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PROJECT APPLICATION AND PROJECT CERTIFICATE FOR PAYMENT <br /> AIA DOCUMENT G722/CMa PAGE ONE OF FIVE PAGES <br /> TO OWNER: PROJECT: APPLICATION NO: 4 Distribution to: <br /> City of Orono City of Orono Police Department PERIOD TO: 11/30/14 �OWNER <br /> 2750 Kelley Parkway Remodel&Ezpansion PROJECT NO: 90447 �CONSTRUCTION <br /> Orono,MN 55356 2730 Kelley Parkway MANAGER <br /> Orono,MN 55356 �— �RCHITECT <br /> 0 <br /> ATTENTION: Jessica Loftus <br /> PROJECT APPLICATION FOR PAYMENT PROJECT CERTIFICATE FOR PAYMENT <br /> Application is made for Payment,as shown below,in connection with the Project. In accordance with the Contract Documents,based on on-site observations and the data <br /> Project Application Summary,AIA Document G723/CMa,is attached. comprising this Application,the Construction Manager and Arclutect certify to the <br /> Owner that to khe best of their knowledge,information and belief the Work has <br /> progressed as indicated,the quality of the Work is in accordance with the Contract <br /> 1. TOTAL CONTRACT SUMS(Item A Totals) $ 2,625,049.00 Documents,and the Contractors are entitled to payment of the AMOiJNT CERTIFIED. <br /> 2. Total Net Changes by Change Orders $ 40,989.00 <br /> (Item B Totals) <br /> 3. TOTAL CONTRACT Si1M TO DATE(Item C Totals) $ 2,666,038.00 <br /> 4. TOTAL COMPLETED&STORED TO DATE $ 1,968,07830 <br /> (Item F Totals) — <br /> 5. RETAINAGE(Item H Totals) $ 98,403.94 <br /> 6. LESS PREVIOUS TOTAL PAYMENTS $ 1,598,996.31 <br /> (Item I Totals) <br /> 7. CURRENT PAYMENT DUE(Item J Totals) $� ���6�F8:05� <br /> TOTAL OF AMOUNTS CERTIFIED $ 270,678.05 <br /> The undersigned Construction Manager certifies that to the best of the ConsUvction C�CTI b��hl�?�aus-Anderson Coustruction Company <br /> Manager's Irnowledge,information and belief of this Project Application for Payment � <br /> is an accurate compilation of the Contractors'Applications for Payment,attached hereto. By: � Date: 12/02/14 <br /> CONS�T j�,�'ION GE :S ' cts,Inc. <br /> By: �(%�� Date: 12/02/14 By: Date: � �/ <br /> State of: Minnesota r��-� 's Certificate is not negotiable. T'he AMOUNTS CERTIFTED aze payable only to the <br /> �°� '.. KqqEN A, MELANDER <br /> County of: Anoka ��""�� ontractors named in AIA Document G723/CMa,attached. Issuance,payment and <br /> Subscribed and sworn to before ;� �"���� Notary Public-Minnesota �p��of payment are without prejudice to any rights of the Owner or the <br /> me this 2nd da y of December,2014 �:,;��`�'�My Commisslo�Expires Jan 31,2ots ntractors under their Contracts. <br /> Notary Public ���a <br /> My Commissi n p res. uary ,2019 <br /> AIA DOCUMENT G702/CMa APPLICATION AND CERTIFICATION FOR PAYMENT�CONSTRUCTION MANAGER-ADVISER EDITION•1992 EDITION AIA �1992 G727JCMa1992 <br /> THE AMERICAN INSTITUTE OF ARCHITECTS,1745 NEW YORKAVE.,N.W.,WASHINGTON,DC 200085292 <br /> Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of DocumenYs Authenticity <br />