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AIA Type Document � Application and Certification for Payment Page 3 of 3 TO(OWNER):City of Orono PROJECT: Orono Police Department APPLICATION NO: 4 DISTRIBUTION TO: 2750 Kelley Parkway Remodel&Expansion OWNER Orono,MN 55356 2730 Kelley Parkway PERIOD TO:71/30/2014 CONSTRUCTION Orono,MN 55356 MANAGER ARCHITECT FROM Kelleher Construction,Inc. ARCHITECTS _CONTRACTOR PROJECT NO: SUBCONTRACTOR (SUBCONTRACTOR):��531 Rupp Drive - Burnsville,MN 55337 VIA CONSTRUCTION MANAGER: Kraus-Anderson Construction Company CONTRACT FOR:Concrete Work VIA ARCHITECT: SKD Architects,Inc. CONTRACT DATE: 7/29/2014 SCHEDULE PREVIOUS COMPLETED STORED COMPLETED ITEM DESCRIPTION VALUE APPLICATIONS THIS PERIOD MATERIAL STORED % BALANCE RETAINAGE 20 Stoops 300.00 300.00 0.00 0.00 300.00 100.00 0.00 15.00 2� Building Aprons 300.00 300.00 0.00 0.00 300.00 100.00 0.00 15.00 22 Exterior Slab 600.00 600.00 0.00 0.00 600.00 100.00 0.00 30.00 23 Set Bollards/Switchgear Pad 500.00 500.00 0.00 0.00 500.00 100.00 0.00 25.00 24 Sidewalks/Paving 13,755.00 8,253.00 0.00 0.00 8,253.00 60.00 5,502.00 412.65 25 Rebar 21,000.00 21,000.00 0.00 0.00 21,000.00 100.00 0.00 1,050.00 26 Waterproofing 3,400.00 3,400.00 0.00 0.00 3,400.00 100.00 0.00 170.00 27 Fluid Applied Air Barrier 1,000.00 1,000.00 0.00 0.00 1,000.00 100.00 0.00 50.00 Zg Joint Sealants/Firestopping 2,000.00 0.00 100.00 0.00 100.00 5.00 1,900.00 5.00 29 Curb&Gutter 9,273.00 9,273.00 0.00 0.00 9,273.00 100.00 0.00 463.65 30 Masonry 40,500.00 16,500.00 20,900.00 0.00 37,400.00 92.35 3,100.00 1,870.00 3� Performance/Payment Bonds 3,300.00 3,300.00 0.00 0.00 3,300.00 100.00 0.00 165.00 32 Change Order#1 685.00 0.00 685.00 0.00 685.00 100.00 0.00 34.25 33 Change Orcler#2 939.00 0.00 939.00 0.00 939.00 100.00 0.00 46.95 REPORTTOTALS $432,045.00 $331,199.00 $67,524.00 $0.00 $398,723.00 92.29 $33,322.00 $19,936.15