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♦ : � T� _,. - � �,
<br /> �-:::: Document G732 — 2009 �� ��,- .�,,
<br /> ��. . .. �- . , _ .. .
<br /> Appl►Cation and Ce►'tificat'e fo►'Paymen� Construction Manager as Adviser Edition
<br /> TO OWNER: City Of Orono PROJECT: City Of Orono Police Department APPLICATION N0:�93�'Z � DISTRIBUTION T0:
<br /> 2750 Kelley Pazkway Orono, Remodel&Expansion
<br /> MN.55356 2730 Kelley Pazkway pERIOD T0:Ner�e+n�f¢t^ZT�114 �^'�'�����.,q�r! 3,CONS�RUCTION MANAGER X
<br /> Orono,MN.55356 �Z�'�'es1��" ARCHITECT X
<br /> FROM VIA CONS7RUCTION Kraus-Anderson Conctruction CONTRACT DATE:July 29,2014 CONTRACTOR
<br /> CONTRACTOR: Lambert Commercial MANAGER: PROJECT NOS: 1225.00/90447/1225.00 FIELD
<br /> Construction 21040
<br /> Chippendale Ave. OTHER
<br /> Farmington,MN.55024
<br /> CONTRACT FOR: VIA ARCHITECT: SKD Architects
<br /> CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and
<br /> belief the Work covered by this Application for Payment has been completed in accordance with the
<br /> Application 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
<br /> AIA Document G703T"�,Continuation Sheet,is attached. Certificates for Payment were issued and payments received from the Owner, and that current
<br /> 1. ORIGINAL CONTRACT SUM .......................................................................$ 315,195.00 payment shown herein is now .
<br /> 2. NET CHANGES IN THE WORK ..................................................................$ 0.00 CONTRA
<br /> 3. CONTRACT SUM TO DATE(Line 1 f 2) ..............................................$ 315,195.00 By: te: December 23,2014
<br /> 4. TOTAL COMPLETED AND STORED TO DATE(Column G on G703) ...$ 306,605.00 State of:Minesota ���'�`i
<br /> 5. RETAINAGE: County of:Dakota `+�{'�`;��/J,q
<br /> a. 5 %of Completed Work Subscribed and sworn to before ( _, ,. ��'`;�'' No RRARFT
<br /> �.�
<br /> b. (�Colum/n of Stored Mat 3n� $ 15,330.25 me this ,�,�r,-tdc day of� �1-�'''��L��� �j „ , My��m pUBUG:� �/ANQ
<br /> Notazy Public: ����� �� `�',orr M�N111 'q�
<br /> (Co(umn F on G703) $ 0.00 M Commission ex �res: �//,� es✓dq FSOjq �
<br /> Total Retainage(Lines Sa+56, or Total in Column I on G703).............$ �s,330.25 CERTIFICATE FOR PAYMENT ' 's
<br /> 6. TOTAL EARNED LESS RETAINAGE ....................................................$ 291,274.75 In accordance with the Contract Documents, based on evaluations of the Work and the data
<br /> (Line 4 minus Line 5 Total) ,�o mprising this application,the Construction Manager and Architect certify to the Owner that to the
<br /> 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT ................................$�,��1��est of their Irnowledge, information and belief the Work has progressed as indicated,the quality of
<br /> (Line 6 from prior Certificate) the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment�f
<br /> �/ y�� e AMOIINT CERTIFIED. �
<br /> 8. CURRENT PAYMENT DUE .................................�r�!.:'.:................. $ .1 Z,-�OUNT CERTIFIED ........................................,................................ $ ��� �Z��'a
<br /> 9. BALANCE TO FINISH, INCLUDING RETaNAGE '�(Attach e�planation if a ount certified d�ers from the amount applied.Initial all figures on this
<br /> Application and on Continuation Sheet that are changed to conform with the amount certified.)
<br /> (Line 3 minu.r Line 6) $ 23,920.25 CONSTRUCTIO GER:
<br /> By: Date: l Z �o I�
<br /> AIA Document G7S2TM'—2009(fortnerly G702T"'CMa—1992).Copyright�1992 and 2009 by The American Institute of Architects.All rights reserved.WARNING:This AIA� Document is protected by U.S.
<br /> Copyright Law and Intematfonal Treaties.UnauthoHzed reproduction or distribution of this AIA� Docume�t,or any portion of k,may resuit in severe civil and criminal penakies,and will be prosecuted �
<br /> to the maximum e�ctent possible under the law.This document was produced by AIA software at 1321.28 on 12/23/2014 under Order No.1276189683_1 which e�cpires on 09/26/2015,and is not for resale.
<br /> User Notes: (1833911127)
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