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. ,� � �r TM =��- Docun�ent G732 — 2009 Application and Certificafe for Payment, Construcfion Manager as Adviser Edition TO OWNER: City of Orono PROJECT: Orono Police Dpt APPLICATION N0: 04 Four DISTRIBUTION T0: 2730 Kelley Parkway OWNER PERIOD T0: CONSTRUCTIOI�MANAGER FROM VIA CONSTRUCTION �rono, MN 55356 CONTRACT DATE: 12/31/2014 ARCHITECT CONTRACTOR�ellington Construction, inc. MANAGER: Kraus Anderson PROJECT NOS: / / CONTRACTOR 01 North 2nd Street FIELD CONTRACT FO�nneanolis MN 55411 VIA ARCHITECT: SKD Architects OTHER CONTRACTOR�S APPLICATION FOR PAYMENT 7'he undersigned Convactor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the App]icaHon is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous AIA Docnment G703T^',Continuation Sheet,is attached Certificates for Payment were issued and payments received from the Owner,and that current payment 1,ORIGINAL CONTRACT SUM............................................................$ 198,250.00 shown herein is now due. 2.NET CHANGES IN THE WORK..........................................................$ -803.00 CONT R: K�IIi gton Co struetion, Inc. 3.CONTI�ACT SUM TO DATE(Line 1 f 2) ............................................. $ 197,447.00 gy. ��"'� Dafe: 12/22/2014 4.TOTAL COMPLETED AND STORED TO DATE(Column G on G703)..............$ 195,758.00 State of: �nneso a 5.RETAINAGE: County of: Hennepin a. 5 %of Completed Work Subscribed and sworn to be e .�ESSiGA L.PLOWMAN (Column D+E on G703) $ 9,78�•90 me this 22 day e mber, 2014 `i l�tary Pt�blk b, 5 %of Stored Material Nota Public MNtnesote rY ^rsslon �anua 312018 (Column F on G703) $ 0.00 My Commission expires: �/3�i2ats Total Retainage(Lines 3a+Sb,or Total in Column I on G703)...................$ 9,787�90 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE................................................... $ 185,970.10 In accordance with the Contract Documents,based on evaluations of the Work and the data comprising (Line 4 minus Ldne S Total) this application,the Construction Manager and Architect certify to the Owner that to the best of theit 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT.................................... 70,138.50 �?owledge,information and belief the Work has progressed as indicated,the quality of the Work is in (Line 6 from prior Certificate) accordance with the Contract Dociiments,and the Contractor is entitled to payment of the AMOtINT 8.CURRENT PAYMENT DUE..............................................................$ 115,831.6 �TIFIED. � 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED......................... .............................$ 1�`S�?j, � (Attach explanation df amo:mt certified d�ers from the arnount applied.Initial ul!figures on this 11,476.90 .A bcation and the Cont:mration Sheet that are chan ed to con orm with the amoa�nt certt aed. (Line 3 minus Ltne 6) $ PP � S .r .f � CONSTRU I MANA . By: Date: ��1��!`� SUMMARY OF CHANGES IN TH�WORK ADDITIONS DEDUCTIONS ARCHITECT:(NOTE:If Multiple Prime Contrac#ors are responsible fo�forming portions of the Total changes a roved in evious months b Owner $ 1,442.57 $ -2,245.57 Proj ' tification is not required) Total approved this month,including Construction 0.00 0.00 By� Date: j I) Change Directives $ $ This Certificate is n t negotiable.The AMOUNT CERTIFIED is payable only o the Contractor named TOTALS $ 1 442.57 $ -2 245.57 herein.Issuance,paymeht and acceptance of payment are without prejudice to any rights of the Owner NET CtIAI�t',rES IN THE WORK $ - 0 .00 or Contractor under this Cnntract. CAUTION:You should sign an original AIA Contract Doc4ment,on which this text appears in RED.An original assures that changes will not be o6scured. AIA Document G732*"'—2009(formerly G702^"CMa—1992�.Copyright�1992 and 2009 by The American Institute of Architects.All rights reserved.MIARNING:Thia AIA'�Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA�'Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copynght@aia.org.