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W.,lIMicown Ku«4i5uuih QrrMklAny.MN SSS2S ii4oi»t I 4 »i , 11 I'oiMC aii*iPtiNli WoiWl biliidlilg NO.PIRIOD lO- IKOJtCr NO :IhMiihuiMMi i«»:n OWN»RFROM CONTHACTOR:NorthtlfU Continictlon vu ARcjir per lk»ixnian Kit^ot ITisicr 222 Noiih Sciund Slicei MN S5401 ('i)NiK.\cr dai >:.f~| AHnirrrcr CONTRACreWOOWnUCTFOR CONTRACTOR'S APPUCATION FOR PAYMENT <br />AppUfiitoii li BiRiR lof F^niienu ri iho*m below* In connccilou with the 0>niraci Conttnuaiion Shcei, <br />AlADocumeni CTOS, la aiiRcbed. <br />• «•••••«•* ••••• • <br />I OWCHAI-OONTRACrSUM.------ <br />t Nct<tiM)f«bf QuagcOidcit. <br />• CONTIACT SUM TO DATE (Unc I A I)..... <br />4 TOTAL OOMrmtOfcTTORED TO DATI •«««••••• <br />I <br />I <br />I <br />I <br />279.980 00 <br />The undeiiignetl Omhin lor ceriinfi ihai lo the bew of ihe Comiacior'i kn«»wled|e. information and belief the Work covered by ihii Applkaiit>n for Faymeni has been <br />cumpieied In accoidame wiih i!»e Ctinira&i |V n uinenu. ihai all amounii have been <br />paid by the (amiractot for Work for which pieviouaCenifuaiei for Faymeni weie <br />issued aiiu payinenis leccKed fiuni ihe Owner, and tliai curieni payment shown <br />herein It msw due <br />(20.228 00)CtMiTRACTOR: NoflhlWc Cimslnicllon <br />250,752 00 <br />I>aie: <br />259.75200 <br />UTiUNACt: <br />ofCoflapItltd Work <br />(Coluinn D A t cm CTOS) <br />Stare of; <br />County of; <br />Subscribed and f%eL»rn lo fKfoie <br />m« tNs day d <br />of Suwed Materia) <br />(ColiMi Fern CTOS)Notary l^lblir: <br />bfy Commission ripUei <br />toial ReuOiiaic (Unc %a A SE or <br />Toml In Column lof CTOS). <br />• TOTAL lAIHID US MTAEfACE. <br />(Unc i teat Unc S Total) <br />259.75200 <br />I Liapuvious cnmncATts foe pA\Mita <br />(Unc 0 Aom prior CmtIAcacc) <br />256.384 00 <br />ARCHITECT'S CERTIHC aATE FOR PAYMENT <br />In accordance with the ('amuiact fv^ uniems. based or* on site obaenraclons and the <br />data comprising the above application, the Aichiiect ceriifiea to the Owner that lo ihc <br />ben of ihe An hlieci'i knowledge. Information and belief the Work has progressed aa <br />indicaicd. die quality of ihe Wmk it In arcocdance with the Coniraci Ikocumenta. and <br />the extractor b entitled to payment of the AMOUNT CEITTinED <br />CUitlNT FAYMtKr DUE <br />i lALAHClTOFINlSlirUaETTAINACR <br />(Unc SkaaUnci) <br />3.368 00 AMoim ciEnnii). <br />fAffatk opf*»«isf»sn ^ smeiMsf itrftfitd d»§mt fiwm mmmtni <br />sM/igutu m iktf tU •« tk» fimfwmsrisn SAsW fkai mt tkmmgmi is <br />esn/sns Is lA * am^nt tmUfitd ) <br />ouNci vnui iisaioi7~Ah^rttONS htiunmoNs <br />Qkci^ Orders approved In <br />prmd^ montha by comet <br />Annroved ihb kdoniii <br />^ foiaii <br />|Hct dumge by Oangc Orders _ --------------------------1 <br />AKCdiriKT <br />This Cei life ate is ncH neguuabic the AMOUNT COrTintl* 't payalile cwilv .o the <br />Ci»niraiiof named herein Iwuance, payment and arcefnance ol psymctii ut wtthutM <br />picjudue to any iiglus of the rkvnier «*i f‘wi»nifaLKAf under ihi* fVwurati <br />sNi siffucjtTicmAnocirnncATEK'i fowim*iwifi>moN«Au*issiMHt AMnutAwiNtTnirrioi Astitnirit <br />i; a ms mm *a« w ii«w pi i ;to2 im