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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: 5 DISTRIBUTION TO: 2750 Kelley Parkway Remodet&Expansion OWNER Orono,MN 55356 2730 Keiley Parkway PERIOD T0:12/31/2014 CONSTRUCTION Orono,MN 55356 MANAGER ARCHITECT FROM Kelleher Constnidion,Inc. ARCHITECTS CONTRACTOR (SUBCONTRACTOR):11531 Rupp Drive PROJECT NO: _SUBCONTRACTOR Bumsville,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 Boliards/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 2g Waterproofing 3,400.00 3,400.00 0.00 0.00 3,400.00 100.00 0.00 170.00 27 Fluid Applied Air Banier �,ppp.pp 1,000.00 0.00 0.00 1,000 00 100.00 0.00 50.00 2g Joint Sealants/Firestopping 2,000.00 100.00 0.00 0.00 100.00 5.00 1,900.00 5.00 2g 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 37,400.00 3,100.00 0.00 40,500.00 100.00 0.00 2,025.00 31 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#1 685.00 685.00 0.00 0.00 685.00 100.00 0.00 34.25 33 Change Order#2 939.00 939.00 0.00 0.00 939.00 100.00 0.00 46.95 REPORT TOTALS $432,045.00 $398,723.00 $10,000.00 $0.00 $408,723.00 94.60 $23,322.00 $20,436.15