Laserfiche WebLink
<br />Dale <br /> <br />rOJec anager <br />ARC ERTIFICATE FOR PAYMENT <br /> <br />In .)( ('(Jr<l~lflCe \vil h 1 he Coni rilCI Docunlcnts, btlScd on on.sitc observations and I he <br /><I.lld c()nlIHi~jng the above applicJtion, the Architect certifies 10 Ihe Owner thai to the <br />l)(I~.d 011 he Ar<.hdccl's kn()\vledge, in IOrnlJtion and belief the Work has pr()gres~cd as <br />illcfil tlll'd, tht! qUJJily of the \Vor~ i~ in JccordJncc with the Conlracl [)u<.unll'nls. Jnd <br />I Ill' Coni r Jclor i~ l'oritJl"u to (lJrlncnl o( the Afv10UNT Cl ~TI f IL I). <br /> <br />^I'" DOC; <br />lilt ^~\ll<\\ <br /> <br />\N <br /> <br />(;70'1 · API'IICA11C IN ^ND Cl KI <br />I r-~ 'd IIll Il (H ^ ~ ( III' (( 1 '), I 7 <br /> <br />f1CAfl IOJ( PAYt\U N r · ",,^v <br />r~ Nt \V YC H<I\ ^Vl NUl, N Vv. <br /> <br />III II llllON · AlA' · <br />\VA~,IIINC ION. D.C <br /> <br />. I <br />1000h <br /> <br />By:.< ] <br />T 11 i ~..c) r l i I i <br />CCJnlriH.lor <br />prejudice <br /> <br /> <br />),He <br />C JI C is not ncgol i,lhlc. Thl.' At-.. \() UN Tel J.: fI r t l 0 i~ p..l}',lhl e <br />named herein. 1~~lJJn(ef P,lyoll'nt ,lnd L}eTl'pl,lnct' of p,lynll'nt ,1 <br />o any rights of Ihe {)\vner or Contractor under this (:0 (I. <br /> <br />c: 'in" <br /> <br />)Illy to Ihl' <br />e \\'ilhoul <br /> <br />5//3/13- <br /> <br />\y <br /> <br /> <br />May <br /> <br />2 <br /> <br />993 <br /> <br />A^'-10UNT CERTlfIEO... . <br />(I\ttach explanatio1l jf anHHlIl <br />AI{Cl-flT[ CT <br /> <br />Stale 0 .Mlnnesota <br />Subscribed and sworr <br />Notary Public: <br />My COfllnlission cxpir <br /> <br />'1- <br /> <br />... .. ... .. till .. . .. .. <br /> <br /> <br />(crt i fled eli {h.'r~ <br /> <br />.2S~-=D <br /> <br />c< <br /> <br />~ <br /> <br />I he lIndt'r~igned Conlractor certifies th..lt to the best or the Contractor's knovvledgc, <br />I\lo"n,llion and belief the \\'ork covered by this Applicillion for P,lynlcnt hJS been <br />(On\pll'll'd in ,1ccordancc \vilh the Contract Oocunlcnts, that all,HnoLJnt~ have been <br />p.litl h}' t he Coni ractor tor Work tor \vhich previous Certificates for Paynlent were <br />i~~\Jl'd .11HI pJy'ncnts received (roln the Owner, and that current payment shown <br />Ill'rein b now due. <br /> <br />N <br /> <br />I{AC10R <br /> <br />BOR-SON Construct <br /> <br />on <br /> <br />nc <br /> <br />8. <br />9. <br /> <br />N <br /> <br />-7 <br /> <br />)v ChJnJ:ic <br /> <br />TOTAl.S <br />Orders <br /> <br />lil!I <br />ii_ll. <br /> <br />($1 <br /> <br />4 <br /> <br />Month <br />Dale Approved <br /> <br />(Column G on G703 <br />RETAINAGE: <br />a. -2- % of Completed Work <br />(Column 0 + E on G70)) <br />b. _ ('/0 of Stored Material <br />(Column F on G703) <br />Total Rctainage (line Sa + 5b or <br />Tolal in Column I ot G703) . <br />TOTAL EAJlNED LESS RETAINAGE <br />(l.ine 4 less line 5 Total) <br />LESS PHEVIOUS CERT <br />PAYMENT (Line 6 <br /> <br />II <br /> <br />FICATES FOR <br />ronl prior Ccr <br />CUR RENT PAY ME NT 0 U E . . . . . . . . . . . <br />BALANCE TO FINISH, PLUS RETAINAGE <br />ine 3 less line 6) <br /> <br /> <br />s <br /> <br />Cou <br /> <br />calC <br /> <br />$ <br />$ <br />$ <br /> <br />2 <br /> <br />o <br /> <br />25 <br />50 <br /> <br />307.00) <br />307.001 <br /> <br />307.00) <br /> <br />7. <br /> <br />6. <br /> <br />$ <br /> <br />s <br />s <br /> <br />2 <br /> <br />o <br /> <br />05,970.25 <br />3143Q.75 <br /> <br />$ <br /> <br />05 <br /> <br />970 <br /> <br />2S <br /> <br />Appr()Vl'd <br />Nunlbcr <br /> <br />Cl-iANCE OR[)ER SU1\'1Mt\RY <br /> <br />ChJngc Orders approved in <br />rrl'vi()u~ rnonlhs by O\vncr <br />TOTAL <br /> <br />5 <br /> <br />5. <br /> <br />1. ORIGINAL CONTRACT SUM <br />2. Net change by Change Orders. . . . <br />3. CONTRACT SUM TO DATE (Line :t 2 <br />4. TOTAL COMPLETED & STORED TO DATE <br /> <br />s <br />S <br />$ <br />$ <br /> <br />2 <br /> <br />2 <br />2 <br /> <br />182 <br />{ 1 LI <br />168 <br />9 <br /> <br />500.00 <br />307.00 <br />193.00 <br />L105.00 <br /> <br />ADOIT <br /> <br />ONS <br /> <br />DEDUCT <br /> <br />ONS <br /> <br />Applicalion is made (or Payment, as <br />Continuation Sheel, AlA Document <br /> <br />shown belcl\v, in connec <br />G70J, is atlJched. <br /> <br />CONTRACTOR'S APPLICATION FOR PAYMENT <br /> <br />()Nl <br /> <br />RACT <br /> <br />CONTR:\CTOR) : <br />BOR-SON Construction, <br />2001 Killebrew Drive, #1 <br />Bloomington, MN 5SQ25 <br /> <br />rC)R <br /> <br />Inc <br />4 <br /> <br />VIA (ARCJiITECT): <br />EOS Architecture <br />21 Water Street <br />Excelsior, MN <br /> <br />5533 <br /> <br />CONTRACT DATE <br /> <br />on \v <br /> <br />ARCt.iITECT'S <br />>ROJECT NO <br /> <br />~()"\ <br /> <br />City of Elk River <br />720 Dodge Avenue <br />Elk River I MN <br /> <br />N.W <br />55330 <br /> <br />PERIOD TO <br /> <br />I. /08/93 <br />5/08/93 <br /> <br />o <br />o <br />o <br />o <br />o <br />o <br /> <br />c Con <br /> <br />t. <br /> <br />51 rll>U110n <br />OWNER <br />ARCt-t 1"1 (CT <br />CONTRACTOR <br /> <br />l() <br /> <br />APPl <br /> <br />()\VN(~ <br /> <br />CATION AND CERTIFICATE <br /> <br />PRO <br /> <br />fOR PAYMENT <br /> <br />ECT <br /> <br />AlA DOCUMENT C702 <br /> <br />EII< Rive,'" City Hall / <br />Police Station <br /> <br />APPLICATION NO <br /> <br />ns <br /> <br />ruc <br /> <br />ons <br /> <br />on <br /> <br />reverse <br /> <br />o <br /> <br />sid <br /> <br />I'A C I <br /> <br />()NI or <br /> <br />',\( <br /> <br />\ <br /> <br />\ <br />