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<br />~ <br /> <br />Page.1l <br />August 6, 2001 <br />Application for Payment No. 1 <br />City of Arden Hills, Minnesota <br />ABC Project No.: 99502-2505 <br /> <br />. <br /> <br />CONTRACTOR'S CERTIFICATION: <br /> <br />The undersigned CONTRACTOR certifies (1) all previous progress payments received fro <br />OWNER on acconnt of Work done nnder the Contract referred to above have been applied t <br />discharge in full all obligations of CONTRACTOR incurred in connection with Work cover <br />prior Applications for Payment numbered 1 through 1 inclusive; and (2) title to all material <br />and equipment incorporated in said Work or otheJWise listed in or covered by this Applicati <br />for Payment will pass to OWNER at time of payment free and clear of all liens, claims, <br />security interests and encumbrances (except such as covered by Bond acceptable to OWNE <br /> <br />Champion Coatings, Inc. <br />8790 207th St. West Suite 207 <br />P.O. Box 905 <br />Lakeville, M!'l <br />./" <br />/ <br />~/ <br />BY: <br />Contra <br /> <br /> <br />DATE 8-7-0i <br /> <br />Payment of the above AMOUNT DUE TIllS APPLICATION to the above listed contractor <br />recommended. <br /> <br />. <br /> <br />ABC Engineering <br />400 First Avenue North #400 <br /> <br />:W~ <br /> <br />-DATE y:.-6'-CJ / <br /> <br />1\027E <br /> <br />. <br />