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APPLICATION AND CERTIFICATE FOR PAYMENT Page1 of 2 <br /> <br />TO (OWNER): City of Elk River - Pat Klaers - PROJECT: Elk River Public City Hall - APPLICATION #: <br /> <br />21 <br /> <br />CONSTRUCTION ARCHITECT <br />MANAGER: Kraus-Anderson Construction Tushie Montgomery <br /> 200 Grand Avenue <br /> Saint, Paul, MN 55102 <br /> <br />SECTION ~CONTRACTOR/SUPP[_IER CURRENT PAYMENT DUE <br /> 3 RHC Construction, Inc. :~;~ ,0o --C::mg~2.00 <br /> 4 Molin Concrete Products Co. 2~027.75 <br /> ~ 8 Western Steel Erection, Inc. 3,9~,~.,~ ° ~ <br /> 9 Regal Contractors Inc. ~.~.~_~ "T3~372.10 <br /> 1 0 George F Cook Construction Co. 591.00 <br /> I 3 Roof Tech, Inc. 1,628.72 <br /> I 5 Carciofini Caulkin9 Company 2,869.00 <br /> ~ 16 Glewwe Doors, Inc. ~ <br /> 20 Ceilings & Floors Inc. 2,683.04 <br /> 21 Spectra/Contract Flooring Services 19~127.26 <br /> 22 Steinbrecher Paintin9, Inc. 5,314.30 <br /> 23 Marsden Building Maintenance LLC 140.58 <br /> 24 Bartley Sales Co, Inc. 1 2,471.00 <br /> 34 Albers Mechanical Services, Inc. 13,393.41 <br /> -, 37 Direct Digital Controls, Inc. ~ <br /> 39 Systems Mgmt & Balancing of MN, Inc. 9,815.40 <br /> Kraus-Anderson Construction Co. 1,748.00 <br /> TOTAL: .4-9t~t~4~5~' <br /> <br />PERIOD FROM: 4/1/04 <br />PERIOD TO: 4/30/04 <br /> <br />CONTRACTOR'S PROJECT #7751 <br />CONTRACT DATE <br /> <br />ARCHITECT'S CERTIFICATE FOR PAYMENT <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 ~--e-i~t, fi ~//~ _~'~_L~__~.~ ~' ~ <br /> <br />" ~shih/~tgomery And Associates <br /> <br /> <br />