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Period To: <br />Contractor's Application For Payment No. 18 <br />412912016 lApplication Date: 412912016 <br />To (Owner): City of Elk River JFrorn (Contractor): Rice lake Construction Group IVia (Engineer): Bolton & Menk, Inc. <br />Contract: All Construction <br />Owner's Contract No.: JContractor's Project No.: 1422 1 <br />Application for Payment <br />Change Order Summary <br />Contractor's Certification <br />The undersigned Contractor certifies that, (1) all previous progi <br />payments received from Owner on account of Work done under <br />Contract have been applied on account to discharge Contracl <br />legitimate obligations incurred in connection with Work covered by r <br />Applications for Payment; (2) title of all Work, materials and equipir <br />incorporated in said Work or otherwise listed in or covered by <br />Application for Payment wilt pass to Owner at time of payment free <br />clear of all Liens, security interests and encumbrances (except such as <br />covered by a Bond acceptable to Owner indemnifying Owner against <br />such Liens, security interest or encumbrances); and (3) ail Work cove <br />by this Application for Payment is in accordance with the Cont <br />Documents and is not defective_ <br />By - <br />Payment of: <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% x $13,663,648.47 Work Completed <br />J. 5% x $0.00 Stored Materials <br />;. Total Retainage (Line 5a + Line 5b) <br />AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5c) <br />LESS PREVIOUS PAYMENTS (Line 6 from prior Application) <br />AMOUNT DUE THIS APPLICATION <br />BALANCE TO FINISH, PLUS RETAINAGE <br />(Column G on Progress Estimate + Line 5 above) <br />$172,047.85 <br />(Line B or othe-rr - attach explanation of other amount) <br />is recommended by: � ' 1 <br />(Engineer) <br />Payment of: <br />is approved by: <br />Approved by: <br />$172,047.85 <br />(Line 8 or other - attach explanation of other amount) <br />(Finance Director) <br />Funding Agency (if applicable) <br />EJCDC Nn. C-620 (2002 Edition) <br />Prepared by the Engineers' Joint Contract Documents Committee and endorsed by the Associated General Contractors of America and the Construction Specifications Institute. <br />$16,525,200.00 <br />$259,991.59 <br />$16,785,191.59 <br />$13,663,648.47 <br />$683,182.42 <br />$0.00 <br />$683,182.42 <br />$12,980,466.05 <br />$12,808,418.20 <br />$172,047.85 <br />$3,804,725.54 <br />May 4, 2016 <br />(Date) <br />(Date) <br />(Date) <br />