4F, Pay Application #6 from A.J. Spanjers

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1A Docu. ent G702 1992 TM Application and Cerfta:te for Payment TO OVIfItfER: City of Ards Ii118PROJECT: Arden Hills Citv Hall APPLICATION :NO!*::: Distribution to: AH-00006 1245-W-.e* st:Highway 96 1245 West Highway 96 PERIOD°T ...: 2 :. Arden mills, MN 551 I2 Arden Hills, MN 8! 12009 OWNER ❑ CONTRACT FOR: Masonry Restoration ARCHITECT Q FROM CONTRACTOR: A. J. Spanjers, Company, Inc. VIA ARCHITECT: Wiss Janney Elstner Assoc • 4/7/2048 CONTRACTOR CONTRACT DATE. El9257 West River Road Brooklyn Park, MN 55444 605 North Hwy 169 PROJECT NOS. 4-08-124 / 1 FIELD ❑ Minneapolis, MN 55441 CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document G703, is attached. 1. ORIGINAL CONTRACT SUM .. ....................:;...:....................... ......... . .::........ 2. Net change by Change orders ... ..... .... . 3. CONTRACT SUM TO DATE (Line :1: ± 2) : , .................. . . . . ............. 4. TOTAL COMPLETED & STORED TO -:DATE (Column G on G703) ...... 5. RETAINAGE: a. ty o arnpletW Work (Colunj. - :+ E on G703) $ b• J° Io of Stored Material (Column F on G703) $ Total Retainage (Lines 5a + 5b or Total in Column I of G703)....... 6. TOTAL EARNED LESS RETAINAGE.................................... (Line 4 Less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT ...................... (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE ......................., :.................... 9. BALANCE TO FINISH, INCLUDING RETAI.NAGE (Line 3 less Line 6) 203,090.00 93,487.50 296.577.50 296,577.50 $ 0.00 $ 296,577.50 $ 2819748.62 $ 14,828.88 0.00 CHANGE ORDER SUM M1 X:**RY: " ADDITIONS DEDUCTIONS Total changes apprpv.ed in previous months by Owner $ 3,487.50 $ Total approyed ,this 1 M-` nth $ $ TOTALS $ 93,487.50 $ NET CHANGES by Change Order $ . 50 OTHER The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown beret is w due. CONT . J. Sp j C y, nc Ey: Date: 8-12--09 Stai'e of: Minnesota County of: Hennepin Subscribed and sworn:to b.40,re:2 me this 12 :::dad;of ::-Aiigust 2009 uenUer sa�l�x� �rorsstwu�o Notary Public- elosauufv v 1VIy Commis x n r s: ollgnd XJeloN SS3n1E)s8a!jEj,; Pr ARCHITECT'S CERTIFICATE FOR PAYMEN-r} ilvl• In accordance with the Contract Documents, based on on -site observations and the data 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 quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNTCERTIFIED ............................................:. ....:::..................... $ (Attach explanation if amount certified diffed f rom:: 'lie amount applied. Initial all figures on this Application and on the Continuation Sheet .thczt are changed to conform with the amount certified.) 'Slv�iss Janney Elstn °`Assoc K � By: :. Date:SAO/017 This Certific to ' ,. I � The AMOUNT CERTIFIED is payable only to the Contractor named herein.�'I.��tance; payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. CAUTION: You should sign an original AIA Contract Document, on which this text appears in ICED. An original assures that changes will not be obscured AIA Document G702TM--1992. Copyright 0 1953, 1953, 1965, 1971, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and Inrternational Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of It, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel, copyright0aia.org.