4.7. SR 02-18-2020 - Laserfiche WebLink

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APPLICATION AND DOCUMENT City of Elk River Elk River Ice Arena & Lion John Weicht Park Facilities 13065 Orono Parkway NW 1000 School Street NW Elk River, MN 55330 Elk River, MN 55330 VIA CONSTRUCTION MANAGER: FROM CONTRACTOR: RJM Construction, LLC High Five Erectors 11, Inc. 30054th Avenue East, P.O. Box 477 VIAARCHITECT: Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document 3703, is attached. 1. ORIGINAL CONTRACT SUM ............................................. $ 435,750.00 2. Net Change by Change Orders ......................................... $ (2,698.15) 3. CONTRACT SUM TO DATE (Line f a 2).................................. $ 433,051.85 4. TOTAL COMPLETED & STORED TO DATE fColumn G on G7o3) .. $ 228,201.00 5. RETAINAGE: a. 5% of Completed Work (Column D « E on G703) $ 11,410.05 b. 0% of Stored Material (Column F on 3703) $ Total Retainage(Lines Sat No or Tool in Column l or G703) $ 11,410.05 6. TOTAL EARNED LESS RETAINAGE.................................. $ 216,790.95 (Une 4less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT ............... $ 204,456.15 (Line a from prior CeNfcale) 8. CURRENT PAYMENT DUE ............................................... $ 12,334.80 9. BALANCE TO FINISH, INCLUDING RETAINAGE ................. (Line 3 less Line 6) $ 216,260.90 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total Changes approved in provkus woofs by Owner $ $ Tofaleppoved Mis Monty 4,190.00 (6,888.15) CO #1 - PR 2 Lease Space CO #2 - Deduct from Allowance TOTALS $ (2,698.15) $ NET CHANGES by Change Orders I $ (2,698.15) PERIOD TO: 01-30-20 CONTRACT DATE: 07-10-19 PROJECT NO: OWNER ❑ CONSTRUCTION MANAGER ❑ ARCHITECT ❑ CONTRACTOR ❑ CONTRACT FOR: Install Steel & Misc. Metals Ll Work covered by this Application for Payment has been completed In accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for wich previous Certificates for Payment were issued and payments received from the Owner, antl at current payment shown herein is now due. CONTRACTOR: BY Date: State of: Minnesota County of: Scott Subscribed an sworn to before KIM A STOCK me this 2b dayof T.nma r ,20� Notary Public - Minnessta Notary Pu I' . My Commission Expires 01131R025 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on -site observations and the data comprising this application, the Construction Manager and Architect certify, to the Owner that to the best of their knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED, AMOUNT CERTIFIED.................................................................$ rA 1`on anafian Aam rM-110ASW,In.( nMe emounf c', IrWIt 0, rguream,s naar�,aenammme can�inuat n s�eemei erernanaednwnanm cam, me amountce,arvl CONSTRUCTION MANAGER: By: ARCHITECT Date: By: Date: This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rightsof the Owner or Contractor under this Contract.