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Contractor's Application for Payment No. <br />8 <br />To City of Elk River <br />Application 11/2/2017 <br />Application Date: April 11, 2018 <br />(Owner): <br />Period: 4/11/2018 <br />Project: 2017 Street Improvements <br />From (Contractor): <br />Via (Engineer): Hakanson Anderson <br />North Valley, Inc. <br />Application For Payment <br />Change Order Summary <br />Approved Change Orders <br />Number <br />Additions Deductions <br />1 <br />101,722.24 <br />2 <br />83,206.98 <br />TOTALS <br />NET CHANGE BY <br />CHANGE ORDERS <br />$184,929.22 $0.00 <br />$184,929.22 <br />1. ORIGINAL CONTRACT PRICE ................................. $ $3,777,635.22 <br />2. Net change by Change Orders ....................................... $ $184,929.22 <br />3. Current Contract Price (Line 1 f 2) .............................. $ $3,962,564.44 <br />4. TOTAL COMPLETED AND STORED TO DATE $ $4,350,670.81 <br />5. RETAINAGE: <br />a. 1% X Work Completed ........................... $ $43,506.71 <br />b. 0% X Stored Material .............................. $ $0.00 <br />c. Total Retainage (Line 5.a + Line 5.b) ................. $ $43,506.71 <br />6. AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5.c).. $ $4,307,164.10 <br />7. LESS PREVIOUS PAYMENTS .................................... $ $4,125,097.77 <br />8. AMOUNT DUE THIS APPLICATION ........................ $ $182,066.33 <br />Contractor's Certification <br />The undersigned Contractor certifies, to the best of its knowledge, the following: <br />(1) All previous progress payments received from Owner on account of Work done under the <br />Contract have been applied on account to discharge Contractor's legitimate obligations <br />incurred in connection with the Work covered by prior Applications for Payment; <br />(2) Title to all Work, materials and equipment incorporated in said Work, or otherwise listed <br />in or covered by this 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 covered by a bond <br />acceptable to Owner indemnifying Owner against any such Liens, security interest, or <br />encumbrances); and <br />(3) All the Work covered by this Application for Payment is in accordance with the Contract <br />Documents and is not defective. <br />Contractor Signature <br />By: Date: <br />ENGINEER: HAKANSON ANDERSON <br />Certification: We recommend payment for work and quantites shown. <br />(Engineer) (Date) <br />OWNER: CITY OF ELK RIVER <br />(Owner) (Date) <br />