08-24-1992 Council Packet - Laserfiche WebLink

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m 40435P.o. BOX 21031 MINNI-APOLIS. MN 55421rEjULY 13/ 1992^IT FROM THIS INVOICE,T 10 DAYS FROM INVOICE DATE ............ ....... V"...amount '$ 1,490.00 / liM I, t . SERVICE CHARGE .1 .I *' 0.; #» <Hf'''. f.I •. . t • < . . : * .• . - • ^ < •« * i V APPLICATION AND CERTIFICATE FOR PAYMENT AIA POCUMtNl G702 (instructions on reverse sk M pace om or PACES --------------------- application NO; 3PERIOD TO: 7-31-9210 (OWNER):City of Orono 1335 Brown Road South Crystal Bay, MN 55323 IROM (CONTRACTOR):Allied I'echanlcal Systems 3A0 Michigan St., Hutchinson, MN 55350 CQNIRACT FOR: Mechanical Work________CONTRACTOR'S APPLICATION FOR PAYMENTPROIECTOrono City llall/Police and Public Works Buildings Distribulion 10:□ OWNER□ ARCHITECT□ CONTRACTOR□□CHANGE ORDER SUMMARYChange Orders approved in previous months by Ownc'TOIALApproved Ihis Monthj ryopj^ApprovedJliL i:B)?. TOTALS By,Chao^^Pfdcrs addiiions VIA (ARCHITECT): ARCHITECT SBoarman Kroos Pfister and Assoc. PROIECT NO; 1124.04 222 North Second StreetMinneapolis, MN 55 4 01 CONTRACT DATE:Application is made (or Payment, as shown below, in connection with Ihe Contract. Continuation Sheet, AIA Document C703, is attached.t 390,000.001 ORIGINAL CONTRACT SUM........................................... S-------------2. Net change by Change Orders....................................... JDEDUCTIONS -0- The undersigned Contractor cerlifies that to the best ol ihe'Contrac.or’s knowledge, inlormalion and belief ihe Work covered by lliis Applii alion (or Paymcnl has been comirleled in accordance with the Contract Documents, tint all amounts have been paid by the Contractor (or Work (or wliich previous Cerlihcales (or Payment were issued and payments received (rom the Owner, and that current payment sliown herein is now due. CONlfi^vCTOR: Alllfed Mechanical Systems of Hutchinson, Inc. ,,y. JS ^ ^ __3- IT.ile ZLl2-Q_:^^ CONTRACT SUM TO DATE (Line 1 ± 2)..........................SA TOTAL COMPLETED & SIORED TO DATE......................S(Column C on G70J) Ib^.ooS RETAINAGE:a 10 % o( Completed Work S —4j.9A2_i.QQ —(Column D + F on G703)b i0_ % of Stored Material S _^A82-ii0fl-----(Column F on C703) TotalRetainagelLineSa . 5bor ^ Total in Column I of C703)...............................— T —?^7".n0— _ 0. TOTAL EARNED LESS RETAINAGE ...........................T (Sri.nSnrftfl HlA-3 (Line A less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 (rom prior Certificate)................$ ??*???*»? 911-^ 0. CURRENT PAYMENT DUE...................................................$ 9. BALANCE TO FINISH, PLUS RETAINAGE..........................$ ______(Line 3 less Line 6) State of: Minnesota Subscribed and.j/woriV to bJotcJmc^[W[s County ol: McLeod BCCKVosfUE ^ rOTAItV PUBLIC • MINNESOTA ? ARCHITECT'S CERTIFICATE FOR PAYMENT In accordance willi lire ConiracI Documeirls, based ixt on sile olrsetvalions and the daia conrpiismg the above application, Ihe Arcir.leci ce. ubes to lire Owner that to the best ol the Architect's knowledge, miomrahon and bel.O Hie Work has progressed as indicated, the quality ol the Work is in accoidaiice wiili die (ronliai.1 Dot umenis. and the Coiilractor is entitled to payment ol the AMOUNI CLUlll IID Notary Public: Afc t-' My Commissiob expires AMOUNT CERTIFIED W...............................|C-in^Eiip. June (Much exphnadon il amoimt cerdiied ARCtiiTfCT: Boarman Kroos Pfister and Associates By:Date; This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named lietein. Issuance, paymen' ,.nd acceptance of payment are without prejudice to any rights o( ttie Owner or Contractor under ttiis Contract. ___ AIA UUCUMtNI C702 • AITtlCAFION AND aHhIlt AM I OK IV\SMIN1 • MAY •.'liD IDIItON • AIA- • fc mi mi^llRlCAN INSUIUlt Of ARCinUCIS. 171S NIW VOKK AVINUI. N W. WASIIINC.ION, D C 70001. WAnNlIKi: Unlicentdd pl>olocopy ’nt| vlol#lfs U S. eoiiy'tnt'l '•'« «nd I* »ubIeclloleo"tpfO»*«v''°"' C702-1983