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171k-AIADocument G702 —1992
<br />Application and Certificate for Payment
<br />TO OWNER: City of Ok River
<br />13065 Orono Parkway NW
<br />Elk River, MN 55330
<br />FROM `Cerra General Contractors
<br />CONTRACTOR: 21025 Commerce Blvd Ste 1000
<br />Rogers MN 55374
<br />Code: 421-4-2190-4520
<br />PROJECT: 20-700 Elk River Public Safety Building APPLICATION NO: 20-700-009
<br />Expansion and Fire Station No. 3 PERIOD TO: June 30, 2021
<br />CONTRACT FOR: General Construction
<br />VIA BKV Group CONTRACT DATE: October 19, 2020
<br />ARCHITECT: 222 N 2nd St, #101 PROJECT NOS: I20-700 I
<br />Mlnncapolis, MN 55401
<br />CONTRACTOR'S APPLICATION FOR PAYMENT
<br />Application is made for paynicnt, as shown below, in connection with the Contract.
<br />AIA Document G7031, Continuation Sheet, is attached.
<br />1. ORIGINAL CONTRACT SUM ....... ........... ....... ... .......... ................ I ...... ,.................. $6,290,219.00
<br />2. NET CHANGE BY CHANGE ORDERS................................................................. $0.00
<br />3. CONTRACT SUM TO DATE (Line 1 ;k 2) ............................................................ $6,290,219,00
<br />4. TOTAL COMPLETED & STORED TO DATE (Column G on 0703) ................. $4,669,396.69
<br />5. RETAINAGE:
<br />a. 5,00 % of Completed Work
<br />(Column D + E on G703) $233,469.84
<br />b, 0 % of Stored Material
<br />(Column F on G703) $0.00
<br />Total Retainage (Lines 5a + 5b or Total in Column I of 0703) ................. $233,469.84
<br />Distribution to:
<br />OVINER; E
<br />ARCHITECT:
<br />CONTRACTOR
<br />HELD. �]
<br />OTHER: ❑
<br />The undersigned Contractor certifies that to the best of the Contractor's knowledge,
<br />information and belief the Work covered by this Application for Payment has been
<br />completed in accordance with the Contract Documents, that all atno2mts have been paid
<br />by the Contractor for Work for which previous Certificates for Payment were issued and
<br />payments received I the caner, and that current payment shown herein is now duc.
<br />CONTRACTOR: r70 By; Date: -71' 7 !/
<br />Stale of Minneso
<br />County of: Hennepin
<br />Subscribed and swom to before STACEY E. GRl1ETT
<br />�-yyy
<br />T Not Public, State of Minnesota
<br />Inc thisa 0�. , �, �Y
<br />My Commission Expires
<br />- , January 31, 2025
<br />Notary Pu
<br />My Commission expires: January 31, 2025
<br />6. TOTAL EARNED LESS RETAINAGE ................................................................... 54,435,926.85 ARCHITECT'S CERTIFICATE FOR PAYMENT
<br />(Zinc 4 Less Line 5 Total) In accordance with the Contract Documents, based on on -site observations and the data
<br />7. LESS PREVIOUS CERTIFICATES FOR PAYMENT ........................................... $4,150,379.76 comprising this application, the Architect certifies to the Owner that to the best of the
<br />(Line 6 from prior Certificate) .Architect's knowledge, infon-nation and belief the Work has progressed as indicated, the
<br />quality of the Work is in accordance with the Contract Documents, and the Contractor is
<br />S. CURRENT PAYMENT DUE $285,548.091
<br />entitled to payment of the AMOUNT CERTIFIED,
<br />9. BALANCE TO FINISH, INCLUDING RETAINAGE
<br />(Line 3 less Line 6) $1,854,29115
<br />CHANGE ORDER SUMMARY
<br />ADDITIONS
<br />DEDUCTIONS
<br />Total changes approved in previous months by Owner
<br />$0.00
<br />$0.00
<br />Total approved this Month
<br />$0.00
<br />$0.00
<br />TOTALS
<br />$0,00
<br />$0.00
<br />NET CHANGES by Change Order
<br />$0.00
<br />AMOUNT CERTIFIED.....................................................................I......I......... $285,548.09
<br />(Attach explanation ifamount certified differs from the antaunt applied. Initial cell figures on this
<br />Application and on the Continuation Sheet that are changed to conform with the amount certified.)
<br />ARCHITECT-/��
<br />13y: /' vDate
<br />07/07/2021
<br />This Certificate is not negotiable. The AMOUNT CFRTll�IF'.D is payable only to the Contractor
<br />named herein, Issuance, payment and acceptance of payment are without prejudice to any rights of
<br />the Owner or Contractor under this Contract.
<br />AIA Document G702a'-1992. Copyright @ 1953, 1963, 1965, 1971, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. The "American Institute of Architects," "AIA," the AIA Logo,
<br />"G702 " and "AIA Contract Occuments" are registered trademarks and may not be used without permission. This document was produced by AIA software at 1525:57 CT on 07/0612021 under Order No.1547996054
<br />which expires on 04/2412022, is not for resale, is licensed for one -lime use only, and may only be used in accordance with the AIA Contract Documentse Terms of Service. To report copyright violations, e-mail
<br />copyright c@aia.org.
<br />User Notes: [3139ADA57]
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