CC PACKET 09241996 - Laserfiche WebLink

Home Browse Search

APPLICATION AND CERTIFICATE FOR PAYMENT AIA Document MWR): City Of St. Anthony PROJECT: ST. ANTHONY COMMUNITY CENTER APPLICATION NO: 8 DISTRIBUTION TO: 3301 Silver Lake Rd. ASR St. Anthony, MN 55418 PERIOD TO: 8/31/96 ARCHITECT _CONTRACTOR FROM (CONT): GRAUS CONSTRUCTION VIA (ARCHITECT): Williams/O'Brien Assoc. ARCHITECT'S 360 HIGHWAY 61 N. PROJECT NO: HASTINGS, MN 55033 CONTRACT FOR: General Construction CONTRACT DATE: 10/24/95 Application is made for Payment, as shown below, in connection CONTRACTOR'S APPLICATION FOR PAYMENT with the contract. Continuation Sheet is attached. ICHANGE ORDER SUMMARY 1 1. ORIGINAL CONTRACT SUM ........................ S 3151900.00 1 -- - -- 1 2. Net Change by Mange Orders .................. t 108471.00 (Change Orders approved in I ADDITIONS I DEDUCTIONS 1 3. CONTRACT SUM TO DATE ..........................1 3260371.00 (previous months by owner I I 1 4. TOTAL_ COMPLETED b STORED TO DATE ............. S 1724834.00 I TOTAL 1 88103.00 1 1 (Column 6 ) 1-- - --- 1 5._ RETAINAGE: (Approved this Month I I I a. _ 5.00 %'of Completed Work 1 82591.70 I (Column D+E ) (Number IDate Approved I I I b.. 5.00 % of Stored Material f 3650.00 SEE ATTACHED CHANGE ORDER REPORT faf I (Column F) I I I 1 I Total Retainage (Line 5a+5b) or I --- --- I (Total in Column I) ...................... E 86241.70 1� TOTALS i 20368.00 1 1 6. TOTAL EARNED LESS RETAINACE .................. S 1638592.30 I -- 1 (Line 4 less Line 5 Total) INet Change by Change Orders f; 108471.00 1 7. LESS PREVIOUS CERTIFICATES FOR I — - — — —1 PAYMENT (Line 6 from prior Certificate) .. 1 997484.80 The undersigned Contractor certifies that to the best of the Con- 8. CURRENT PAYMENT DUE .......................... 1 641107.50 tractor's knowledge, information, and belief the Work covered by 9. BALANCE TO FINISH, PLUS RETAINAGE .............S 1621778.70 this Application for Payment has been completed in accordance with (Line 3 less Line 6) the Contract Documents, that all amounts have been paid by the Con- tractor for Work for which previous Certificates for Payment were �� PAMBAKSCHM 4 issued and payments received from the Owner, and that current pay- ; sent shown herein is now due. CONTRACTOR:GRAUS CONST ION State of: P) N County of: s )AKO 4 Q Subscribed and qrn-to_b`eforee me this y day ofSEp4,1946 . 19Z Notary Public:V'�^�.By. Date: / My Commission expires: �.�.�, ',) ajpp - -- — -- --- ---------- — --- AMOUNT CERTIFIED ............................... A R C H I T E C T'S C E R T I F C A T E F O R P A Y M E N T (Attach explanation if amount certified differs from the amount ap lied for.) In accordance with the Contract Documents, based on on-site observe-?ayable lli s/O'Br' n Assoc. ations and the data comprising the above application, the Architect C��,, certifies to the Owner that to the best of the Architect's know- Date:' 1 information, and belief the Work has progressed as indicated, icate is of negotiable. The AMOUNT CERTIFIED is t lity of the Work is in accordance with the Contract Documents, y to the Contractor named herein. Issuance, pay- and the Contractor is entitled to payment of the AMOUNT CERTIFIED. ceptance of payment are without prejudice to any rights of the Owner or Contractor under this contract.