07-13-2022 Council Packet - Laserfiche WebLink

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From 1. 2. 3. 4. 5. a.X b.X c. 6. 7. 8. 9. Name:Name: 6,893.65$ -$ 130,979.29$ 6,893.65$ 130,979.29$ to Original Contract Price Total Work completed and materials stored to date (Sum of Column G Lump Sum Total and Column J Unit Price Total) 5/1/2022 Balance to finish, including retainage (Line 3 - Line 4) 6/30/2022 Application Date:7/1/2022 139,166.96$ -$ 137,872.94$ 139,166.96$ Retainage Current Contract Price (Line 1 + Line 2) Net change by Change Orders N.:1 City of Little Canada Sunram Construction, Inc. Bolton & Menk, Inc. 2022 Rondeau Park Improvements Owner's Project No.: Engineer's Project No.: Agency's Project No.: Application Period: Contract: Owner: Contractor: Engineer: Project: 0N1.124568 Total Retainage (Line 5.a + Line 5.b) Amount eligible to date (Line 4 - Line 5.c) Less previous payments 5% $ 137,872.94 $ - Work Completed Stored Materials Contractor's Certification Date: Signature: Sunram Construction, Inc.Contractor: Amount due this application 1,294.02$ Approved by City of Little Canada The undersigned Contractor certifies, to the best of its knowledge, the following: (1) All previous progress payments received from Owner on account of Work done under the Contract have been applied on account to discharge Contractor's legitimate obligations incurred in connection with the Work covered by prior Applications for Payment; (2) Title to all Work, materials and equipment incorporated in said Work, or otherwise listed in or covered by this Application for Payment, will pass to Owner at time of payment free and clear of all liens, security interests, and encumbrances (except such as are covered by a bond acceptable to Owner indemnifying Owner against any such liens, security interest, or encumbrances); and (3) All the Work covered by this Application for Payment is in accordance with the Contract Documents and is not defective; and (4) The provisions of M. S. 290.92 have been complied with and that all claims against me by reason of the Contract have been paid or satisfactorily secured. Recommended by Bolton & Menk, Inc. Name: Date: Title: Date: By: Title: By: Title: EJCDC C-620 Contractor's Application for Payment (c) 2018 National Society of Professional Engineers for EJCDC. All rights reserved. DocuSign Envelope ID: DF3F5221-0638-4457-9E09-B51913A8B7CB Ryan Sunram July 1, 2022 President PM July 1, 2022 Eric Seaburg July 1, 2022 Bryce Shearan Parks & Recreation Director