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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.: 4. Distribution to: 3301 Siler Lake Road PERIOD TO: 10/31/97 ❑ OWNER St.Anthony ,MN 55418-1699 PROJECT NOS.: 97467 [1 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 [1 Accounting 3023 Randolph St N E 300 First Avenue North APPLICATION DATE: 11/1/97 ❑ 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- 1. ORIGINAL CONTRACT SUM. . . . . . . . . . . . . . . . . .8 714,100.00 ments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: Lund Martin Construction 2. Net change by Change Orders . . . . . . . . ... . . . . .8 3. CONTRACT SUM TO DATE (Line 1 t 2). . . . . . . .8 714,100.00 a�. •�,4�t� Date: November 1, 1997 By: 4. TOTAL COMPLETED & STORED TO DATE . . . . . .8 5861 `State of: MN Tom Randall (Column G on G703) County of: . Hennepin 5. RETAINAGE: 3S Subscribed and sworn to before a. % of Completed Work 8 - me this 1 day of November 97 (Columns D + Eon G703) 0.00 �Lynodens b. 5 % of Stored Material 8(Column F on G703) Notary Public: iner LYNN R.BODENo 1._i:.',: , Total Retainage (Line 5a + 5b or �6•;999.ee 6�4q3. S My Commission expires: 1131/00 NOTARY PUBLIC-MINNESOTA Total in Column I of G703) . . . . :. . . . . . . . . . . .8 3 40, Comm.Ex Tres Jan.31 2000 6. TOTAL EARNED LESS RETAINAGE. . . . . . . . . . . .$ So3�373kS ARCHITECT S CERTIFICATE FOR PAYMENT (Line 4 less Line 5 Total) LESS OWNER P.O.'s...$ 0.00 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT a'2 '(6�a5 In accordance with the Contract Documents,based on on-site observations and the data (Line 6 from prior Certificate) . . . . . . . . . . . . . . . . . i 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 . . . . . . . . . . . . . . . . . 8 a44r,4 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 -257+ C (Line 3 less Line 6) 8 ��e V 0�7�6.35 AMOUNT CERTIFIED . . . . . .•. . . . . . . . . . . . . . . . . . . . . . . . .8 (67.0 (Attach expla� tion if amount certified differs from the amount applied for. Initial CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS all figur r t i Applicati and on the Continuation Sheet that are changed to con on t he urt ce t ed. Total changes approved in See Attached(Page 3) Change Orders ARC E f ) previous months by Owner ' Total approved this Month By: Date: TOTALS This Certificate is not negotJeOwner e.The AMOUNT CERTIFIED is payable only to the Con- NET CHANGES by Change Order s tractor named herein. Issu e, payment and acceptance of payment are without prejudice to any righ of t or Contractor under this Contract. AllAIA DOCUMENT G702•APPLICATION AND CERTIFICAT.W. E,FOR PAYMENT• 1992 EDITION •AIA° • ©1992 •THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N , WASHINGTON, D.C. 2000X-5292 • WARNING: Unlicensed photocopying violates US. copyright laws and will subject the violator to legal prosecution. G702-1992 y: 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.