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APPLICATION .AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 (instructions on reverse side) PAGE ONE of 2 PAGES TO OWNER: Saint Anthony Village PROJECT: S A V Liquor APPLICATION NO.: 3 Distribution-to: 3301 Silir Lake Road PERIOD TO: 9/30/97 ❑ OWNER St.Anthony ,MN 55418-1699 PROJECT NOS.: 97467 [ARCHITECT ARCH PROJ NO: 95-08-1179 F-1 CONTRACTOR FROM CONTRACTOR: Lund Martin Construction VIA ARCHITECT: K K E Architects. Inc. CONTRACT DATE: 6/24/97 EJ Accounting 3023 Randolph St N E 300 First Avenue North APPLICATION DATE: 10/1/97 ❑ 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. 1. ORIGINAL CONTRACT SUM. . . . . . . . . . . . . . . . . .8 CONTRACTOR: Lund Martin Construction 2. Net change by Change Orders . . . . . . . . . . . . . . .8 714,100.00 October 7, 1997 3. CONTRACT SUM TO DATE (Line 1 t 2). . . . . . . .S By Date: 4. TOTAL COMPLETED & STORED TO DATE . . . . . .8 State of: MN rl Bozicevich (Column G on G703) County of: �iv\ ■ l,r,nhw 5. RETAINAGE: . I it(01 Subscribed and sworn to before, October 97 LYNN R.BODENS i EINER a. % of Completed Work 8 me this day of NOTARY PUBLIC-MINNESOTA (Colyumns D + E on G703) 0.00 ■ MY COMM Expires Jan.31,2000 b. % of Stored Material 8 ■ (Column F on G703) Notary Public C Total Retainage (Line 5a + 5b or My Commission exp s: 1 (3l ar7�0 Total in Column I of G703) . . . . . . . . . . . . . . . . .8 6. TOTAL EARNED LESS RETAINAGE. . . . . . . . . . . .8 /207'g° ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 less Line 5 Total) LESS OWNER P.O:s....$ 0.00 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 148,507.80 In accordance with the Contract Documents,based on on-site observations and the data Line 6 from 8 comprising this application, the Architect certifies to the Owner that to the best of the (Line Certificate) ' ' ' ' ' Architect's knowledge,information and belief the Work has progressed as indicated,the 8. CURRENT PAYMENT DUE . . . . . . . . . . . . . . . . .1 8 16017M 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 469;88'2'26'¢�j��{?i (Line 3 less Line 6) 8 AMOUNT CERTIFIED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .804/ 70Q (Attach explanation if amount certified differs from the amount applied for. Initial CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS all figures on this Aplplicatio i nd on the Continuation Sheet that are changed to Total changes approved in See Attached(Page 3)-Change Orders "conform to th a nt certif a .) previous months by Owner ARCHITEC o �� Total approved this Month By: Date: TOTALS This Cer ficate is not negotiable. he AMOUNT CERTIFIED is payable only to the Con- NET CHANGES by Change Order tractor named herein. Issuanc , pa yment and acceptance of payment are without prejudice to any rights of the wner or Contractor under this Contract. ` AIA DOCUMENT G702•APPLICATION AND CERTIFICATE FOR PAYMENT• 1992 EDITION•AIA® • ©1992 •THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK g - AVENUE, N.W., WASHINGTON, D.C. 20006-5292 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.