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_/ a AUu 0 3 1999 APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 (Instructions on reverse side) PAGE ONE OF PAGES TO OWNER: City of St Anthony Village PROJECT: Central Park APPLICATION NO.: 3 Distribution to: Water Tower Playground Improvements PERIOD TO: 7-30-99 ❑ OWNER. PROJECT NOS.: ❑ ARCHITECT ❑ CONTRACTOR FROM CONTRACTOR: Arrigoni Brothers Company VIA ARCHITECT: Augie Wong CONTRACT DATE: ❑ 817 Vandalia St BRW, Inc ❑ St Paul MN 55114 700 3rd St So CON rl:Vr.T F >R. Mpls MN 55415 Hie undcrnigncd Ointractor ccrtitics that u)the hcm of the Gmtraculr s knmyledge, infor- CONTRACTOR'S APPLICATION FOR PAYMENT ntatiOn and hchct the �Citrk covered h% this Applicanon for Payment his been completed :lpplicauon is m.Ide fur pa%-ment, as shown below, in connection %%ith the Contract. in accordance with the Contract Documents, that all amounts have been paid by the Continuation sheet, AIA Document G-03, is attached. Contractor for Work for which previous Certificates for Payment were issued and pay- ments received trom the Owner. :tnd that current payment shown herein is now due. Net change by Change Orders . . . . . . . . . . . . . . .s -0- CONTRACTOR: A R I BROTHERS COMPANY 3. CONTRACT SUM TO DATE (Line I t 2). . . . . . . .3 265,662.00 By: ��--- Da1e: 8-2-99 �,1, ^^ state of: Minnesota -4. TOTAL COMPLETED & STORED TO DATE . . . . . .S «;�� (Column G on G-03) � � ��.�..t��.��..,, County of: Ramsey 5. RETAINAGE• 199+- � Subscribed and sworn to before a. 5 % of Completed Work f -'- -*?11•� ra,QS7 me this 2 day of August 1999 ItlOtoty M•�� (Columns D + E on G703) �EYCO(pgy b. % of Stored Material S _ j0rL3j•2= (Column F on G,03) Notary Public: Total Retainage (Line 5a + 5b or r 0 My Commission expires: Total in Column 1 of G703) . . . . . . . . . . . . . . . . .S ; 7 6. TOTAL EARNED LESS RETAINAGE. . . . . . . . . . . .S ; -2D8��3��`T ARCHITECT'S CE, RTIFICATE FOR PAYMENT (Line i less Line 5 Total) a-}$-e16 -49-71tti1 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT In accordance with the Contract Documents,based on on site observations and the data (Line 6 from prior s 145 690.10 comprising this application, the Architect certifies to the Owner that to the best of the rior Certificate) . . . . . . . . . . . . . . . . . Architect's knowledge,information and belief the Work has progressed as indicated,the 8. CURRENT PAYMENT DUE . . . . . . . . . . . . . . . . . E 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 , (Line 3 less Line 6) AMOUNT CERTIFIED . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .f _ (Attach explanation if amount certified differs from the amount applied for. Initial CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS all figures on this Application and on a Continuation Sheet that are changed to Total changes approved in cunfor to the anJOrcnt certified.) previous months by Owner ARCHI Q S. Total approved this Month By: Date: GG]] TOTALS This Ce ificate i not negotiabl The AMO NT CERTIFIED is pay le my to the Con- NET CHANGES by Change Order tractor n ed erein. Issuance, aymen and acceptance of payment are without prejudice to y rights of the Own ontractor under this Contract. AIA DOCUMENT G'702•APPLICATION AND CERTIFICATE FOR PAYMENT• 1992 EDITION•ALA* • ©1992 - THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK `\';1 AVENUE. N.W. WASHINGTON. D.C. 24")&5292 • WARNING: UntkensW photocopying vloWn U.S. eopyrlgta laws and wN subject tits violator to legal pros—dklm G702-1992 _1 0