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APPLICATION AND CERTIFICATE FOR PAYMFNT ma document C702 (Instructions Ofwevorse side) PACEONtOf PACESTO (OWNER): CITY OF ORONO <br />r.O. BOX 66 <br />CRYSTAL BAY, MN 55323 <br />PROIECT: ORONO MUNICIPAL FACILITIES <br />BID PACKAGE #3 <br />APPLICATION NO: 3 <br />PERIOD TO: <br />FROM (CONTRACTOR): ZAHL EQUIPMENT COMPANY ^lA (ARCHITECT): BOARMAN & ^^SOC. <br />'11 1 1 Mr* M I? 222 NORTH 2ND ST •JlOl SPRING Sr. N.E. <br />MPLS., MN 55A13 Mii.b., MN <br />CONTRACT FOR: _____________ <br />ARCHITECT'S <br />PROIECT NO: <br />BID PACKAGE 93 <br />CONTRACT DATE: 6/15/92 <br />Distribution '.o: <br />13 OWNER <br />|3 ARCHITECT <br />□ CONTRACTOR <br />□□ <br />CONTRACTOR'S APPLICATION FOR PAYMENT <br />ruAKjr.F ORDFR SUMMARY <br />Change Orders approved in <br />previous rnoMihs by Owner <br />TOTAL <br />ADDITIONS DEDUCTIONS <br />Approved this Month <br />Nund^cr Date Approved <br />TOTALS <br />Net change by Change Orders . <br />Application is made (or Payment, as shown below, in connection with the Contract. <br />Continuation ShccI, AIA Document G703, is attached. <br />1. ORIG‘; ;AL CONTRACT SUM......................................... 5 31^712.00-------------- <br />2. Net change by Change Orders......................................S ■ ■ -------------- <br />3. CONTRACT SUM TO DATE (Line 1 ± 2).........................S -------------- <br />4. TOTAL COMPLETED & STORED TO DATE.....................$ _11 , 71 2 ,.QQ---------------- <br />(Column G on G703) <br />5. REIAINAGE: <br />a.___% of Completed Work $---------------------------— <br />(Column D + E on (3703) <br />b____% of Stored Material $ ---------—--------------- <br />(Column F on G7U3) <br />Total Relainage (Line 5a f Sb or <br />Total in Column I of G703) <br />The undersigned Contractor cerliiies mat to me oesi oi me a <br />information and beiief the Work covered by this Application for Payment has been <br />completed in accordance with the Contract Documents, that all amounts have been <br />paid by the Contractor for Work for which previous Certificates for I’ayrnenl were <br />issued and payments received from the Owner, and that current payment shown <br />herein Is now due. <br />6. TOTAL EARNED LESS RETAINAGE..................................S 3I.7L2.vQQ. <br />(Line 4 less Line 5 Total) <br />7. LESS PREVIOUS CERTIFICATES TOR <br />PAYMENT (Line 6 from prior Cerlificale)...............$ _2 3.367..>±'^. <br />8. CURRENT PAYMENT DUE...............................................^ 8 .3i^M <br />9. DALANCE TO FINISH, PLUS RETAINAGE.......................S ~ 0 7 ■ - <br />(Line 3 less Line 6) _______ <br />CONTRACTOR: <br />Slate <br />By:M.Oa,e: ‘/22/?3 <br />Subscr <br />Notary <br />My Co M <br />aG«unlyuf; <br />f ^•*)' v-r <br />AMOUNT CERHHED............................................................' • <br />.vnvUOv|,19 <br />/\mvyui’^i II ...................................................................................... t <br />data comprising the above applualion, the Afchilecicerldies to the Owner thattonc Due- A ^ <br />best of the Architect's knowledge, information and heliel the Work has progressed as Ry:-------------ZlJLtLKirC;:--------------------------— ^ ® ' . , • . . ,i <br />inrjicated the quality of tlic Work is in accordance with the Contract Documoi'.ls, and T||,jj CcrtificatKjsX t negolialjle. Tlie AMOUNI CLKHTIEl) is pay.ilile only lo »e <br />lt,e Conir'aclur is enlUled lo payment of the AMOUNI CERUHtD. Contractor named herein. Issuance, payrnent are wiihoul <br />prejudice to any rights of the Owner or Contractor under iliis Contracl. <br />AIA IMK UAtlNT f.7«J • API^'r MION AND nBliriTAU HI* rArM»Nl • ^ ^G702I983