5.8. SR 12-16-1996 - Laserfiche WebLink

Home Browse Search

APPL ATION AND CERTIFICATION FOR PAYMENT A/.4 DOCUMENTGZ02 v^OEO.EOF 2 v^~; TO OWNER City of Elk River PROJECT: Elk River Ice Arena APPLICATION NO: 7 Disb'ibution to: 13065 Orono Parkway Elk River, Minnesota 55330 Expansion Elk River, Minnesota FROM CONTRACTOR: M. A. Mortenson Company 700 Meadow Lane North Golden Valley, Minnesota 55422 VIA ARCHITECT: RSP Architects, Ltd. 120 First Avenue North Minneapolis, MN 55401 PERIOD TO: 1 i/30/96 PROJECT NO: 951019 [~ARCI~TECT co r CTOR CONTRACT FOR: Construction Management CONTRACT DATE May, 1995 CONTRACTOR'S APPLICATION FOR PAYMENT ~be undersigned Contractor certifies that to the best orthe Contractoes ~owledge, Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document G703, is attached. 1. ORIGINAL CONTRACT SUM 2. Net change by Change Orders 3. CONTRACT SUM TO DATE (Line I 4- 2) 4. TOTAl, COMPLETED & STORED TO DATE (Column G on G703) 5. RETAINAGE: a. ~ % of Completed Work (Column D + E on G703) b. % of Stored Material (Column F on G703) Total Retainage (Lines 5a + 5b or Total in Column l of GT03) 6. TOTAL EARNED LESS RETAINAGE (Line 4 Less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE $ $ $ 2,288,204.00 $ 118,744.00 2,40~,94S.00 1,932,171.00~ 30,542.00 $ 30,542.00 $ 1,901,629.00 9. BALANCE TO FINISI[, INCLUDING RETAINAGE (Line 3 less Line 6) 1,654,610.00 505,319.00 CHANGE ORDER SUMMARY ADDI'IIONS DEDUCI'IONS Toial changes approved in previous months by Owner $ I 18,744.00 Total approved this Month TOTALS $118,744.00 $0.00 NET CHANGES by Change Order $118,744.00 information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contraclor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: M.A. Mortenson Company State of: MinneSOta County of.' Hennepin Subscribed and sworn to before me this 10th day of December, 1996 Notary Public: My Commission expires: January 31, 2000 '"ARCHITECTS CERTIFICATE FOR PAYMENT In accordance with the Contract DoeumenLs, based on on-site observations and the data comprising the application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and beliefthe Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNr CERTIFIED. AMOLrNT 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 Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the L'ontraetor named herein. Issuance, payment and acceptance ot payment are wtthout prejudice to any rights of the Owner or Contractor under this Contract. .MA DOCUMENT G702. APPLICATION AND CERnFIC~TION FOR PAYMENT · 1992 EDITION. AIA . O1992 TH~ AMERICAN INSTITUTE Of= ARCHITECTS. 1735 NEW YORK AVE.. ,.W., WASHINGTON. DC 20006-5292 Usem may obtain validation of this document by requesting a completed AIA Document D401. Certification of Document's Authenticity from the Licensee.