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APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT C702 io^;ooPAGt ONt Of PACISPROIECT: J Public Works Garage(name, address)TO (Owner^ij^y Orono <br />Orono, MN <br />ATTN: <br />ARCHITFCT: Kroos, Pfister & Assoc.ARCHITECT'S PROIECT NO: U24.04CONTRACTOR:j^j.Qy signs,Inc., 6325 \telcome Ave. No., Mpls., MN 55429 <br />CONTRACT FOR: <br />APPLICATION DATE: 7/23/93 APPLICATION NO: 2 <br />PIRIOD FROM: 5/] 1/92 TO 7/23/93 <br />CHANGE ORDER SUMMARY <br />Change Orders approved <br />in previous months by <br />Owner — <br />TOTAL <br />ADDITIONS $Dfout (IONS $ <br />Subsequent Change Orders <br />Number Approved <br />(date) <br />rtucu <br />JUl 2 <br />•4/12/93 <br />IVeu <br />Ejm <br />$120.00 <br />Appli(iilion is made for Payment, as shown lielow, in connection with the Contract. <br />Continuation Sheets AIA Document G702A, is attached. <br />The present status of the account for this Contract is as follows: <br />ORIGINAL CONTRACT SUM ........................................f 2,538.00 <br />Net clwnne by Change Orders..................................$___120.00 <br />CONTRACT SUM TO DATE .........................................% 2,658.00 <br />Kreus/I^ariji, <br />L^Vjnr^fcrnmifHi Orders 120.00 <br />TOTAL COMPLETED & STORED TO DATE .................i 2,658.00_ <br />(Column G on G702A) <br />RETAINAGE _________% .............................................f ~0~ <br />State of:County of: <br />or as noted in Column 1 on G702A <br />TOTAL EARNED LESS RETAINAGE ................................$ 2,658.00 <br />The undersigned Contractor certifies that the Work covered by this Appli­ <br />cation for Payment has been completed in accordance with the Contract <br />Documentf, that all amounts have been paid by him for Work for which <br />previous Certificates for Payment were issued and payments received from <br />the Owner, and that the current payment shown herein is now due. <br />LESS PREVIOUS CERTIFICATES FOR PAYMENT.............% 2/538.00 <br />CURRENT PAYMENT DUE .............................................$____ <br />Contractor: <br />•y: <br />lieroy Signs, Inc.Subscribed and <br />Notary Pubii <br />Dale: 7/23/93 <br />My ronimisYUin e» “res <br />mfmm <br /><Pyoi July , n 93 <br />.............................................................. <br />THOMAS P. OUFFY <br />In accoidance with the ConliacI and this Application (or Paymrnt the Contractor iy entitled to payment in the amount thown airove <br />Architect: <br />! <br />□ ARCHITECT <br />□ CONTRACTOR□ n <br />This Certificate is m;1 negotiable. It is payable only to the payee named herein and its issuance, payment and acreptanre are withonr prejudice to any rights of thr Owner or ContrictOf UAdef theif Contract. <br />AIA DOCUMENT C7li • APPIICATION AND CnUlHCAU fOk PAYrMtNT • MAKCH 19/1 tOlIION • AlA<Si <br />• 1971 • THt AMIRICAN INSIlTlill Of ARrHIUi IS. 17IS NtW VOKk AVI . N W . WASHIN(a l()N. t> < <70006