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EXHIBIT E <br />APPLICATION AND CERTIFICATE <br />FOR PAYMENT <br />Page 1 of 3 <br />SUBMfTTEDTO: RJM Construction, LLC <br />PROJECT: Elk River Ice Arena 6 John Weicht Park Facilities <br />APPLICATION NO: 5 <br />830 Boone Avenue NUM <br />1000 School Street NW <br />APPLICATION DATE: 1117,2020 <br />Golden Valley, MN SM27 <br />Elk River, MN 55330 <br />PERIOD FROM: 1 /1/2020 <br />SUBMITTED FROM: Design Electric, Inc. <br />ARCHITECT: 292 Design Group <br />PERIOD TO: 1/31/2020 <br />4807 Heathenvood Road <br />3533 East Lake Street <br />St. Cloud, MN 56301 <br />Minneapolis, MN 55406 <br />PROJECT NO: <br />CONTRACT DATE: 7/10/2019 <br />CONTRACT FOR: 26 00 00 Electrical <br />CONTRACT NO.: <br />COMMITMENT: <br />I hereby codify that the work Padorned and me material supplied to date, as shown here, <br />represent the actual value of accomplishment under the terms of the contact (and all authorized <br />changes hereto) between the undersigned and RJM Construction relating to the above -referenced <br />Project. I further certify Nat no labor or materials have been supplied under contacts. <br />agreements, verbal or written, or any other arrangement of any type whatsoever,other than the <br />contract duly authorized and executed change orders, and the undersigned does hereby releases <br />RJM Constecton from any claim or liability therefor for the parted covered by this applicati(in. I <br />also comfy that payments, less applicable reten(ma, have been made through the period covered <br />by pmvious payments received from the contractor to 1) all my subcontractors (sub- <br />subcontactors) and 2) for all materiel and labor used in or In connection with the performance of <br />this contract, I fuller party that I have complied with Federal. State, and bcal lax laws, including <br />Social Society laws, Unemployment Compensation Laws and WOMman's Compensation laws <br />insofar as applicable to the performance this contact. <br />PARTIAL WAIVER OF LIEN <br />Now therefore, upon receipt of the payment of the current payment due on this application the <br />undersigned does hereby irrevocably release and waive any and all mechanic's liens or rights to <br />claim any and all mechanic's liens or other liens against the above real estate or any pad thereof <br />for any of me materials and/or labopr therefore furnished or performed in connection with this <br />project, reserving, however, all lien rights for labor and/or materials furnished after said date. <br />ORIGINAL CONTRACT SUM................................................................... <br />1,786,914.00 <br />NET CHANGE BY CHANGE ORDERS TO......... .................................. <br />......-32,807.14 <br />CONTRACT SUM TO DATE.................................................................... <br />1,754,106.86 <br />TOTAL COMPLETED AND STORED TO DATE ........................................... <br />288.992.07 <br />5 % OF COMPLETED WORK 14,449.60 <br />% OF STORED MATERIAL <br />TOTAL EARNED LESS <br />14,449.60 <br />274,542.47 <br />LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER ......................... <br />LESS PREVIOUS CERTIFICATES FOR PAYMENT ..................................... 231,792.47 <br />CURRENT PAYMENT DUE..................................................................... 42,750.00 <br />BALANCE TO FINISH INCLUDING RETAINAGE....... .......... ....... ............ ..... 1,479,564.39 <br />Slate of: MN ter <br />The person signing below, does hereby carry that helshe is fully authorized and empowered to execute this instrument and to bind the undersigned hereto, and does in lect so execute this County of: Benton 4' <br />Instrument. Subsgibed and sworn to before me this <br />17 day of January rag 20 <br />NOTARY PUBLIC: <br />SIGNED: Signed: <br />PRINTED, TITLE amen SChoon, VP My Commission Expires: 1/31/2020 <br />