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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: 5 Distribution to: <br /> City of Orono City of Orono Police Department PERIOD TO: 12/31/14 �OWNER <br /> 2750 Kelley Parkway Remodel&Expansion PROJECT NO: 90447 �CONSTRUCTION <br /> Orouo,MN 55356 2730 Kelley Parkway MANAGER <br /> Orono,MN 55356 �AKCHITECT <br /> 0 <br /> ATTENTION: Jessica Loftus <br /> PROJECI` 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 Architect certify to the <br /> Owner that to the 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 Coniractors are entitled to payment of the AMOiJNT CERTIF'IED. <br /> 2. Total Net Changes by Change Orders $ 107,704.00 <br /> (Item B Totals) <br /> 3. TOTAL CONTRACT SUM TO DATE(Item C Totals) $ 2,732,753.00 <br /> 4. TOTAL COMPLETED 8c STORED TO DATE $ 2,370,680.75 <br /> (Item F Totals) <br /> 5. RETAINAGE(Item H Totals) $ 118,534.05 <br /> 6. LESS PREVIOUS TOTAL PAYMENTS $ 1,869,674.36 <br /> (Item I Totals) <br /> 7. CURRENT PAYMENT DUE(Item J Totals) $'�� �;�''��m�`38�4�f3 34' <br /> TOTAL OF AMOUNTS CERTIFIED $ 382,472.34 <br /> The undersigned Conshvction Manager certifies that to the best of the Construction CONSTR ON G�raus-Anderson Construction Company <br /> Manager's knowledge,information and belief of ttus Project Application for Payment <br /> is an accurate compilation of the Contractors'Arrlications for Payment,attached hereto. By: ,s_ Date: Ol/08/15 <br /> CONST�R JLT.ION R�^ ARC CT:SI A�u hitects}Inc. <br /> � � � � <br /> By: Date: O1/08/15 By: Date: <br /> State of: Minnesota This Certificate is not negotiable. The AMOUNTS CERT'IFIED are payable only to the <br /> County of: Anoka �nnn Contractors named in AIA Document G723/CMa,attached. Issuance,payment and <br /> +Tesxrar Kq�EN A. MELANDER <br /> Subscribed and sworn to before „�'w'•'•� acceptance of payment are without prejudice to any rights of the Owner or the <br /> me this 8th day of January,2015 �n,"�� Notary PubliC-Minnesota Contractors under their Contracts. <br /> C'j�`���•�r�Y <br /> � ���!� '��i�.'.�'. Commission Expires Jan 31,2019 <br /> No Publ�c: ��..�� �v <br /> My Commission exp s: Jauuary 31,2019 <br /> AIA DOCUMENT G702/CMa�APPLICATION AND CERTIFICATION FOR PAYMENT•CONSTRUCTION MANAGER-ADVISER EDRION�1992 EDITION�AIA 01992 G722/CMa-1992 <br /> THE AMERICAN INSTITUTE OF ARCHfTECTS,1745 NEW YORK AVE.,N.W.,WASHINGTON,DC 200065292 <br /> Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity <br />