5.1. A & B SR 05-15-1995 - Laserfiche WebLink

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APPL•ATION AND CERTIFICATE FOR PAYM~ AIA DOCUMENT G702 Instructions on reverse side rACS o~F PACia c ) 'I'O OWNER: Clty of Elk River PROJECT: Elk River Pub11C Library Exp. APPLICATION NO.: 9 Distribution to: 13065 Orono Parkway 413 Proctor Avenue PERIOD TO: 2/28/95 ^ OWNER Elk River, NILV 55330 Elk River, NIlV 55330 PROJECT Nos.:94103 ®ARCH["I'ECT _ ^ CONTKACTOR I1tOh1 CONTKACTOR: KUE COritraCtOrS, IriC. VIA ARCIIITF,CT: FAS Architecture CONTRACT DATES/12/94 ^ 14806 160th Street 21 Water Street ^ Watkins, N>LV 55389 Excelsior, N1D1 55331 coN'rRACI' FoR: General Contractor CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, infor- mation and belief the Work covered by this Application for Payment has been completed Application is made for payment, as shown below, in connection with the Contract. in accordance with the Contract Documents, that all amounts have been paid by the Continuation Sheet, AIA Document G703, is attached: Contractor for Work for which previous Certificates for Payment were issued and pay- ments received from the Owner, and that current payment shown herein is now duc. I. ORIGINAL CONTRACT SUM ...........:...... ~ 43 8, 897.00 . Net change by Change Orders ............... ~ croR: KUE Contractors, Inc. 8 , 541 _O.Q 3 . CONTRACT SUM TO DATE (Line I f 2) ........ $ 44 '7, 438 QO ~ ~ _ ~`~~ Date: 2/2$/95 os ph E. K echle ~i . TOTAL COMPLETED & STORED TO DATE ...... ~ 44 7, 4?8 00 slat of: Minnesota (Column G on G703) County of: Stearri5 . RETAINAGE• Subscribed and sworn to before a. `%> of Completed Work (Columns D + ti on G703) h. '%~ of Suucd Material $ (Column F on G7O3) 7btal Rctainage (l.inc Sa + Sb or 'Iixal in Column I of G703) ................ . 6 . TOTAL EARNED LESS RETAINAGE ............ ~ a¢.~ a~g..,.Qp (Line 4 less Line 5 'Ibtal) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 445,019.00 (Line ti Cron prior Certificate) ................. $ 8 . CURRENT PAYMENT DUE ................. ~ 2, 419.00 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) $ 0.00 CHANGE ORDER SUMMARY ADDITIONS DEDCiCTIONS 7btal changes approved in previous ITx~nths by Owner $g 541.00 ~ Total approved this Month TOTALS NET Cf1ANGES by Change Order $,541.00. me this 28~ day of February, 1995 MARY R. KUECHLE Notary Public/ ~~~~ ~~ NOTARYPUBLIC-MINNESOTA eTeeonlc r^nl InlTv ARCHITECT'S CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on-site observations and the data comprising this application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated, the yuality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. ~~ AMOUNT CERTIFIED ............................... - ..-- (Attach ex[~l ationz if amount certif'ed differs fromthe amount applied for. Initial adl figur s.-~ a tl~ pltcgtion ann on the Continuation Sheet th. at are ranged to conforn t th mo nt certified:) AR, ~ I3y: Date: This Certificate is not negotiable. h A ~ OUNT CERTIFIED is paya le only to the Con- tractor named herein. Issuance, pay ent and acceptance of payment are without prejudice to any rights of the Own ~ or Contractor under this Contract. `~/~ AIA DOCUMENT G702 • APl'LICA'f10N AND GBRI'IFICA'fli FOR PAl'MFN'C • 1993 EDI"r10N •AIA® • ©1992 • THR AMERIC'.AN INtiT1TtfTE OF ARCHII'F.CTS, P35 NFW YORK ~\~~~ AvF:Nt'F:. N.W.. ~ASRINGroN. D.C. 3otuK,-5392 WARNING: Unlicensed photocopying violates US. copyright laws and will subject the violator to legal prosecutbn. G702-1992 .:.__. CAUTION: You should use an original AIA document which has this caution printed in red. An original assures that changes will not be obscured as may occur when documents are reproduced.