CC PACKET 01281997 - Laserfiche WebLink

Home Browse Search

e APPLICATION AND CERTIFICATE FOR PAYMENT AIR Document TO (OWNER): City Of St. Anthony PROJECT: ST. ANTHONY COMMUNITY CENTER APPLICATION NO: 13 DISTRIBUTION TO: 3301 Silver Lake Rd. —OWNER St. Anthony, M 55418 PERIOD TO: 12/31/96 ARCHITECT _CONTRACTOR FROM (CONT): 6RAUS 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 C0NTRA.CT0RIS APPLICATION FOR PAYMENT with the contract, Continuation Sheet is attached. ---------- --------------------------------------- I CHANGE --ICHANGE ORDER SUMMARY 1 1. ORIGINAL CONTRACT SUM ........................ 1 31519«.00 I---------------------------------------------------------1 2. Net Change by Change Orders .................. t 119114.0+0 (Change Orders approved in I ADDITIONS I DEDUCTIONS 1 3. CONTRACT.SUM TO DATE ..........................$ 3271@14.00 (previous months by owner . I 1 1 4. TOTAL COMPLETED b STORED TO DATE ............. t 3218239.00 I TOTAL 1 119114.00 1 I (Column 6 ) I------------------------------------------------------------1 5. RETAINAGE: (Approved this Month I I I a. 5.00 % of Completed Work $160,%1.95 1— —_--------------I I I (Column D+E ) (Number (Date Approved I I I b, 5.00 % of Stored Material f .90 I I I I I (Column F) 1 I I I 1 Total Retainage (Line 5a+5b) or. I— -----------------------------I (Total in Column I) ....................... $160,911.95 1 TOTALS I I 1 6. TOTAL EARNED LESS RETAINAGE .................. $3,057,327.05 ------------------- ---------------------------------I (Line 4 less Line 5 Total) INet Change by Change Orders $ 119114.00 1 7. LESS PREVIOUS CERTIFICATES FOR I---------------------------------------------------I PAYMENT (Line 6 from prior Certificate) .. $ 273'4498,05 The undersigned Contractor certifies that to the best of the Con- B. CURRENT PAYMENT DUE .........................: $ 322,829.00 tractor's knowledge, information, and belief the Work covered by 9. BALANCE TO FINISH, PLUS RETAINAGE .............$ 213,686.95 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 :.,;`, PAMELA M.SCHMITT issued and payments received from the Owner, and that current pay- C-MINNESOTA 68tTIfiY-------- ------------------- sent shown herein is now due. -- - - ---CaentlssMEVIresJK31,2000 CONTRACTOR:GRAUS CONSTRUCT State of:�N �t p County of: _31L Subscribed a orn to before me this,t1 day of Tq�v ,19 4ti Notary Public . �u'v — By: Date. Y 7`r My Commission expires-- 31, 'acxa -------------- --- ------- ---------- -- ------------------------------------- --------------------------------- AMOUNT CERTIFIED ............................... $ 3Z0$ZY•(Jo A R C H I T E C T'S C E R T I F I C A T E F O R P A Y M E N T (Attach explanation if amount certified differs from the amount applied for.) In accordance with the Contract Documents, based on on-site observa- ARCHITECT: illiass/O'Brien Assoc ations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's know By: ate: /-/"M7 ledge, information, and belief the Work has progressed as indicated, Thi rtificate is not negotiable. The AMOUNT CERTIFIED is the quality of the Work is in accordance with the Contract Documents, p le only to the Contractor named herein. Issuance, pay- and the Contractor is entitled to payment of the AMOUNT CERTIFIED. m and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this contract.