4.3. SR 03-15-2021 - Laserfiche WebLink

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To City of Elk River 3065 Orono Parkway Elk River, MN 55330 From Apex Facility Solutions, SBC 403 Jackson St Suite 308 Anoka MN 55303 612-581-0219 CONTRACTORS APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the contract signed 10/19/2020 1. ORIGINAL CONTRACT SUM $ 2,070,067.00 2. NET CHANGE BY CHANGE ORDERS $ 3. CONTRACT SUM TO DATE (1+2) $ 2,070,067.00 4. TOTAL COMPLETE TO DATE (D) $ 1,565,418.59 5. RETAINAGE 5% $ 24,702.96 6. TOTAL EARNED LESS RETAINAGE $ 1,540,715.63 7. LESS PREVIOUS PAYMENTS $ 1,322,611.77 8. CURRENT PAYMENT DUE LL 218,103.86 9. BALANCE TO FINISH, INCLUDING RETAINAGE $ 529,351.37 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Prior months approved change orders Total approved CO's this month Total $ - $ NET CHANGES by Change Order $ Project Guaranteed Energy Savings Agreement Remit payment to Apex Facility Solutions, SBC 403 Jackson St Suite 308 Anoka MN 55303 APPLICATION FOR PAYMENT Invoice No Invoice date Billed through Apex Project number 3 3/9/2021 3/31/2021 30320046 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the 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 which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herin is now due. Contractor: By: Apex Facility Solutions, SBC �17 A Z-&,tz