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APPLIAION AND CERTIFICATE FOR PAYMEOIA DOCUMENT G702 (Instructions on reverse side) PAGE ONE PAGES TO OWNER: Saint Anthony Village PROJECT. S A V Liquor APPLICATION NO.: 5 Distribution to: 3301 Siler Lake Road PERIOD TO: 12/31/97 ❑ OWNER St.Anthony ,MN 55418-1699 PROJECT NOS.: 97467 ARCHITECT ARCH PROJ NO: 95-08-1179 ❑ CONTRACTOR FROM CONTRACTOR: Lund Martin Construction VIA ARCHITECT: K K E Architects. Inc. CONTRACT DATE: 6/24/97 j Accounting 3023 Randolph St N E 300 First Avenue North APPLICATION DATE: 1/12/98 ❑ Minneapolis,MN 55418 Minneapolis,MN 55401-168 INVOICE NO: CONTRACT FOR: General Construction CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,infor- mation and belief the Work covered by this Application for Payment has been completed Application is made for payment, as shown below, in connection with the Contract. in accordance with the Contract Documents, that all amounts have been paid by the Continuation Sheet, AIA Document G703, is attached. -Contractor for Work for which previous.Certificates for Payment were issued and pay- 714,100.00 ments received from the Owner, and that current payment shown herein is now due. I. ORIGINAL CONTRACT SUM. . . . . . . . . . . . . ... . . .3 CONTRACTOR: Lund Martin Construction 2. Net change by Change Orders . . . . . . . . . . . . . . .S 714,100.00 _ , �� Date: January 12, 1998 3. CONTRACT SUM TO DATE (Line 1 t 2). . . . . . . .S Y 714100.00 Tom Randall- 4. TOTAL COMPLETED & STORED TO DATE . . . . . .S , State of: MN (Column G on G703) County of: Hennepin 5. RET NAGE• Subscribed and sworn to before Qy YNN R.BODENSTEINcR a. Ag /E of Completed Work $ 35,705.00 NOTARY PUBLIC-MINNESOTA 5 o me this 12 day of January. 98 (Columns D + E on G703) (� u Comm.Expires Jan.31,2000 0.00 —IC.. b. '5. % of Stored Material 8 (Column F on G703) Notary Public: Lyn Bodensteiner Total Retalnage (Line Sa + Sb or 35,705.00 My Commission expires: 1/31/00 Total in Column I of G703) . . . . . . . . . . . :. . . . .S 6. TOTAL EARNED LESS RETAINAGE. ... . . . . . . . . .S 678,395.00 ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 less Line 5 Total) LESS OWNER P.O.'s...$ 0.00 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT In accordance with the Contract Documents,based on on-site observations and the data (Line 6 from prior Certificate) . . . . . . . . . . . . ... . . .$ 503,373.65 comprising this application, the Architect certifies to the Owner that to the best of the Architect's knowledge,information and belief the Work has progressed as indicated,the 8. CURRENT PAYMENT DUE . . . . . . . . . . . . . . . . . S 175,021.35 quality of the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH, INCLUDING RETAINAGE 35,705.00 . , • ,$1$,OQ (Line 3 less Line 6) S AMOUNT CERTIFIED . . . . . . . . . . . . . . . . . . . . . . (Attach explanation if amount certified differs from the amount applied for. Initial CHANGE ORDER SUMMARY 'ADDITIONS DEDUCTIONS all figures on this Application and on the Continuation Sheet that are changed to conform to Total changes approved in previous months by Owner. See Attached(Page 3) Change Orders ARCHI'T Total approved this Month i3y: Date: I TOTALS This Certi icate is not negotiable.' he AMOUNT CERTIFIED is payable only to the Con- NET CHANGES by Change Order tractor named herein. Issuanc payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under.this Contract. A AIA DOCUMENT G702•APPLICATION AND CERTIFICATE FOR PAYMENT• IIY)2 EDITION • AIAO THE AMERICAN INS-rITt1TE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 2000&5292 • WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution. G702-1992 .. CAUTION:You should use an original AIA document which has this caution printed in red.An original assures that changes will not be obscured as may occur when documents are reproduced.