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p►r�PLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER-ADVISOR EDITION AIA DOCUMENT G702/Cma � TO(OWNER): PROJECT: - � A�LICATION NO.: 5 Distribution to: City of Orono Ciry of Orono Police Department�� P 'IOD TO: 12/31/2014 OWNER 2750 Kelley Parkway Remodel and Expansion PROJECT NO.S: 1225.00 CONSTRUCTION Orono, MN 55356 � :;'_ ' , .' MANAGER ARCHITECT FROM: :. ,C, NTRACT DATE: 7/29/2014 CONTRACTOR Minnetonka Plumbing Inc. F�'��. , � - ,�;,;a�'�NTRACT NO.: Category 22A 520 South River Street VIA CONSTRUCTION MANAGER: Kraus Anderson Construction Co. Plumbing&HVAC PO Box 1080 VIA ARCHITECT: SKD Delano, MN 55328 CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, AppNcation is made for payment,as shown below,in connecUon with the Contract. information and belief the Work covered by this Applicatlon for Payment has been Continuation Sheet,AIA Document G703,is attached. completed in accordance with the Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and 1. ORIGINAL CONTRACT SUM $ 380,300.00 payments received from the Owner,and that current payment shown herein is now due. 2. Net Change by Change Orders............................................................$ 849.00 .......................................................... 3. CONTRACT SUM TO DATE $ 381,149.00 CONTRAC ' �lumbing Inc. 4. TOTAL COMPLETE�STORED TO�DA7'E $ 372, 854.00 �` (Column G on G703) ................................ By. �_� Date: 12/19/2014 5. RETAINAGE: a s °�o ot compieted wo�c $ 18,642.70 State of: Minnesota County of: Hennepin (Column D+E on G703) Subscribed and s rn to before e thi:19th day of December,2014 b 5 % of Stored Material $ 0.00 Notary Public: �� -L (Column F on G703) My Commissi�pires: 01/31/2020 ' ��(Q��o�� Total Retainage(Line 5a+5b or $ 18,642.70 KR,�T N .M1NN�,80�A Total in Column I on G703) CERTIFICATE FOR PAYMENT �M�SIONFxP� 6. TOTAL EARNED LESS RETAINAGE $ 354,211.30 In accordance with the Contract Documents,based o s��ion (Line 4 less Line 5 Total) comprising this application,the Construction Manager rtify to the Owner 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 283,021.15 that to the best of their knowledge,information and belief the Work has progressed as (Line 6 from prior cerGflcate) indicated,the quality of the Work is in accordance with the Contract Documents,and the 8. CURRENT PAYMENT DUE $ 71,190.15 �/ Contractor is entided to payment of the AMOUNT CERTIFIED. ................................................................... ' 8. BALANCE TO FINISH, PLUS RETAINAGE ..,....$ 26 937.70 � . � (Line 3 less Line 6) AMOUNT CERTIFIED $ �,��,,� (Attach explanation if amount differs from the amounf applied for. Initial all figures on CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS this Application and on the Continuation Sheet that are changed to conform to the Total changes approved in amount cert�ed. previous months by Owner 849.00 CONSTRU I N I�B;--Kraus-Anderson Construction Company gy. Date: �Z fb Total approved this Month ARC ITE D gy; Date: � �� TOTALS 849.00 0.00 This Certificate is not n go able. The AMOUNT CERTIFIED is payable only to the ConVactor named herein. Issuance,payment and acceptance of payment are without NET CHANGES by Change Order 849.00 prejudice to any rights of the Owner or Contractor under this Contract.