12-10-1990 Council Packet - Laserfiche WebLink

Home Browse Search

APPLIL h TION and certificate for PAYMEN i aia document C702 P>CE ONE OE 2 PACES TO (Owner);City of Orono 1335 Brown Road Crystal Bay, Minnesota 55323 PROJECT: Lift Station No. 8 Renovation application NO: 2 PERIOD FROM; lQ/24/90 TO:11/28/90 Distribution to □ OWNER □ ARCHITECT □ CONTRACTOR □ ATTENTION:CONTRACT FOR Northwest Mechanical Inc. 432 Mill Street, Box 40 1 nnQ 1 fll'p MfJ ARCHITECT’S PROJECT NO; CONTRACT DATE: 8/23/90 □ CONTRACTOR'S APPLICATION FOR PAYMENT CHANCE ORDi i SUMMARY Change Orders approved in previous months by Owner TOTAL Approved this Month Number Date Approved ADDITIONS TOTALS Net change by Change Orders DUCT IONS Continuation Sheet, AIA Document G703, is attached. The present status of the account for this Contract is as follows: ORIGINAL CONTRACT SUM.....................................................$------- Net change by Change Orders.................................................S- CONTRACT SUM TO DATE........................................................S- 00 48,000.00 The undersigned Contractor certifies that to the best of his knowledge information and belief the Work covered by this Application tor Payment has been completed in accordance with the Contract Docu ments, that all amounts have been paid by him for Work lor which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due TOTAL COMPLETED & STORED TO DATE........................S- (Column G on G703) RETAINAGE-5---------------%...........................................................S- or total in Column I on C703 TOTAL EARNED LESS RETAINAGE .........................................S- lESS PREVIOUS CERTIFICATES FOR PAYMENT...............S- 46,000.00 2,300.00 43,700.00 9*044.00 CURRENT PAYMENT DUE..........................................................S-34,656.00 CONTRAC 'm NORTHV :hanical INC. Date: il/Ifi/90 —P ooT-4t- Ogl and y ■Pres4<Iefh ARCHITECT'S CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on-siie obser vations and the data comprising the above application, the Architect certifies to the Owner that the Work has progressed to the point indicated; that to the best of his knowledge, iniormation and belief, the quality of the Work is in accordance with the Contract Docu ments; and that the Contractor is entitled to payment oi the AMOUNT CERTIFIED. Stale of. County of: Subscribed and sworn to before me this r^ay of Notary Public: My Commission expires: AMOUNT CERTIFIED ....................................................................S___________ fAttach explanation it amount certified differs from the amount applied for.) ARCHITECT: By:Dale: This Certificate is not negotiable The AMOUNT CERTIFIED is payable only to the Contractor named herein Issuance, payment and acceptance of payment are without pre)udice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT C702 ' ■ ‘'ICATION AND CERTIFICATE FOR PAYMENT • APRIl 1976 EDITION • AIA* • (T 1978 THE AMERICAN tNSTIlUTl OF ARCHITECTS. 1735 NEW YORK AVENUE, N W., WASHINGTON. D C. 20006 G702 —1978