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APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT 6702 (Instructions on reverse side PAGE ONE OF PAGES TO OWNER: City of St Anthony Village PROJECT: Central Park APPLICATION NO.: 1 Distribution to: Water Tower Playground Improvements PERIOD TO: 6-13-99 ❑OWNER PROJECT NOS.: ❑ARCHITECT ❑CONTRACTOR FROM CONTRACTOR: Arrigoni Brothers Company %IA .ARCHITECT: Augie Wong CONTRACT D.%.TE: ❑ 817 Vandalia St , BRW, Inc St Paul MN 55114 700 3rd St So CON-1 R U:T FOR Mpls MN 55415 I'hr Out u t the 1•c,t of the Contractor,knowledge.infor- CONTRACTOR'S APPLICATION FOR PAYMENT niatiun and hclief the NVork co\•cred h\ thl,.1ppl:._auon for Payment his been completed Application is made fin pavment. as shown below, in connection nith the Contract. in accordance with the Contract Documents. that all amounts have been paid by the Continuation �,hect. AIA Document G-03, is attached. Contractor for Work for which prc\-ious Certititates for Payment were issued and pay- tnents received from the Owner. and that current payment shown herein is now due. 1. ORIGINAL CONTRACT SUM. . . . . . . ... . . . . . . . . .S 265,662.00 CONTRACTOR: ARR NI BROTHERS COMPANY 2. Net change by Change Orders . . . . . . . . . . . . . . .S —0— (� 3. CONTRACT SUM TO DATE (Line 1 t 2). . . . . . . .s 265,662.00 B%-:�/ Date: 6-14-99 4. TOTAL COMPLETED & STORED TO DATE . . . . . .s 32,130.00 State of: Minnesota (Column G on G-03) County of: Ramsey 5. RETAINAGE• Subscribed and sworn to before WONEKAWEN a. 5 % of Completed %cork s 1.606.50 me this 14 day of June 1999 RAMSEYCOUNIY (Columns D + E on G,03) Y/ConLnibL wAM31.= b. % of Stored Material s (Column F on G-03) Nota ' Public: Total Reuinage (Line is + ib or My Commission expires: Total in Column I of G'03) . . . . . . . . . . . . . . . . .s 1,606.50 6. TOTAL EARNED LESS RETAINAGE. . . . . . . . . . . .s 30 523.50 ARCHITECT'S CERTIFICATE FOR PAYMENT (Line i less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT In accordance with the Contract Documents,based on on-site observations and the data Line 6 from US Certificate s —0 comprising this application, the Architect certifies to the Owner that to the best of the l p ) . . . . . . . . . . . . . . . . . Architect's knowledge,information and belief the Work has progressed as indicated,the 8. CURRENT PAYMENT DUE . . . . . . . . . . . . . . . . .1 s 30,523.50 quality of the Work is in accordance with the Contract Documents,and the Contractor is entitled to pavmeni of the AMOUNT CERTIFIED. 1 9. BALANCE TO FINISH, INCLUDING RETAINAGE 235,138.50 AMOUNT CERTIFIED . . . . . . . . . . . . . . . . . . . . .. . . .. . . . . .s 301 19 1 2 A•150 (Line 3 less Line 6) f (Attach explanation if amount certified differs from the amount applied for. Initial CHANGE ORDER SUMMARY ADDITIONS I DEDUCTIONS al!figures on this Application and on the Continuation Sheet that are changed to Total changes approved in conform to the amount cgrtified.) previous months by Owner ARCHI CT• /' • ��+ • �Q Total approved [his Month By: Date: TOTALS This Cert no[negotiable.The O NT CERTIFIED is payable only to the Con- tr2etor nrein. Issuance, paymeWt and acceptance of payment are without NET CHANGES by Change Ordcri prejudice to any rights of the Owner or.Contractor under this Contract. '4�!� ALA DOCUMENT 6702•APPUCATION AND CERTIFICATE FOR PAYMENT• 1992 EDITION•AIA* • ©1992 •THE.%.%tERICAN INSTITUTE OF ARCHITECTS. 1'•35 NEW YORK G702-1992 114 IXENI'E. N\r•. WASHINGTON. DC. 2OMxKs5292 • WARNING: Unlicensed photocopAV vlolatas 11S eopyrLyht Laws sM wl� � �� r p