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Contractor's Application For Payment No. 2 <br />Period To: 12130/2014 Applicat €on Date: 12/30/2014 <br />To (Owner): City of Elk River From (Contractor): Rice Lake Construction Group Via (Engineer): Bolton 8, Menk, Inc. <br />Project: Wastewater Treatment Facility Improvements 2014 Contract: All Construction <br />Owner's Contract No.: r..nntrnretnr'c Pinion Nn - 1A" <br />Application for Payment <br />Change Order Summary <br />Contractor's Certification <br />ORIGINAL CONTRACT PRICE <br />Net change by Change Orders <br />CURRENT CONTRACT PRICE (Line 1 t 2) <br />TOTAL COMPLETED AND STORED TO DATE <br />(Column F on Progress Estimate) <br />RETAINAGE: <br />1. 5 %a x $1,564,271.60 Work Completed <br />3. 5 % x $303,875.00 Stored Materials <br />Total Retalnage (Line 5a + Line 6b) <br />AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5c) <br />LESS PREVIOUS PAYMENTS (Line 6 from prlor Application) <br />AMOUNT DUE THIS APPLICATION <br />BALANCE TO FINISH, PLUS RETAINAGE <br />(Column G on Progress Estimate + Line 5 above) <br />The undersigned Contractor certifies that: (1) all previous progress <br />Payment of <br />payments received from Owner an account of Work done under the <br />Contract have been applied on account to discharge Contractoras <br />legitimate obligations Incurred in connection with Work covered by prior <br />Applications for Payment; (2) title of all Work, materials and equipment <br />is recommended by: <br />incorporated in said Work or otherwise listed in or covered by this <br />Application for Payment will pass to Owner at time of payment free and <br />clear of all Liens, security interests and encumbrances (except such as are <br />covered by a Bond acceptable to Owner indemnifying Owner against any <br />such Liens, security interest or encumbrances); and (3) all Work covered <br />Payment of: <br />by this Application for Payment is in accordance with the Contract <br />Documents and is not defective. <br />is approved by: <br />Approved by: <br />$16,525,200.00 <br />$0.00 <br />$16,525,200.00 <br />$1,888,146.60 <br />$79,213.58 <br />$15,193.75 <br />$94,407.33 <br />$1,793,739.27 <br />$1,231,295.04 <br />$562,444.23 <br />$14,731,460.73 <br />$562,444.23 <br />(Line 8 or other - att ch explanation of other amount) <br />';0A. Jan. 5, 2015 <br />(Engineer) (Date) <br />$562,444.23 <br />(Line 8 or other - attach explanation of other amount) <br />(Finance Director) <br />(Date) <br />Funding Agency (if applicable) (Date) <br />EJCDC Na. C -620 (2002 Edition) <br />Prepared by the En inmrs' Joint Cantroct Documents Committee and eadarmil by the Assaciwed General Contractors of America and the Construction Specifiradans Institute. <br />