. 20,003.20 <br /> Kraus-Anderson Construction Co. 1,696.00 <br /> TOTAL: 38,365.24 <br /> <br />ARCHITECT'S CERTIFICATE FOR PAYMENT <br /> <br />In accordance with the Contract Documents, based on <br />on-site observations and the data comprising the <br />above situation, the Architect certifies to the Owner <br />that to the best of the Architect's knowledge, <br />information 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 />Amount Certified _-~___~_~_.__~__~_~ <br /> 4 <br /> <br /> TushJe Montgomery And Associates <br /> <br /> <br />