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Contractor's Application for Payment No. <br />2 <br />To (Owner): City of Elk River <br />Application 3/30/2022 to 4/30/2022 <br />Application Date: <br />May 5, 2022 <br />Period: <br />Project: Natures Edge Business Center <br />From (Contractor): <br />Via (Engineer): <br />Hakanson Anderson <br />Third Addition <br />Northwest Asphalt <br />Application For Payment <br />Change Order Summary <br />Approved Change Orders <br />Number <br />Additions <br />Deductions <br />TOTALS <br />NET CHANGE BY <br />CHANGE ORDERS <br />$0.00 <br />$0.00 <br />$0.00 <br />Certification <br />The undersigned Contractor certifies, to the best oft <br />(1) All previous progress payments received fro ton <br />applied on account to discharge Conuactoes I timate <br />prior Applications for Payment; <br />(2) Title to all Work, materials and equip t in orpor <br />Application for Payment, will pass to Ot er c of <br />encumbrances (except such as are cover d /��' <br />Liens, security interest, or encumbron d(3) All the Work covered by this App lion (defective. , / <br />By: <br />1. ORIGINAL CONTRACT PRICE ............ .................... ................. .................. I <br />2. Net change by Change Orders........................................................................... <br />3. Current Contract Price (Line I t 2).................................................................. <br />4. TOTAL COMPLETED AND STORED TO DATE <br />5. RETAINAGE: <br />a. 5 % X Work Completed ............................................. <br />b.0% X Stored Material .............................................. <br />c. Total Retainage (Line 5.a + Line 5.b)................. --............................. <br />6. AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5.c)...............--.................. <br />7. MATERIAL ON HAND (75% of Cost)....................... ................ .................... <br />7. LESS INSTALLED MATERIAL ON HAND........... ....................................... <br />8. LESS PREVIOUS PAYMENTS....................................................................... <br />9. AMOUNT DUE THIS APPLICATION........................................................... <br />nvledge, the following: <br />on account of Work done under the Contract have been <br />)ligationswuired in connection with the Work covered by <br />ise listed in or covered by this <br />I Liens, security interests, and <br />wing Owner against any such <br />Contract Documents and is not <br />91 <br />S S1,967,329.71 <br />$ $0.00 <br />S $1,967,329.71 <br />$ $640,364.64 <br />S <br />S $32,018.23 <br />$ S0.00 <br />S S32,018.23 <br />S $608,346.41 <br />$ S196,333.82 <br />S <br />S $360,645.10 <br />S $444,035.13 <br />ENGINEER: HAKANSON ANDERSON <br />Certification: We recommend payment fx work and quantites shown. <br />w Fi <br />5/10/22 <br />F <br />%�. <br />—� W (Engineer) Date <br />OWNER: CITY OF ELK RIVER � <br />5-10-2022 <br />(Owner) Date <br />Code: 245-4-6210-4530 <br />