3.7. SR 11-18-1996 - Laserfiche WebLink

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APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 2 PAGES TO OWNER City of Elk River 13065 t-)rant, Pm k way Elk River, Minnesota 55330 PROJECT: Elk River ice Arena Expansion Elk River, Minnesota FROM CONTRACTOR: VIA ARCHITECT: RSP Arch)reels, Ltd. M. A. Morlenson Company 120 First Avenue No~h 700 k'leadov~ I.~mc N.rlh Mim~capolJ~. MN 55401 Golden Valley, Mimmsola 55422 CL)NTRA(?T FI)R: Construclion Managcmcm APPLICATION NO: 6 PERIOD TO: 10/31/96 I'ROJECT NTIS: 951019 CC)NTRACT I)ATF. May 1995 Distribution to: ["~O\VN ER ['--~ A RCI IITECT [-'~CONTRACTOR CONTRACTOR'S APPLICATION FOR PAYMENT ( *m~im~:,ti, m %hctq, AJA [ h VllliiCIll (;?03:J5 I. ORIGINAl. CONTRACT SUM 2. Net change by Change Orders 3. CONIll. ACT SlIM '1~¢~ DATE (lAne I = 2) 4. TOfAI. COMPI.ETEI) & S'I'O~D TO I)A'I'E (Coh,mn G on G703) 5. RLIAINAGE: (Column I) + E on (;703) b. % of Stored Material (Column F on G703) 'lolal Relamage (lAnes 5a + 5b or ~olal m Colunm I of GT03) 6. TOTAl, EARNED LESS RETAINAGE (Line 4 Less Li~ 5 lb~al) 7. i~SS PREVIOUS CERTIFICAT~ FOR PAYMENT (Line 6 I~om prior Ceflifica~) 8. CUR~NT PAYMEN~ DUE $ 2,288,204.00 8,74400 2,406,948.00 $ 1,679,593.00 ,)83.00 $ 24,983.00 1,654.610.00 9. BALANCE TO FIN1SIt, ~CLUDING REI'AINAGE $ (l. ine 3 less Linc 6) $ 1,275,201.00 752,338.00 CHANGE ORDER SUI~M'ARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner $2,514.00 Total approved this Month $116,230.00 TOTALS $118:744.00 S0.00 NET CiIANGES by Change Order $118,744.00 Thc undersigned Co,maclor ccrlifies Ihat to the Ix:si of thc Contractor's knowledge. irsfi:,'mation and belief thc Work ct')vcrcd I)y (his Application fi)r Payment has I)ecn COmlAetcd m acc(mia;me with the (.'o~llracl I')ocuments, thai all alllouiiIs liars ~en paid by thc Contractor for Work tbr which previous Ceflificatcs lbr Payment were issued and payments received JY,.)]n the Owner. aim that ct]rrcfll j)ilylllCllt shoxvII herein is ilow due. CON'I'RACTOR: M.A. Mortenson Company Stale o12 Mi,mcsola County ~.~q'~RI ANNE BARNE-UI'~ Subscribed and sworn to ~fore me lifts My Conunission ex fires' January 31 ~000 ARCHITECT'S CERTIFICATE FOR PAYMENT In accordance with tile Contract Documents, based on on-site observations and tile data comprising the application, the Architect ceslifies lo the Owner thai to the best of the Architect's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance wilh the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED ........... $ (Attach explanation if amount certified differs from the amount applied Initial all figures on this Application and onthe Continuation Sheet that are changed to conform with the amount certified) ARCHITECT: By: Date: This Ccdificate is not negotiable. The AMOUNT CERTIFIED is payable only W the Contractor named hereto. Lssuancc, payment and acceptance ot payment are w~thout prejudice to any rights of the Owner or Contractor under this Contract. ~dX OOCUMENT G702 - APPLICAIlON AND CERTIFICATION FOR PAYMENT. 1992 EDITION · AP, - 01992 THE AMERICAN INSTITUTE OF ARCHITEC1~, 173~ NEW YORK AVE., N.W~ WASHINGTON. DC 20006-5292 Users may obtain validation of this document by requesting · completed AIA Document D401 - CertiflcaUon of Document's Authenticity from the Licensee.