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4.3. SR 09-16-2019 EGty1� ,.,�� Request for Action River To Item Number Mayor and City Council 4.3 Agenda Section Meeting Date Prepared by Consent September 16, 2019 jenna Fabish P.E.,Assistant City Engineer Item Description Reviewed by Pay Estimates Justin Femrite P.E.,Public Works Director Reviewed by Cal Portner, City Administrator Action Requested Approve,by motion, the pay estimates detailed below. Background/Discussion The following pay estimates have been reviewed and found to be accurate and in accordance with the approved contracts. Financial Impact PROJECT Pay Est. # Contractor Amount Multipurpose Facility& Lions Park 2-Partial RJM Construction LLC $924,464.24 Lions Park Drive Storm Sewer 1-Final Metro Utilities,Inc. $18,600 Attachments ■ Pay Estimates The Elk River Vision A PehoMing community 2a itb revolutionary and spirited resourcefulness, exceptional POWERED By service, and community engagement that encourages and inspires prosperity INAMIRE1 ,OrAIA Document G702'M -1992 Cir:y of Elk River ,Pul;e Works Director Date Lo' Application and Certificate for Payment $25.772'257.00 Code: 607-4-9310-4409 $0,00 TO OWNER: City of Elk River PROJECT: Elk River Multi -Purpose Facility and APPLICATION NO: 002 - 9520003302 DistribuUmn to: Attn: Justin Femrite Lion John Weicht Park PERIOD T0: August 31, 2019 OWNER: 13065 Orono Parkway 1000 Schools Street NW $0.00 (Column F on G703) Elk River, MN 55330 Elk River, MN 55330 CONTRACT FOR: General Construction ARCHITECT: ❑ FROM RIM Construction VIA CONTRACT DATE: CONTRACTOR: ❑ CONTRACTOR: 830 Boone Avenue North ARCHITECT: 292 Design Group, Inc. PROJECT NOS: / 1 Golden Vallcy, MN 55427 3533 East Lake Street FIELD: ❑ Minneapolis, MN 55406 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...».»»„....»».........„...»...............„.....».„...„.„„....» $25.772'257.00 2 NET CHANGE BY CHANGE ORDERS .„.»,.„.„..„»„.„„.....„„„,„ ................ ,,,„„. $0,00 3. CONTRACT SUM TO DATE (Line 1 + 2) ..„ ........................................»„....„»,.. $25,772,257.00 C TOTAL COMPLETED & STORED TO DATE (Column G on G703) ...»»....„.. $1,398,353.07 & RETAINAGE: $0.00 a. 3.14 % of Completed Work $0. (Column D + E on G703) $43,972.42 b. 0 % of Stored Material $0.00 (Column F on G703) $0.00 Total Retainage (Lines 5a + 5b or Total in Column i of G703) ...».....».„». $43,972.42 6. TOTAL EARNED LESS RETAINAGE „,„,„„,,,.,,,„..„...„..„,,.,. ...... .... „.... $1,354,380.65 (Linc 4 Less Line 5 Total) T. LESS PREVIOUS CERTIFICATES FOR PAYMENT .... ........... „................ .......„„ $429,916.41 (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE........................................................................ $924,464.24 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) 524,417,876.35 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner $0. 50.00 Total approved this Month $0.0 $0.00 TOTALS $0. NET CHANGES by Change Order $0.00 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 a Owner, and that current payment shown herein is now due. CONTRACTOR: By: Date: .19 State of. Minneso County of 4Q?�In Subscribed aq4sworn to methis -day of fS_�-�. 9D I J ERIN M, CROCKER Notary Public: Notary PtibThsMInnescia ARCHITECT'S CERTIFICATE FOR PAYMENT 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. AMOUNT CERTIFIED ...»..».„... »„».„»..„.......».»„„.„„»„„„„ „„„..„....„.. „ $924.464.24 (Attach explanation if amount certified d Pers from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) ARCHITECT: By:. it, I Y M� Date: This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. AIA Document 6702*” —1992. Copyright ®1953, 1963, 1965, 1971, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIAe Document Is protected by U.S. Copyright Law and Intemational Treaties. Unauthorized reproduction or distribution of this AIAe 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. This document was produced by AIA software at 09:16.47 ET on 08/30/2019 under Order No. 6898725545 which expires on 0810812020, and is not for resale. User Notes: (MADAM) CONTINUATION SHEET Page 2of3 Application and Certification for Payment, containing (u+t+J- Application No.: 2 Contractor's signed certification is attached. 1 Elk River Multi -Purpose Facility and Application Date : 08130/19 In tabulations below, amounts are stated to the nearest dollar. 0.00 0.00 0.00% 0.00 Use Column I on Contracts where variable retainage for line items may apply. Lion John Weicht Park To: 08131119 Architect's Project No.: Invoice #: 9520003302 Contract: 19520.0033 Elk River Multi -Purpose Facility and Lion John Weicht Park 1A Final Cleaning A B C D E F G 0.00 H I Item Description of Work Scheduled Work Completed Materials Total % Balance Retainage No. Value From Previous This Period Presently i Completed (G 1 C) To Finish 2A Building Demolition Application In Place Stored and Stored 154,890.00 (C -G) 154,890.00 86.58% (D+E) To Date 2B Selective Demolition (Not in u ort) (u+t+J- 1 Elk River Multi -Purpose Facility and 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 Lion John Weicht Park 1A Final Cleaning 80,651.00 0.00 0.00 0.00 0.00 0.00% 80,651.00:1 0.00 1 B Survey 41,280.00 0.00 0.00 0.00 0.00 0.00% 41,280.00. 0.00 2A Building Demolition 178,890.00 0.00 154,890.00 0.00 154,890.00 86.58% 24,000.00 7,744.50 2B Selective Demolition 223,800.00 0.00 0.00 0.00 0.00 0.00% 223,800.00 0.00 3C Concrete Floor Finishes 104,390.00 0.00 0.00 0.00 0.00 0.00% 104,390.00 0.00 4A Masonry Systems 2,935,000.00 0.00 0.00. 0.00 0.00 0.00% 2,935,000.00 0.00 5A Structural Material 1,308,353.00 0.00 75,000.00 0.00 75,000.00 5.73% 1,233,353.00 3,750.00 5B Structural Labor 435,750.00 0.00 0.00 0.00 0.00 0.00% 435,750.00 0.00 6A Carpentry 1,300,000.00 458.61 1,272.60 0.00, 1,731.21 0.13% 1,298,268.79. 86.56 7A Waterproofing &WB 39,630.00 0.00 0.00 0.00 0.00 0.00% 39,630.00: 0.00 7B Roofing Systems 1 1,020,690.00 0.00 0.00 0.001 0.00 0.00%! 1,020,690.00 0.00 7C Metal Wall Panel 202,415.00 0.00 0.00 0.00 0.00 0.00% 202,415.00 0.00 8A Aluminum Entrances/Storefronts 601,000.00 0.00 0.00 0.00: 0.00 0.00% 601,000.00 0.00 8B Overhead Coiling and Sectional 61,760.00 0.00 0.00 0.00 0.00 0.00% 61,760.00 0.00 Doors 9A Gypsum Board 309,300.00; 0.00 0.00 0.00 0.00 0.00% 309,300.00. 0.00 9B Tiling 155,980.00: 0.00 0.00 0.00 0.00 0.00% 155,980.00 0.00 9C Acoustical Ceilings 149,410.00 0.00 2,250.00 0.00 2,250.00 1.51% 147,160.00 112.50 9D Flooring ! 103,900.001 0.001 0.00 0.00 0.00 0.00% 103,900.00 0.00 9E Painting 412,750.00 0.001 5,000.00 0.00 5,000.00 1.21% 407,750.00 250.00 10A Signage 50,340.00 0.00. 0.00 0.00 0.00 0.00% 50,340.00 0.00 11A Athletic Equipment 133,955.00 0.00 0.00 0.00 0.00 0.00% 133,955.00 • 0.00 11B Concessions 101,740.00 0.00 0.00 0.00 0.00 0.00% 101,740.00: 0.00 12A Roller Shades 27,886.00 0.00 0.00 0.00 0.00 0.00% 27,886.00 0.00 13B Ice Rink Systems 2,162,742.00 0.00 175,000.00 0.00 175,000.00 8.09% 1,987,742.00 8,750.00 13C Leg Truss System 125,797.00 0.00 0.00 0.00 0.00 0.00% 125,797.00 0.00 14A Elevators79,500.00 ; 0.00 0.00 1 0.00 0.00 0.00% 79,500.00 0.00 21A Fire Protection 256,485.00 0.00 8,788.50 1 0.00 8,788.50 3.43% 247,696.50 439.43 22A Plumbing Systems 1,206,000.00 0.00 31,333.00: 0.00 31,333.00 2.60% 1,174,667.00 1,566.65 23A HVAC 1,783,692.93 0.00 27,500.00 0.00 27,500.00 1.54% 1,756,192.93 1,375.00 26A Electrical Systems 1,786,914.00 0.00. 0.00 0.0011 0.00 0.00% 1,786,914.00 0.00 31A Multipurpose Earthwork 572,787.00. 6,990.00 36,182.00 0.001 43,172.00 7.54% 529,615.00 2,158.60 CONTINUATION SHEET 502,200.00 0.00 0.00 0.00 0.001 0.00% 502,200.00 Asphalt Paving 324,100.00€ 0.00 Page 3of3 Application and Certification for Payment, containing 0.00 0.00% 324,100.00 Application No.: 2 Contractor's signed certification is attached. 10,304.00 0.00 10,304.00 Application Date : 08130119 In tabulations below, amounts are stated to the nearest dollar. 39,800.00 0.00 0.00 To: 08131119 Use Column I on Contracts where variable retainage for line items may apply. 39,800.00 Lions Landscaping 96,500.00 0.00 0.00 0.00 0.00 0.00% Architects Project No.: 126,918.001 Invoice #: 9520003302 Contract: 19520.0033 Elk River Multi -Purpose Facility and Lion John Welcht Park 0.00 0.00 0.00 A B C D E F G 319,080.00 H ! Item Description of Work Scheduled Work Completed Materials Total % Balance Retainage No. Value From Previous This Period Presently Completed (G / C) To Finish 0.00 0.00 Application In Place Stored and Stored Precast Raker/Plank/Stadia 1,013,283.00. (C -G) 0.00 0.00 (D+E) 0.00% To Date General Conditions/Requirements 1,036,794.00 95,832.51 31B 32A 32B 32C 32D 32E 33A 36.1 3B.2 3B.3 01-00 90-50 90-60 90-70 90-80 99-99 Lions Earthwork 502,200.00 0.00 0.00 0.00 0.001 0.00% 502,200.00 Asphalt Paving 324,100.00€ 0.00 0.00 0.00 0.00 0.00% 324,100.00 Concrete/Sidewalk/Curb/Gutter 387,400.001 0.00 10,304.00 0.00 10,304.00 2.66% 377,096.00 Multipurpose Landscaping 39,800.00 0.00 0.00 0.00 0.00 0.00% 39,800.00 Lions Landscaping 96,500.00 0.00 0.00 0.00 0.00 0.00% 96,500.00 Chain Link Fence 126,918.001 0.00 0.00 0.00 0.00 0.00% 126,918.00 Utilities 586,000.00; 0.00 319,080.00 0.00 319,080.00 54.45% 266,920.00 Precast Concrete 1,190,000.00: 0.00 0.00 0.00 0.00 0.00% 1,190,000.00 Precast Concrete 925,000.00': 0.00 0.00 0.00 0.00 0.00% 925,000.00 Precast Raker/Plank/Stadia 1,013,283.00. 0.00 0.00 0.00 0.00 0.00% 1,013,283.00 General Conditions/Requirements 1,036,794.00 95,832.51 103,496.21 0.00 199,328.72 19.23% 837,465.28 General Liability Insurance 257,723.00 257,723.00 0.00 0.00 257,723.00 100.000/0 0.00 Construction Contingency 965,543.07 0.00 0.00 0.00 0.00 0.00% 965,543.07 Value Engineering -161,771.00 0.00 0.00 0.00 0.00 0.00% -161,771.00 Builders Risk Insurance 61,853.00 61,853.00 0.00 0.00 61,853.00 100.00% 0.00 Contractors Fee 468,126.00 7,822.86 17,576.78 0.00 25,399.64 5.43% 442,726.36 Grand Totals 125,772,257.00 967 0.00 1 1 0.00 0.00 515.20 0.00 0.00 0.00 15,954.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,269.98 5.43% 24,373,903.93 43,972.42 W C.) 0� � � ] 0 V / § a ° m o % a d _ ; £ 2 � co § 2 E ) % J G ( © k \ © 2 La u ] § m _ / / 2 2 J \ r ) 7 ~°~ f k k ) K 2 LL G m a QLLI i k A ! 2 / 2 2 a R q@ g S S m 8 S m 8 8 E m a 2 C) s ; n w . a o d 06 \ k P- � � Lr) Ci � C�i k § V) » a _ / / LS � ° ° _ a R R 2 £ 3 a d ; £ 2 � co ) _ m _ U CN } 7 ~°~ f k k ) 8 2 LL LU � � A m 2 § k d s a « ° f o 2 j g « 0 § 2 §E §/ ■ § § E k§ k § £ » § 2 § k � 8 t � Jz § k ) & § ( C ) f a I k C ) e k m �_ -) m m£ o ■ A �� ƒ (n a k% ƒ 2f k 0 a § CL . / « & § E CO LUj ■ Lo 2 2 G § 2 a / / $ / 3 d ; £ 2 � ) _ m _ U / } f k ) 8 2 LL 2 � � A 3 d ; £ 2 � ) } f k ) 2 LL m 2 § § 2 / d 8IMO ° f o 2 j 0 § 2 §E §/ ■ § § E k§ k § £ » 2 § 2 § k � 8 t � Jz § k A § ( C k§ k a I k C ) e k m �_ -) m m£ o ■ A �� ƒ (n a k% ƒ 2f 0 0 a § . / « & E CO § U C 0 C C7 O z O C p ffl coo N N ,Z g N 7 m .0 q (9U( O (p M 09O v94i d E x U Cl) L C w Q y m C a (O w O M 0 z n c C x W O p M O a p i O O (- O O O O H d 0 C E a O U C m x 4f U °a N C C Z 0 E C) a E % c FL co -O 9 Q x C/) m O O O O O c O O p M O a p O O O (- O O O O O 0 m N O a O N0 N O O p c O O p c C O O O O O p m O O O O � L � � N O co ad U y ¢� D Cl) M rj 9 C O C C, Ea N {V N F� -_ N a aLoO U Q N cm o p ui 0 O 00 M M a9 O O O U OD G N a O O M O O C CO C aD W m f0 N N v A n S M M c) N N N d a 'LD '9 0 Z a` a` a 2 — M 4 M (O p ON Cl) N N M M p r O M {�+' N M CO M r M H d 0 C E a O U C m x 4f U °a N C C Z 0 E C) a E % c FL co -O 9 Q x C/) m O O N O c Cl) M O 7 m (- a o a O1 a X N W LO W C W c 3 > 'evi U c C c N y c 7 N N O1 a t� c 3 > 'evi U c N y z m H c O r U WD U y ¢� D ai :2� U c � U ci � � 9 C O a a � Ea COL � � � F. y F� -_ N F. 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O :° N O m N U 00� N U) m� N �� N Q N 0 CL mwaly N N N m 0: N E Q Q Q V W Meq M 0) N to f0 O) Of r N N N M M M O 0) N APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER -ADVISER EDITION AIA DOCUMENT G702/CMA PAGE ONE OF PAGES TO RIM Construction PROJECT: Elk River Ice Arena OWNER: Attn: Demolition 830 Boone Ave N APPLICATION NO_: 19066.01 PERIOD TO: 8131/2019 Distribution to: OWNER CONSTRUCTION MANAGER Golden Valley, MN 55427 FROM Rachel Contracting, Inc CONTRACTOR: 4125 Napier Court NE CONTRACT DATE: 7/10/2019 ARCHITECT CONTRACTOR St Michael, MN 55376 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 .................................. The undersigned Contractor certifes that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Paymenthas been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Cerificates for payment were issued $ 178,890.00 and payments received from Owner, and that current payment shown herein is now due. 3. CONTRACT SUM TO DATE (bine 1+-2) ................ $ 178,890,00 4, TOTAL COMPLETED & STORED TO DATE ................... $154,890.00 (Column G on G703) S. RETAINAGE: a. 5 % of Completed Work (Columns D a E on 6703) b. % of Stored Material (Columns F on G703) Total Retainage (line 5a + 5b or Total in Column I of G703)...... S 7,744.50 .••••.•.•• $ 7,744.50 6. TOTAL EARNED LESS RETAINAGE ............................ $ 147,145.50 (bine 4 less Line 5 'rotaq 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT $ - (Line 6 from prior Certificate) ................._....._. ,.. ;;.... ....... 8. CURRENT PAYMENT DUE ......................................... I $ 147,145.50 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) .... .._...... $ 31,744.50 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS TOTAL CHANGEs APPROVED IN PREVIOUS MON'T'HS HY OWNER 'T'OTALAPPROVED THIS MONTH TOTALS $ 0 NEI' CFIANGES BY CHANGE' ORDER 1 $ CONTRA R. . acI el Contracting, Inc BY:Zf Date: 08/23/2019 State of: MN County of: Wright Described and sworn to before the this 23rd day of August, 2019 JENNIFER LEIGH AMENRUO Notary Public NOTARY PUBLIC MINNESOTA My Commission Expires: 1/31/20'l4 r my Comtnisslon EVims Jan, 31, 2024 CERTIFICATE FOR PAYMENT In accordance with the Contract Document, based on on-site observation and the data comprising the application, the Architect certifies to the Owner that to the best of the Architect's Knowledge, information and belief the Work has progresses as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERIFI ED. AMOUNT CERTIFIED $ CONSTRUCTION MANAGER: By: Date: Amirri C'ti By: Date: _ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. CONTINUATION SHEET AIA DOCUMENT G703 PAGE 2 OF 2 PAGES AIA DocumentC702,AMAGATION AND CERTIFICATION FOR PAYMENT, cnntalning APPLICATION NO: 19066.01 Contractor's signed certification is attached, PERIOD BILLING: 08/31/19 In tabulations below, amounts are stated to the nearest dollar•• APPLICATION DATE: 08/23/19 Use Column I on Contracts where variable retainage for line items may apply, ^ rTl'-M NO t+ [ISCRII'f]ON 01' WORK C 5('fll'[)UL1;1) VALUF 1) 1 L WORK COMPI 1AFIDMATLRIAI I 5 mki.simmrLY STORED (NM IN D OR Ii) c. TOTAI. t'omm,i L•D ANDSTORED 70 DATE (D+E+F) n (li eCl Complcic H 10TAN04 rU l•INIS11 IC (•, It RI(TAINAOF (IP VARIAnI.I: RATE) FROM PR 1'.Vl()I IS THIS PHRIOD APPLICATION (D+GI 1 Buildiriv Demolition $158,890.00 $154,890.00 $154,890.00 97.487, $4.000,00 $7,744.50 2 Allowance $20,000.00 $0.00 0.00% $20,000.00 $0.00 GRAND TOTALS $178,890.00 $154,890.00 $0.00 $154.890.00 86.58% $24,000.00 $7,744.50 ,,,. �.a,in.v.in,nanci.ir,ncc,n�c ivvu•.inllcnv•nIn•��Ivvz G703-1992 THIS ANCRIC.AN INS i11 UTG 01: ARCUrnic'm 1735 NIi1V YORK AVIiNUII. N.W. WASHIN(,roN, D.C. 20006-5292 APPLICATION AND CERTIFICATE FOR PAYMENT Page of SUBMITTED TO: RJM Construction, LLC PROJECT: Elk River Ice Arena APPLICATION NO: 1 830 Boone Avenue North 1000 School St NW APPLICATION DATE: 8-21-2019 Golden Valley, MN 55427 Elk River, MN 55330 PERIOD FROM: 8-1-2019 SUBMITTED FROM: Distinctive Iron, LLC ARCHITECT: 292 Design Group PERIOD TO: 8-30-2019 19128 Industrial Blvd NW 3533 E Lake St PROJECT NO: 19520-0033 Elk River, MN 55330 Minneapolis, MN 55406 CONTRACT DATE: 7-10-2019 CONTRACT FOR: Elk River Ice Arena & Lion John Weicht Park CONTRACT NO.: 19520-0033 COMMITMENT: YESINO I hereby certify that the work performed and the material supplied to date, as shown here, represent the actual value of accomplishment under the terms of the contract (and all authorized changes hereto) between the undersigned and RJM Construction relating to the above - referenced project. I further certify that no labor or materials have been supplied under contracts, agreements, verbal or written, or any other arrangement of any type whalsoever,other than the contract duly authorized and executed change orders, and the undersigned does hereby releases RJM Construction from any claim or liability therefor for the period covered by this application. I also certify that payments, less applicable retention, have been made through the period covered by previous payments received from the contractor to 1) all my subcontractors (sub -subcontractors) and 2) for all material and labor used in or in connection with the performance of this contract. I further certify that I have complied with Federal, State, and local tax laws, including Social Security laws, Unemployment Compensation Laws and Workman's Compensation laws insofar as applicable to the performance this contract. PARTIAL WAIVER OF LIEN Now therefore, upon receipt of the payment of the current payment due on this application the undersigned does hereby irrevocably release and waive any and all mechanic's liens or rights to claim any and all mechanic's liens or other liens against the above real estate or any part thereof for any of the materials and/or labopr therefore furnished or performed in connection with this project, reserving, however, all lien rights for labor and/or materials furnished after said date. The person signing below does hereby cerify that he/she is fully authorized and empowered to execute this instrument and to bind the undersigned hereto, and does in fact so execute this instrument. #REF! Distinctive Iron, LLC 19128 Industrial cl W SIGNED: L: PRINTED, TITLE , 1'�k ORIGINAL CONTRACT SUM-.... .... ___ NET CHANGE BY CHANGE ORDERS TO. ....................................... $ 1,308,353.00 CONTRACT SUM TO DATE ....................... ....................................... :.... $ 1,308,353.00 TOTAL COMPLETED AND STORED TO DATE ..............................,.......... $ 75,000.00 5 % OF COMPLETED WORK $ 3,750.00 5 % OF STORED MATERIAL $ - TOTAL RETAINAGE ........... ............................ :...:...:......... .................... . $ 3,750.00 TOTAL EARNED LESS RETAINAGE....................................................... $ 71,250.00 LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER ...... ............ ....... $ - LESS PREVIOUS CERTIFICATES FOR PAYMENT .................................... CURRENT PAYMENT DUE..................................................................... $ 71,250.00 BALANCE TO FINISH INCLUDING RETAINAGE ........................................ $ 1,237,103.00 State of: County of: J� Subscribed and sworn to before me this day of fiuc, 20 j f -- NOTARY PUBLIC: n Signed: �U,x j ! r]'� MICHELLE L JOHNSON My Commission Expires: _ J �J ✓ "'p 1, NOTARY PUBLIC MINNESOTA Jan, 31, 2024 From: PLEASE SUBMIT PAYMENT APPLICATIONS TO: ACCOUNTING-MN®RJMCONSTRUCTION.COM To: RJM Construction, LLC 830 Boone Avenue North Golden Valley, MN 55427 Schetfaie of V8114e3 Invoice No. 1923 Aool. No.: 1 Apps.ONW, 08!21119 From: 8-1-2019 To: 8-30-2019 ITEM NO. I DESCRIPTION CURRENT CONTRACT PREVIOUS APPS. 1 CURRENT APPLICATION WORK IN MATERI. PLACE ON SITE 1 TOTAL APPS. TO DATE PERCENT COMPLETE BALANCE TO COMPLETE RETAIN TO DATE 1 11Draw #1 - Elk River Ice Arena $1,308353 $75,000 $75,000 5.73% wtnc 2 $0 0.00% $C $0 3 $0 0.00% $C $o a $0 0.00% $C Sc 5 I ! $0 R00% $C $a 6 $0 0.00% $C $0 7 $0 0.00°k$0 $0 8 $0 0.00% $C $0 9 $o 0.00% $C $a 10 1 1 $o 0.006h $0 $Ir 11 $0 0.00% $0 $a 12 $0 0.00% $0 $C 13 . . $0 0.00% $0 $C 14 $0 0.000A $C. $0 15 $o 0.00% $0 $0 16 $0 0.00% $0 $C 17 $0 0.00% $0 $C 18 $0 0.00%• $0 $C 19 1 1 $0 0.00%1 $o $0 20 $0 0.00% $o $C 21 $0 0.00% $0 $C 22 $0 0.00% $0 $0 23 $0 0.00% $0 $C 24 1 $0 0.00% $0 $Q 25 1 $01 0.00% $0 $0 TOTAL 1 $1,308,353 $0' $75,000 $O' $75,0001 5.73% $0 $0 Page 1 of 1 g I o $ j ƒ \ / \ ƒ � - 0- / 2 \ E .- ^ _ 2 / Q OR 2 r to V § 1 x 2 m \ 2 0 m � k \ I _ ¥ \ = 7 = c } 7 ; ~ k E 4 u � ? ¥ / § - a 2 /m 2 } / V) § � ƒ ± ) \ e / I 7 APPLICATION AND CERTIFICATE FOR PAYMENT Page of SUBMITTED TO: RJM Construction, LLC PROJECT: Elk River Ice Arena & Lion John Weicht Park APPLICATION NO: #1 830 Boone Avenue North APPLICATION DATE: 711 612 01 9 Golden Valley, MN 55427 PERIOD FROM: 7/1/2019 SUBMITTED FROM: Twin City Acoustics, Inc. ARCHITECT: 9449 Science Center Drive New Hope, MN 55428 CONTRACT FOR: Acoustical Treatment CONTRACT NO.: I hereby certify that the work performed and the material supplied to date, as shown here. represent the actual value of accomplishment under the terms of the contract (and all authorized changes hereto) between the undersigned and RJM Construction relating to the above - referenced project I further certify that no Tabor or materials have been supplied under contracts, agreements, verbal or written, or any other arrangement of any type whatscever,other than the contract duly authorized and executed change orders, and the undersigned does hereby releases RJM Construction from any claim or liability therefor for the period covered by this application. I also certify that payments, less applicable retention, have been made through the period covered by previous payments received from the contractor to 1 j all my subcontractors {sub -subcontractors} and 2) for all material and labor used in or in connection with the performance of this contract. I further certify that I have compiled with Federal, State, and local tax laws, including Social Security IaWS. Unemployment Compensation Laws and Workman's Compensation laws insofar as applicable to the performance this contract. PARTIAL WAIVER OF LIEN Now therefore, upon receipt of the payment of the current payment due on this application the undersigned does hereby irrevocably release and waive any and all mechanic's liens or rights to claim any and all mechanics liens or other liens against the above reale estate or any part thereof for any of the materials andlor labopr therefore furnished or performed in connection with this project, reserving, however, all Iien rights for labor andler materials furnished after Bald date. The person signing below does hereby cerlfy that he/she is fully authorized and empowered to execute this instrument and to bind the undersigned hereto, and does In fact so execute this instrument. Twin City Acoustics, Inc. 9449 Science Center Drive •~" �' New Hope, MN 55428 r SIGNED: PRINTED, TITLE Dave Brinker, President PERIOD TO: 7131/2017 PROJECT NO: #19005.00 CONTRACT DATE: 7111 /2019 COMMITMENT: YES/NO ORIGINAL CONTRACT SUM. .................... 1-1 ... I..". ............................... $ 149,410.00 NET CHANGE BY CHANGE ORDERS TO .......... ......................... I............ CONTRACT SUM TO DATE ....................... .......................... I ......... I....... $ 149,410.00 TOTAL COMPLETED AND STORED TO DATE ......................................... $ 2,250.00 5 % OF COMPLETED WORK 5 % OF STORED MATERIAL 5 112.50 TOTALRETAINAGE ............................. .................. —..... --l- ...... ...... $ TOTAL EARNED LESS RETAINAGE....................................................... $ LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER ........................ $ LESS PREVIOUS CERTIFICATES FOR PAYMENT .................................... $ 112.5n 9 137 5n CURRENT PAYMENT DUE.................................................................... $ 2.137.50 BALANCE TO FINISH INCLUDING RETAINAGE ........................................ $ 147,272.50 State of: Minnesota County of: Anoka Subscribed and swom to before me this 16th day of July NOTARY PUBLIC: Signed: Mycommiss Expires: 1/31/2022 JULIE LYNN HAUPERT Notary Public tl Minnesota It My Commission Expires Jan 31. 2022 N N O O O a Z 0 n N ., C a �Wo 3 E CD W n 7 0 0 � s aj rD zoz� = a N �� 41 v w 3 u+ J ow OA H `%400° N z a 0 " R � H V w F' Sa v o �Z-4m y w n 6 w T ~ O Lj O1 O C W tµ0 • D r � = fD M. Di From: Twin City Acoustics, Inc. 9449 Science Center Drive New Hope, MN 55428 PLEASE SUBMIT PAYMENT APPLICATIONS TO: ACCOUNTING-MN@RJMCONSTRUCTION.COM To: RJM Construction, LLC 830 Boone Avenue North Golden Valley, MN 55427 Schedule Valu s Invoice No. 84929-1 Appi, Datr 07115!18 From: C7/01/19 To: 07/31/19 ITEM NO- DESCRIPTION CURRENT CONTRACT CURRENT APPLICATION PREVIOUS I WORK IN MATERL. I APPS. I PLACE ON SITE TOTAL APPS. TO DATE BALANCE PERCENT TO COMPLETE COMPLETE RETAIN TO DATE 095100 I $ $ S 1 Material $ 97,380.00 $ 0% $ 97.380.00 $ 2 Labor S 44.500.00 s 0% $ 44.600.00 S - 30 I I$ $ $ 4 Material $ 3,450.00 $ 0% $ 3.450.00 $ 5 Labor 1,830.00 ' $ 0% $ 1.830.00 $ - 6 Bonds $ 2,250,00 !$ 2,250.00 . $ 2,250.00 100% $ $ 112-50 $ $ $ $ I 1 $ $ I I 1 TOTAL 149,410.00 - 2250.00 1 2.250.001 % 147,160.001 112.50 Page 1 of 1 TWIN CITY ACOUSTICS, INC. Application and Certificate for Payment 7CFA 9449 Science Center Drive, Ste 100 p N New Hope, MN 55428 Phone: 763-535-6697 Fax: 763-535-5309 JEL�wD�LNEN. Contractor: RJM Construction Job : Elk River Ice Arena & Lion John Weicht Park Application: 1 830 Boone Avenue North Golden Valley MN 55427 Billing Cycle: 7/01/2019 to 7/31/2019 Application For Payment On Contract Original Contract ...................................... Net Change by Change Orders ................ Contract Sum to Date ............................... Total Complete to Date ............................ Total Retained .......................................... Total Earned Less Retained .................... Less Previous Billings .............................. 149,410.00 0.00 149, 410.00 2,250.00 112.50 2,137.50 0.00 Current Payment Due ............................. 1 2,137.50 Balance on Contract ................................. 147,272.50 Terms: Invoices are due and payable 30 days from the date of the invoice. Please make checks payable to: Twin City Acoustics, Inc. Invoice Date: 07/16/2019 The undersigned Contractor certifies to the best of the Contractor's knowledge, information and believe 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 herein is now due. . .... ..... CONTRACTOR -,Twin City Acoustics, Inc. `mow By; - _ p2t+r .?116/19 Dave Brin -Pa' ent State of: Minnesota~ County of: Anoka Subscribed and Sworn to before a this 16th "y of Ju JULIE LYNN HAOPERT Notary PublilPyment /; �/'�—j�_- Notary Public " Minnesota My commisss: 011311 022 My Commission Expires Certificate foJan 31 2022 i J 1. In accordance with the Contract Documents, based on on-site observations and the data comprising this application, the Construction Manager and Architect certify to the Owner that to the best of their knowledge, information and belief the Work has progr?ssed 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. Amount Certified $ (Attach explanation if amount certified differs from the amount applied for. Initial all figures on the Application and on the Continuation Sheet that changes to conform to the amount certified.) Construction Manager: Architect: BY, Date: This certificate is not negotiable, The AMOUNT CERTIFIED is payable only to the contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner of Contractor underthis Contract. PROGRESS BILLING Schedule of Work Completed Application: 1 Date: 07/16/2019 Description of Work Scheduled Changes Contract Previous Current Comp. Stored Mat. Total Comp. % Balance Retained 095100 Material 97,380.00 97,380.00 97, 380.00 Labor 44,500.00 44,500.00 44,500.00 098430 Material 3,450.00 3,450.00 3,450.00 Labor 1,830.00 1,830.00 1,830.00 Bonds 2,250.00 2,250.00 2,250.00 2,250.00 100.00 112.50 Totals: 149,410.00 149,410.00 2,250.00 2,250.00 1.51 147,160.00 112.50 Page 2 of 2 APPLICATION AND CERTIFICATE FOR PAYMENT Page 1 of 2 SUBMITTED TO: RJM Construction, LLC 830 Boone Avenue North PROJECT: ELK RIVER ICE ARENA APPLICATION NO: 1 Golden Valley, MN 55427 1000 SCHOOL ST. N.W. APPLICATION DATE: 8/21/2019 SUBMITTED FROM: SUNRISE PAINTING & WALLCOVERING, INC. PERIOD FROM: 8/1/2019 805 TOWER DRIVE ARCHITECT: 292 DESIGN GROUP PERIOD TO. 8/31/2019 MEDINA, MN 55340 PROJECT NO: CONTRACT FOR: PAINTING & WALLCOVERING CONTRACT DATE: 7/11/2019 _ CONTRACT NO.: I hereby certify that the work performed and the material supplied to date, as shown here, represent the actual value of accomplishment under the terms of the contract (and all authorized changes hereto) between the undersigned and RJM Construction relating to the above - referenced project. I further certify that no labor or materials have been supplied under contracts, agreements, verbal or written, or any other arrangement of any type whatsoever, other than the contract duly authorized and executed change orders, and the undersigned does hereby releases RJM Construction from any claim or liability therefor for the period covered by this application. I also certify that payments, less applicable retention, have been made through the period covered by previous payments received from the contractor to 1) all my subcontractors (sub -subcontractors) and 2) for all material and labor used in or in connection with the performance of this contract. I further certify that I have complied with Federal. State, and local tax laws, including Social Security laws, Unemployment Compensation Laws and Workman's Compensation laws insofar as applicable to the performance this contract. PARTIAL WAIVER OF LIEN Now therefore, upon receipt of the payment of the current payment due on this appliaallon the undersigned does hereby irrevocably release and waive any and all mechanie's liens or rights to claim any and all mechanics liens Or other liens against the above real estate or any part thereof for any of the materials andlor labopr lherefvre furnished or performed In connection with this. project, reservtng, however. all lien rights for labor and/or materials furnished after said date. The person signing below does hereby cerify that he/she is fully authorized and empowered to execute this instrument and to bind the undersigned hereto, and does in fact so execute this instrument. SUNRISE PAINTING & WALLCOVERING, INC. 805 TOWER DRIVE MEDINA, MN 55340 /1 SIGNED: r PRINTED, TITLE COMMITMENT: YES ORIGINAL CONTRACT SUM.............. $ 412 7rin no NET CHANGE BY CHANGE ORDERS TO ,. .. .. CONTRACT SUM TO DATE ................. $ 412,750 00 TOTAL COMPLETED AND STORED TO DATE........... ...... ........... ....... I 5 nno nn 5 % OF COMPLETED WORK $ 25000 5 % OF STORED MATERIAL S _ TOTAL RETAINAGE........... ... ..._ ....... $ 25000 TOTAL EARNED LESS RETAINAGE.................................................... $ 4,750.00 LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER... $ LESS PREVIOUS CERTIFICATES FOR PAYMENT.._...., CURRENT PAYMENT DUE .................. .............. S 4,750.00 BALANCE TO FINISH INCLUDING RETAINAGE $ 408 000 00 State of: / s County of: Subscribed and sworn to efore me this z CIL� day of Sf 20 NOTARY PUBLIC Signed: 'A/&", ' i My Commission Expires: / /-Z' " KIM J LAf43OfM-SEI 40fary Putriic ,. „ Minrreapiq 31, = From SUNRISE PAINTING & WALLCOVERING, INC. 805 TOWER DRIVE MEDINA, MN 55340 PLEASE SUBMIT PAYMENT APPLICATIONS TO: ACCOUNTING-MN@RJMCONSTRUCTION,COM To: F?-Jm construction, LLC 830 Boone Avenue North Golden Valley, MN 55427 hodula of Values Invoice No. 57798 #1 Ap I. Date: 08/21/19 From: OW01/19 To: 681?7I19 Page 1 of 1 r, cfl Vl 0 0 0 0 O z r n o a 0 � z b O H x � � a c a C, o tv C a a O H H Z t3 z C O r-� H y n r z {� � r � a � z � V x o H f-] � O O O � � Y O H C-4 t=] n H 0 1.6 o 0 0 0 0 0 c U) 0 o m z 0 (n Ul N v a� �r c� x c HH O Q "ti m n 0 tz7 � z m L=J z a or 0 0 z C f� n tJ Ln v V co v o o) cn C,) H M cn v (DD C) O C � 9 r X (D O � � cn W � � z � C) c w Z CD e APPLICATION AND CERTIFICATE FOR PAYMENT - CONTRACT SUM TO DATE ............. .......................... :....,........,............. $ 2,162,742.00 Page 1 of 2 SUBMITTED TO: RJM Construction, LLC PROJECT: Elk River Ice Arena APPLICATION NO: 2 830 Boone Avenue North Lion John Weicht Park Facilities APPLICATION DATE: 8/21/2019 Golden Valley, MN 55427 1000 School Street N.W PERIOD FROM: 8/1/2019 SUBMITTED FROM: Rink -Tec International, Inc. ARCHITECT: 292 Design Group PERIOD TO: 8/31/2019 3485 Willow Lake Blvd. Suite # 500 3533 E. Lake Street PROJECT NO: 19005 Vadnais Heights, MN 55110 Minneapolis, MN CONTRACT DATE: 7/3/2019 CONTRACT FOR: Elk River Ice Arena CONTRACT NO. COMMITMENT: YES/NO I hereby certify that the work performed and the material supplied to date, as shown here, represent the actual value of accomplishment under the terms of the contract (and all authorized changes hereto) between the undersigned and RJM Construction relating to the above - referenced project. I further certify that no labor or materials have been supplied under contracts, agreements, verbal or written, or any other arrangement of any type whatsoever,other than the contract duly authorized and executed change orders, and the undersigned does hereby releases RJM Construction from any claim or liability therefor for the period covered by this application, f also certify that payments, less applicable retention, have been made through the period covered by previous payments received from the contractof to 1) all my subcontractors (sub-subcontrac(ors} and 2) for all material and labor Used in or in connection with the performance of this contract. I further certify that I have complied with Federal, State, and local tax laws, including Social Security laws, Unemployment Compensation Laws and Workman's Compensation laws insofar as applicable to the performance this contract. PARTIAL WAIVER OF LIEN Now therefore, upon receipt of the payment of the current payment due on this application the undersigned does hereby irrevocably release and waive any and all mechanic's liens or rights to claim any and all mechanic's liens or other liens against the above real estate or any part thereof for any of the materials andfor labopr therefore furnished or perforated in connection with this project, reserving, however, all lien rights for labor and/or materials furnished after said date. The person signing below does hereby cerify that he/she is fully authorized and empowered to execute this instrument and to bind the undersigned hereto, and does in fact so execute this instrument. Rink -Tec International, Inc 3485 Willow Lake Blvd. Suite # 500 Vadnais Heights, MN 55110 SIGNED: PRINTED, TITLE Kyle Gillespie - President ORIGINAL CONTRACT SUM ............... ......................... :..,....1,,—.,......... $ 2.162,742.00 NET CHANGE BY CHANGE ORDERS TO.......... ...................................... 8 - CONTRACT SUM TO DATE ............. .......................... :....,........,............. $ 2,162,742.00 TOTAL COMPLETED AND STORED TO DATE....,. ................... .... .......... :. $ 175,000.00 5 % OF COMPLETED WORK $ 8,750.00 5 % OF STORED MATERIAL $ TOTAL RETAINAGE........................................................................... $ 8,750.00 TOTAL EARNED LESS RETAINAGE.. ....... ........ ........................... $ 166,250.00 LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER........................ S - LESS PREVIOUS CERTIFICAES FOR PAYMENT ........ ......... ............. ....... $ 115,000.00 CURRENT PAYMENT DUE.. .................. -- ........................ $ 51,250.00 BALANCE TO FINISH INCLUDING RETAINAGE— ............ ........... ......... $ 1,996,492.00 State of: Minnesota County of: Ramsey Subscribed and sworn to before ge this 21 day of August 20 19 KATHY MARY BARYON NOTARY PUB'• Notary Public Minnesota A �r MyCommissicnExpres Sig Jan 31, 2023 My Commission E ills: 31 -Jan -23 From: Rink -Tee International Lnc, 3485 Willow Lake Blvd., Suite #500 Vadnais Heights, MN 55117 PLEASE SUBMIT PAYMENT APPLICATIONS TO: ACCOUNTING-MN@RJMCONSTRUCTION.COM To: RJM Construction, LLC 830 Boone Avenue North Golden Valley, MN 55427 Schedule o_ f Vafue� Invoice No. AVEL No.: # Appl. Date: $]2112019 From: 8/1/2019 To: 813 112 01 9 Page 1 of 1 APPLICATION AND CERTIFICATE FOR PAYMENT Page 1 of 2 SUBMITTED TO: RJM Construction, LLC PROJECT: Elk River Ice Arena APPLICATION NO: 1 830 Boone Avenue North Lion John Weicht Park Facilities APPLICATION DATE: 7123/2019 Golden Valley, MN 55427 1000 School Street N. W Elk River, MN 55330 PERIOD FROM: 7/3/2019 SUBMITTED FROM: Rink -Tec International, Inc. ARCHITECT: 292 Design Group PERIOD TO: 7/3112019 3485 Willow Lake BNB. Suite # 500 3533 E. Lake Street PROJECT NO: 19005 Vadnais Heights, MN 55110 Minneapolis, MN CONTRACT DATE: 7/312019 CONTRACT FOR: Elk River Ice Arena CONTRACT NO.: 19005 COMMITMENT: YES/NO I hereby certify thal the work performee and She material supplied to date, as shown here, represent the acluaI value of accomplishment under lint: terms of the con Iracl [and a authorized changes hereto] between the undersigned and RJM Construction relaling to The above - referenced project I further cerlify IhEl no tabor or materials have been supplied under contracts, agreements, verb at or writlen, or any other arrangement of any type what soeve r. other than the contract duly authorized and executed change orders, and the undersigned does hereby releases RJM Construction lrom any claim or liability therefor for the period covered by this application. I also certify That payments, ess applicable retention, have been made through the period covered by previous payments re:eived from the contractor to 1 y all my suhgnrtlractom (sub -subcontractors) and 2) for all mverial and labor used in or in connection with the performance of this contract. I further certify that I have complied with Federal, Stale, and local tax laws, including Social Security laws. Unemploymerrl Compensation Laws and Workman's Compensation laws insofar as applicable io the performance this contract. PARTIAL WAIVER OF LIEN Now therefore, upon receipt of Sine paym:nt of the current payment due on this application the undersigned does hereby irrevocably release and waive any and all mechanic's liens or rights to etaim ally and all mechanic's liens or other liens against the above real estate or any {cart thereof for any of the materials andlor labopr therefore furnished or performed in conneclion with lois PF9jeCl. reserving, however, all Tien rig hls for tabor andlor materials turn Ished afler said dale. ORIGINAL CONTRACT SUM ....... .................... ................ ........ ........ ....... $ 2,162,742 00 NET CHANGE BY CHANGE ORDERS TO.................... ............................ $ CONTRACT SUM TO DATE ....... ........................ :... .......... ................ ..... $ 2,162.742.00 TOTAL COMPLETED AND STORED TO DATE.................... ...................... $ 115,000.00 5 % OF COMPLETED WORK $ 5.750.00 5 % OF STORED MATERIAL $ TOTALRETAINAGE.............................:........................:......::..........I.... $ 5,750.00 TOTAL EARNED LESS RETAINAGE........................................................ $ 109,250.00 LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER........................ $ LESS PREVIOUS CERTIFICATES FOR PAYMENT....; ............ ; .................. CURRENT PAYMENT DUE .................................................... ...._----.. .. $ 109.250.00 BALANCE TO FINISH INCLUDING RETAINAGE_ ............ ..................... ... $ 2,053,492.00 State of: Minnesota The person signing below does hereby verify that he/she is fully authorized and empowered to execute this instrument and to bind the undersigned hereto, and does in fact so execute this County of: Ramse instrument. Subscribed and sworn to before me this Rink -Tec International, Inc. 23 day of July 20 19 3485 Willow Lake Blvd. Suite # 500 NOTARY PUBLIC: ` '� KATHY MARY BARTON Vadnais Heights, MN 5511i1r j �F�� � NofaryPiibtic f 4j Mirwresofa SIGNED: '` Signed: xranission Expires Jan 31, 2023 PRINTED, TITLE Kyle Gillesplq. Vdenl �� My Commission E ires: 31 -Jan -23 From: PLEASE SUBMIT PAYMENT APPLICATIONS TO: ACCOUNTING-MN@RJMCONSTRUCTION,COM To: RJM Construction, LLC 830 Boone Avenue North Golden Valley, MN 55427 Schedule of Values Invoice No. And. No.: # A p pi. Data: 7123P2019 From: 7/3/2019 To. 7131/2019 Page 1 of 1 APPLICATION AND CERTIFICATE FOR PAYMENT Page of SUBMITTED TO: RJM Construction, LLC PROJECT: Elk River Ice Arena and Lion John Weicht Park Facilities APPLICATION NO: i 830 Boone Avenue North 1000 School St. NW APPLICATION DATE: 8/15/2019 Golden Valley, MN 55427 Elk River, MN 55330 PERIOD FROM: 8/1/2019 SUBMITTED FROM: Summit Fire Protection 575 Minnehaha Avenue West St. Paul, MN 55103 CONTRACT FOR: Fire Sprinklers ARCHITECT: 292 Design Group 3533 East Lake Street Minneapolis, MN 55406 CONTRACT NO.: I hereby certify that the work performed and the material supplied to date, as shown here, represent the actual value of accomplishment under the terms of the contract (and all authorized changes hereto) between the undersigned and RJM Construction relating to the above - referenced project. I further certify that no labor or materials have been supplied under contracts, agreements, verbal or written, or any other arrangement of any type whatsoever, other than the contract duly authorized and eX6&9ed change orders, and the undersigned does hereby releases RJM Construction from any dant or liability therefor for the period covered by this application. I also certify that payments, less applicable retention, have been made through the period covered by previous payments received from the contractor to 1) all my subcontractors (sub -subcontractors) and 2) for all material and labor used in or in connection with the performance of this contract. I further certify that I have complied with Federal, State, and local tax laws, including Social Security laws, Unemployment Compensation Laws and Workman's Compensation laws insofar as applicable to the performance this contract. PARTIAL WAIVER OF LIEN Now therefore, upon receipt of the payment of the current payment due on this application the undersigned does hereby irrevocably release and waive any and all mechanic's liens or rights to claim any and all mechanic's liens or other liens against the above real estate or any part thereof for any of the materials and/or labopr therefore furnished or performed in connection with this project, reserving, however, all lien rights for labor and/or materials furnished after said date. The person signing below does hereby cerify that he/she is fully authorized and empowered to execute this instrument and to bind the undersigned hereto, and does in fact so execute this instrument. Summit Fire Protection 575 Minnehaha Avenue West St. Paul, MN 55103 SIGNEDE Q� PRINTED, T �A[ r_ % P/%)Ate PERIOD TO: 8/31/2019 PROJECT NO: CONTRACT DATE: 7/11/2019 COMMITMENT: YES/NO ORIGINAL CONTRACT SUM........................,.,............,,.....I................... $ 256,485.00 NET CHANGE BY CHANGE ORDERS TO ...............................................: $ - CONTRACT SUM TO DATE... . ........... ............. .................. $ 256,485.00 TOTAL COMPLETED AND STORED TO DATE ........ ::...... .......................... $ 8,788.50 5 % OF COMPLETED WORK $ 439.43 5 % OF STORED MATERIAL $ - TOTAL RETAINAGE .................. $ 439.43 TOTAL EARNED LESS RETAINAGE..:.........:.........:................:::............. $ 8,349.07 LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER ........................ $ - LESS PREVIOUS CERTIFICATES FOR PAYMENT ........... __..................... CURRENT PAYMENT DUE................. ...................... .. $ 8.349.07 BALANCE TO FINISH INCLUDING RETAINAGE ........................................ $ 248,135.93 State of: Minnesota County of: Ramsey Subscribed and sworn to before me this trig L� day of hue ]4linewti20 � '' -' � My Ct�mnussirnti [xPires 011 . NOTARY PUBLIC: Signed: ��.+►' My Commission Expires: 1/31/2020 From: Summit Tire Protection 575 Minnehaha Avenue West St Paul, MN 55103 PLEASE SUBMIT PAYMENT APPLICATIONS TO: ACCOUNTING-MN@RJMCONSTRUCTION.COM To: RJM Construction, LLC 830 Boone Avenue North Golden Valley, MN 55427 Invoice No. ApQI. No,; Schedule of Values A15019563300001 #1 AppL Date: 08/15/19 _ �... From: 08/01 /19 To: 08/31/19 ITEM NO. _DESCRIPTION CURRENT CONTRACT CURRENT APPLICATIONTOTAL PREVIOUS I WORK IN MATERL I APPS. PLACE ON SITE APPS. TO DATE PERCENT COMPLETE I BALANCE TO COMPLETE RETAIN TO DATE 1 Labor $87,885.00 $8,788.50 $8,788.50 10.00% $79,096.50 $43943 2 Material $111,200.00 $0.00 0.00% $111,200.00 $0.00 3 Design $312D0.00 $0.00 0.00% $31,200.00 $0.00 4 Fabrication $20 20D.00 I I $0.00 0.00% $20,200.00 $0.00 5 Bonds $6,000.00 $0.00 0.00% $6,000.00 $0.00 6 $0.00 0.00% $0.00 $0.00 7 $0.00 0.00% $0.00 $0.00 8 $0.00 0.00% $0.00 $0.00 9 $0.00 000% $0.00 $0.00 10 $0.00 0.00% $0.00 $0.00 11 $0.00 0.00% $0.00 $0.00 12 $0.00 0.00% $0.00 $0.00 13 I 1 $0.00 0,00% $0.00 $0.00 14 $0.00 0.00% $0.00 $0.00 15 ' $0.00 0.00% $0.00 $0.00 16 $0.00 0.00% $0.00 $0.00 17 $0.00 0.00% $0.00 $0.00 18 I I $0.00 0.00% $0.00 $0.00 19 $0.00 0.00% $0.00 $0.00 20 50.00 0.00% $0.00 $0.00 21 $0.00 0.00% $0.00 $0.00 22 I $000 0.00% $0.00 $0.00 23 $0.00 0.00% $0.00 $0.00 24 $0.00 0.00% $0.00 $O.DD 25 $0.OD 0.00%1 $0.00 $0.00 TOTAL $256,485.00 $0.00, $8,768 50 $0.00, $8.788.50 343%1 $247,696.501 $439.43 Page 1 of 1 APPLICATION AND CERTIFICATE FOR PAYMENT Page 1 of ____._2 SUBMITTED TO: RJM Construction, LLC 830 Boone Avenue North Golden Valley, MN 55427 SUBMITTED FROM: Weidner Plumbing & Heating Company PO Box #1087 St. Cloud, MN 56302 CONTRACT FOR: PLUMBING WORK PROJECT: ELK RIVER MULTI PURPOSE ELK RIVER, MN ARCHITECT: CONTRACT NO.: I hereby certify that the work performed and the material supplied to date, as shown here, represent the actual value of accomplishment under the terms of the contract (and all authorized changes hereto) between the undersigned and RJM Construction relating to the above - referenced project. I further certify that no labor or materials have been supplied under contracts, agreements, verbal or written, or any other arrangement of any type whatsoever, other than the contract duly authorized and executed change orders, and the undersigned does hereby releases RJM Construction from any claim or liability therefor for the period covered by this application. I also certify that payments, less applicable retention, have been made through the period covered by previous payments received from the contractor to 1) all my subcontractors (sub -subcontractors) and 2) for all material and labor used in or in connection with the performance of this contract. I further certify that I have complied with Federal, State, and local tax laws, including Social Security laws, Unemployment Compensation Laws and Workman's Compensation laws insofar as applicable to the performance this contract. APPLICATION NO: 1 APPLICATION DATE: 8/20/2019 PERIOD FROM: 7/15/2019 PERIOD TO: 8/20/2019 PROJECT NO: CONTRACT DATE: 7/15/2019 COMMITMENT: YES/NO ORIGINAL CONTRACT SUM.................................................................. $ 1,206,000.00 NET CHANGE BY CHANGE ORDERS TO ................................................ CONTRACT SUM TO DATE....... .................:................................... $ 1,206,000.00 TOTAL COMPLETED AND STORED TO DATE ....................... -.....s.......... $ 31,333.00 5 % OF COMPLETED WORK $ 1,566.65 5 % OF STORED MATERIAL A. - TOTAL RETAINAGE....................................................4...................... 5 1,566.65 TOTAL EARNED LESS RETAINAGE....................................................... $ 29,766.35 PARTIAL WAIVER OF LIEN LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER...... .......:.......... $ Now therefore, upon receipt of the payment of the current payment due on this application the LESS PREVIOUS CERTIFICATES FOR PAYMENT ............... ... undersigned does hereby irrevocably release and waive any and all mechanic's liens or rights to claim any and all mechanic's liens or other liens against the above real estate or any part thereof CURRENT PAYMENT DUE.................................................................... $ 29,766.35 for any of the materials and/or labopr therefore furnished or performed in connection with this project, reserving, however, all lien rights for labor and/or materials furnished after said date. BALANCE TO FINISH INCLUDING RETAINAGE ....... :....................... ......... $ 1,176,233.65 The person signing below does hereby cerify that he/she is fully authorized and empowered to execute this instrument and to bind the undersigned hereto, and does in fact so execute this instrument. Weidner Plumbing & Heating Company PO Box #1087 St. Cloud, MN 56302 SIGNED: �r PRINTED, TITLE PRESIDENT State of: MN County of: BENTON Subscribed and sworn to before me this 19TH day of AUGUST 20 19 NOTARY PUBLIC: e "y KAREN A SCHENK Signed: G{ ���^ Notary Public State of Minnesota M Commission Expires: t My Commission Expires Y P January 31, 2024 Document G743TM - 1992 Continuation Sheet Pae 2 AIA Document G702T"'-1992, Application and Certificate for Payment, or G732T`1-2009, APPLICATION NO: 1 Application and Certificate for Payment, Construction Manager as Adviser Edition, APPLICATION DATE: 2019 containing Contractor's signed certification is attached. 8/19/2019 In tabulations below, amounts are in US dollars. PERIOD TO: 8/20/2019 Use Column I on Contracts where variable rctainage for line items may apply. ARCHITECT'S PROJECT NO: A B C D E F G H I WORK COMPLETED ITEM DESCRIPTION OF WORK SCHEDULED MATERIALS PRESENTLY TOTAL COMPLETED AND % DALANCETO FINISH RETAINAGE FROM PREVIOUS NO. VALUE APPLICATION THIS PERIOD STORED STORED TO DATE (G=C) (C -G) (ffvarioblerale) (D + E) (Nor in U or E) (D+E+F) PIPING MA'T'ERIAL 1 10.105: BOND 10,333.00 0.00 10,333.00 0.00 10,333.00 100 0.00 516.65 2 � 10.109: ALLOWANCE 7,500.00 0.00 0.00 0.00 0.00 0 7,500.00 0.00 3 10.115: PIPE & FITTINGS 235,689.00 0.00 18,000.00 0.00 18,000.00 8 217,689.00 900.00 4 10.119: DRAINS & CARRIERS 47,196.00 0.00 0.00 0.00 0.00 0 47,196.00 0.00 5 10.123: PUMPS & TANKS 5,400.00 0.00 0.00 0.00 0.00 0 5,400.00 0.00 6 10.127: WATER HEATERS 82,739.00: 0.00 0.00 0.00 0.00 0 82,739.00 0.00 7 10.137: PLBG FIXT & TRIM 79,004.00 0.00 0.00 0.00 0.00 0 79,004.00 0.00 8 10.139: MISC PLUMBING 42,488.00 0.00 0.00 0.00 0.00 0 42,488.00 0.00 510,349.00 0.00 28,333.00 0.00 28,333.00 6 482,016.00 1,416.65 PIPING LABOR 9 11.185: LABOR - PLUMBING 560,753.00 0.00 3,000.00 0.00 3,000.00 1 557,753.00 150.00 560,753.00 0.00 3,000.00 0.00 3,000.00 1 557,753.00 150.00 SUBCONTRACTS 10 ;30.300: DIGGING/BACKFILL 37,034.00 0.00 0.00 0.00 0.00 0 37,034.00 0.00 11 1.30.325: RENTALS 13,000.00 0.00 0.00 0.00 0.00 0 13,000.00 0.00 12 30.360: PIPE COVERING 84,864.00 0.00 0.00 0.00 0.00 0 84,864.00 0.00 134,898.00 0.00 F00 0.00 0.00 0 134,898.00 0.00 GRAND TOTAL 1,206,000.00 0.00 31,333.00 0.00 31,333.00 3 1,174,667.00 1,566.65 CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not be obscured. AIA Document G703 T" - 1992. Copyright @ 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING. This AIAeDocument is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA" Document, orany portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maxlmum 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, copyright@aia.org. 101210ACN4 APPLICATION AND CERTIFICATE FOR PAYMENT Page __]-_ of SUBMITTED TO: RJM Construction, LLC PROJECT: &w kLUF,`,L muLri-?wc-P�,5,9 APPLICATION NO: 1 830 Boone Avenue North 010 Lto) Softer V L-Kef r- PAX—L APPLICATION DATE: Golden Valley, MN 55427 /� PERIOD FROM: 8-1-17 � SUBMITTED FROM: � � h" ""V�' ARCHITECT: Z'32_ _003k,/J 61i'tOl,IP4 PERIOD TO: 0 ^ PO eo4 uoo PROJECT NO: e W ,WARM" 1p, "If ate,A) 9103f-7 CONTRACT DATE: ']`1D •-/ CONTRACT FOR: Z3/y' H -04 e. l eswa CONTRACT NO.: COMMITMENT: YES/NO I hereby certify that the work performed and the material supplied to date, as shown here, represent the actual value of accomplishment under the terms of the contract (and all authorized changes hereto) between the undersigned and RJM Construction relating to the above - referenced project. I further certify that no labor or materials have been supplied under contracts, agreements, verbal or written, or any other arrangement of any type whatsoever,other than the contract duly authorized and executed change orders, and the undersigned does hereby releases RJM Construction from any claim or liability therefor for the period covered by [his application. I also certify that payments, less applicable retention, have been made through the period covered by previous payments received from the contractor to 1) all my subcontractors (sub -subcontractors) and 2) for all material and labor used in or in connection with the performance of this contract. I further certify that I have complied with Federal, State, and local lax laws, including Social Security laws, Unemployment Compensation Laws and Workman's Compensation laws insofar as applicable to the performance this contract. PARTIAL WAIVER OF LIEN Now therefore, upon receipt of the payment of the current payment due on this application the undersigned does hereby irrevocably release and waive any and all mechanic's liens or rights to claim any and all mechanic's liens or other liens against the above real estate or any part thereof for any of the materials and/or labopr therefore furnished or performed in connection with this project, reserving, however, all lien rights for labor and/or materials furnished after said dale. The person signing below does hereby cerify that he/she is fully authorized and empowered to execute this instrument and to bind the undersigned hereto, and does in fact so execute this instrument. 0 0 0 SIGNED: PRINTED, TITLE' ORIGINAL CONTRACT SUM...........................-...-........................-........- 7lPti•..t ID NET CHANGE BY CHANGE ORDERS TO.. .......... _ .... .. ......... ............ ... CONTRACT SUM TO DATE................................................................... s TOTAL COMPLETED AND STORED TO DATE ............................... .. ,;27 5 % OF COMPLETED WORK 5 5 % OF STORED MATERIAL $ TOTAL RETAINAGE.......................................................... I__ ......... ..-. TOTAL EARNED LESS RETAINAGE...................................................... LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER ........................ $ - LESS PREVIOUS CERTIFICATES FOR PAYMENT .................................... d CURRENT PAYMENT DUE .................................... BALANCE TO FINISH INCLUDING RETAINAGE ....................................... State of: County of: �]�� ✓�✓ Subscribed and sworn to before me this ��Z day of U/,LJS! - • - - ---•• 20 NOTARY PUBL Signed, N EFFREY p WALETZKO NOTARY PUBLIC - MINNESOTA My Commission Expires: Cv�iutiisvion Expires Jan.31, 2020 CONTINUATION SHEET AIA DOCUMENT G703 (1115I1'LICI1011i 011 l'LWl'A: iILIQ) IS,tlli 2 llI'3 I5 AIA DOCLtnient G702, APPLICATION AND CERTIFICAI'C FOR PAYMENT, APPLICATION NO.; 1 cojimining Contractor's slgncd Ccrtlflenllon, I5 minhe(I' APPLICATION I�NI'E: 08/21/2019 PROJECT: 23A -HVAC Systems ' In tabulutlOn5 below, Milounts the stated to the nearest (1011;u', Elk River Multi -Purpose Facility and Lion John PGRIOD TO; 08/31/2019 Usz C011lnut I On Conh'llCU where Yar,lable retalnnge Rn' IIr1e ItL:111i may ;11)1)ly, Weicht Park ARCI-HTECT'S PKQlFCT NO.: A - B C D WORK COMPLi'I'Cr) E 111A'I'GIiIALti VOTAL FROM PRGVIOLIS APPLICA'T'ION ITEM NO, DESCRIPTION OF WORKVALIIE 5CI•ICDLILED '1'.118 I'ERIOD I'RtiSCNTLY S1'O1(CI) (:OMPLf•TL'D AND 5'1'UIIF.I) 'r0 DA'T'E �' (C C) UALANCC IC) ' flNlil•I Itl?'fnlNnt l? (If \'AIIIA(11,1{) $0.00 (D t 11) $0.00 (NOR C) 1 ICE ARENA _ $0,00 $0.00 $0.00 $0.00 $0.00 2 Mobilization -labor $5,000.00 $0.00 $0.00 $0.00 $0.00 0% $5,000.00 $0.00 3 Mobilization -mat': $2,500.00 $000 $0.00 $0.00 $0.00 0% $2,500,00 $0.00 4 HVAC Demo -labor $15,000.00 $0.00 $0.00 $0.00 $0.00 0% $15,000.00 $0.00 5 HVAC Demo -mat'[ $5,000.00 $0.00 $0.00 $0.00 $0.00 0% $5,000.00 $0.00 6 230593 Test and Balance $22,000.00 $0.00 $0.00 $0.00 $0.00 0% $22,000-00 $0.00 7 230700 Insulation $32,000.00 $0.00 $0.00 $0.00 $0.00 0% $32,000.00 $0.00 8 232300 Refrigeration Piping $55,000.00 $0.00 $0.00 $0.00 $0.00 0% $55,000.00 $0.00 9 250900 Controls $230,000.00 $0,00 $0.00 $0.00 $0.00 0% $230,000.00 $0.00 10 233000 Ductwork -labor $75,000.00 $0.00 $0.00 $0,00 $0.00 0% $75,000.00 $0.00 11 233000 Ductwork -mat': $23,30000 $0.00 $0.00 $0.00 $0.00 0% $23,300.00 $0.00 12 233000 Misc Round -labor $8,000.00 $0.00 $0.00 $0.00 $0.00 0% $8,000.00 $0.00 13 233000 Misc Round -mat': $4,500.00 $0.00 $0.00 $0.00 $0.00 0% $4,500.00 $0.00 14 233000 Spiral Pipe -labor $84,500.00 $0.00 $0.00 $0.00 $0.00 0% $84,500.00 $0.00 15 233000 Spiral Pipe -mat': $45,000.00 $0.00 $0.00 $0.00 $0.00 0% $45,000.00 $0.00 16 233000 Fabric Duct -labor $2,500,00 $0.00 $0.00 $O.CO $0.00 0% $2,500.00 $0.00 17 233000 Fabric Duct -mat': $4,OOQ.00 $0.00 $0.00 $0.00 $0.00 0% $4,000.00 $0.00 19 233423 Fans/Hoods-labor $10,000.00' $0.00 $0.00 $0.00 $0.00 0% $10,000.00 $0.00 19 233423 Fans/Hoods-mat': $22,000-00 $0.00 $0.00 $0.00 $0.00 0% $22,000.00 $0.00 20 233616 VAV Boxes -labor $8,000.00 $0.00 $0.00 $0.00 $0.00 0% $8,000.00 $0.00 21 233616 VAV Boxes -mat': $24,000.00 $0.00 $0.00 $0.00 $0.00 0% $24,000.00 $0.00 22 233713 Grilles/Registers-labor $17,000,00 $0.00 $0.00 $0.00 $0.00 0% $17,000.00 $0.00 23 233713 Grilles/Registers-mat': $30,000.00 $0.00 $0.00 $0.00 $0.00 0% $30,000.00 $0.00 24 236213 ACCU-labor $4,000.00 $0.00 $0.00 $0.00 $0.00 0% $4,000.00 $0.00 25 236213 ACCU-mat': $80,000.00 $0.00 $0.00 $0.00 $0.00 0% $80,000.00 $0,00 UQ 00.00 $4.00 $0.00 $0.00 $0.00 0% $44,000.00 $0,00 27 237400 Rooftop Units -mat': $445,500.00 $0.00 $0.00 .0 ° 1 ZP4145,DOU,00 pav r ouu_vv- .. . AIA ROCU NVIN(IATIOfV SMEH1' []K V, J-' 1 1992. EDITION • AIA"' 0119'_ 'rl'W 10111ftICAN INiITI'll'I'll Ulf ARCI•II'I'kCTS, 17.15 NL••\V 1'OnK G. AVI?NUC, NX, WA5NINOW14, D.C. 10006-52VI - WARNING: Unllcensad photocopying vlolalaa U -S, copyright laws and will sub)ecl lite YIDlalor to legal pluSecutlon, WOO G703-1992 CAUTION: You should use an original AIA document which ties title caution printed In red, An orlglnul assures that changes will not be obscured as may occurwhen documents are reproduced, "ONTINUATION SHEET AIA DOCUMENT G703 (Il15L1'LICLItll15 un reverse g1LIC) 3 wil. 3 15,tllt, IA DOcun)em G702, APPLICATION AND CERTIFICtiI'C FOR PAYMENT, APPLICATION NO,: 1 outalnlnE Contractor's slg 1cd Cai,dfll orlon, Is ntmellecl' PROJECT: 23A -HVAC Systems AlYLICATKON I)NI'E: 08/21/2019 1 [Ablllildoils below, RI110ullts are st0[ed to the neal'est doll;ll'. Elk River Multi -Purpose Facility and Lion John 1'131000 1'01 08131/2019 Ise Coltlnln I On COnlrllcts Whel'C wtr.l:lble I'etalnngc fOr Ilne IW1116 n1:ly apply, Weicht Park ARCI•IITEC75 I'RQIECT NO.: A 8 ITEM SCEIrDULE0 NO, DESCRIPTION OF WORKS VALLIC 28 238100 Paackaged AC Units -labor 29 I 238100 Packaged AC Units-mat'I 3o 238419 Desiccant Dehumid Units - $0.00 labor 31 238419 Desiccant Dehumid Units - $0.00 mat'[ 32 232100 Hydronic Piping 33 LIONS PARK 34 Mobilization -labor 35 Mobilization-mat'I 36 Ductwork -labor 37 Ductwork-mat'I 38 Grilles/Registers-labor ! 39 Grilles/Registers-mat'I 40 Fans -labor 41 Fans-mat'I 42 Permit 43 Change Order 1 $6,000.00 $25,000.00 $40,000.00 $300,000.00 $80,000.00 $0.00 $1,000.00 $500.00 $2,500.00 $500.00 $500.00 $200.00 $1,000.00 $1,000.00 $20,000.00 $7,692.93 D + E \VORIt COMPLETED PROM PRCVLOUS APPLICNVION 'I'HM PERIOD (D r Is) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7,500.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00, $0.00 $0.001 $0.00 $0.00 $20,000.00 $0.001 $0.00 I I, MA'I'CIII ALS PRVSCNTL,Y STORCID (NUT IN U OR C) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 G _770 FA L C.OMPLRTED AND STORED TO Dn I' E (bfiliTF) $0.00 $0.00 $0.00 $0.00 $7,500.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $20,000.00 $0.00 hl t BALANCE RE"FAINA01 �' IO P VARIABI,RI tc + C) rlNlsrl (II(n'I'li) ([;-G) 0% 0% 0% 9% 0% 0% 0% 100% $25,000.00 $40,000.00 $300,000.00 $72,500.00 $0.00 $1,000.00 $500.00 $2,500.00 $500.00 $500.00 $200.00 $1,000.00 $1,000.00 $0.00 $7,692.93 $0.00 $0.00 $0.00 $375.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $1,000.00 $0.00 SOW 1 27 500.00 2°I $1,756,192.93 1 $1,375.00 AIA DOCl1MF.NT G C D.C.N11TI0N 5hI L'li1' I'Gri'G7slt 19J'- LrpITION N,1^' - ©W92 • 'rl•Iti Ah111RICAN IN�I'I'I'lll'C UI, A11Cl-irrL(a ;i, 11,15 NC\v 1'OIIK ' AVI'.NUE, N.W., IVAtiIiINCTON, D,Cnll(IG-5'2411 1 WARNING: Unllcensod pholocopying vlolalsa U.S. copyrlghl laws and will subject tite vlolalar to legal prosecullon, G703-1992 =TION! You should use an original AIA document which has title caution printed In red, An original assures th;it changes will not be obscured as may occurwhen documents are reproduced APPLICATION AND CERTIFICATE FOR PAYMENT Page / of v? SUBMITTED TO: RJM Construction, LLC 830 Boone Avenue North Golden Valley, MN 55427 SUBMITTED FROM: Minnesota Utilities & Excavating 13932 Lake Drive Forest Lake, MN 55025 CONTRACT FOR: City of Elk River PROJECT: Elk River Ice Arena 1000 School Stret NW Elk River, MN 55330 ARCHITECT: 292 Design Group 3533 East Lake Street Minneapolis, MN 55406 CONTRACT NO.: 0 I hereby certify that the work performed and the material supplied to date, as shown here, represent the actual value of accomplishment under the terms of the contract (and all authorized changes hereto) between the undersigned and RJM Construction relating to the above - referenced project. I further certify that no labor or materials have been supplied under contracts, agreements, verbal or written, or any other arrangement of any type whatsoever,other than the contract duly authorized and executed change orders, and the undersigned does hereby releases RJM Construction from any claim or liability therefor for the period covered by this application. I also certify that payments, less applicable retention, have been made through the period covered by previous payments received from the contractor to 1) all my subcontractors (sub -subcontractors) and 2) for all material and labor used in or in connection with the performance of this contract. I further certify that I have complied with Federal, State, and local tax laws, including Social Security laws, Unemployment Compensation Laws and Workman's Compensation laws insofar as applicable to the performance this contract. PARTIAL WAIVER OF LIEN Now therefore, upon receipt of the payment of the current payment due on this application the undersigned does hereby irrevocably release and waive any and all mechanic's liens or rights to claim any and all mechanic's liens or other liens against the above real estate or any part thereof for any of the materials and/or labopr therefore furnished or performed in connection with this project, reserving, however, all lien rights for labor and/or materials furnished after said date. APPLICATION NO: 2 APPLICATION DATE: 8/20/2019 PERIOD FROM: 8/1/2019 PERIOD TO: 8/31/2019 PROJECT NO: 0 CONTRACT DATE: 1/0/1900 COMMITMENT: YES/NO ORIGINAL CONTRACT SUM ............ ......... ........ :....,;.::::,.... ;;.................. $ 572,787.00 NET CHANGE BY CHANGE ORDERS TO.,....._.....,, ... .................... ......... $ CONTRACT SUM TO DATE .............. .................. ...................... $ 572,787.00 TOTAL COMPLETED AND STORED TO DATE; .............. ,.::..... S 43,171.66 5 % OF COMPLETED WORK $ 2,158.58 5 % OF STORED MATERIAL $ TOTAL RETAINAGE... .. .. $ 2,158.58 TOTAL EARNED LESS RETAINAGE .......................... $ 41,013.08 LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER......:,,..:..........:: $ LESS PREVIOUS CERTIFICAES FOR PAYMENT .....................................- $ 6,640.50 CURRENT PAYMENT DUE.... . $ 34,372.58 BALANCE TO FINISH INCLUDING RETAINAGE. ....................... ___ ......... $ 531,773.92 State of: The person signing below does hereby cerify that he/she is fully authorized and empowered to ` execute this instrument and to bind the undersigned hereto, and does in fact so execute this County of: instrument. Subscribed and sworn to before me this ,�Q Minnesota Utilities &Excavating JQQ! LYNN RUBS NOTARY PUBLIC • MINNESOTA day of 20! 13932 Lake Drive ��; �� � COmmiss6an Expires dart. 31, ZD21 Forest Lake, MN 55025 �"" NOTARY PUBLIC SIGNED: �.-�� t.�L-�' Signed: PRINTED, TITLE L �e Pv ) Iii i?'�MR% r4 Ct�liC_My Commission Expires: �a7% From: Minnesota Utilities & Excavating, LLC 13932 Lake Drive Forest Lake, MN 55025 PLEASE SUBMIT PAYMENT APPLICATIONS TO: ACCOUNTING-MN@RJMCONSTRUCTION.COM To: RJM Construction, LLC 830 Boone Avenue North Golden Valley, MN 55427 Schedule of Values Invoice No. Awl. No.: #2 apps, 090: 0812D119 From: 08/01/19 To: 08/31/19 ITEM NO, I DESCRIPTION CURRENT CONTRACT PREVIOUS I APPS. CURRENT APPLICATION WORK IN MATERL. ( PLACE ON SITE TOTAL APPS. TO DATE PERCENT COMPLETE BALANCE TO COMPLETE RETAIN TO DATE 1 Earthwork $572,787 $6,990' $36.162 $43,1721 0.00% $529,6151 $2159 2 $0 0.00% $o $0 3 1 $0 0.00% $0 $0 4 I I $0 0.00% $0 $0 5 $0 0.00% $0 $0 6 ' $0 0.00% $0 $0 7 ' ' $o 0.00% $D $0 8 $0 0.00% $0 $0 9 $0 0.00% $0 $0 10 ' $0 0.00% $0 $0 11 $D 0.00% $0 $0 12 $0 0.00% $0 $0 13 I I $0 0.00% $0 $0 14 $0 0.00% $0 $0 15 $0 0.00% $0 $0 16 . $0 0.00% $0 $0 17 $0 0.00% $0 $0 18 1 1 $0 0.00% $0 $0 19 $0 0.00% $0 $0 20 $0 0.00% $D $0 21 , $0 0.00% $0 $0 22 $0 0.00% $0 $0 23 $0 0.00% $0 $0 24 $0 0.00% $0 $p 25 $01 0.00% $0 $0 TOTAL 1 $572,7871 $6,990, $38.182 $0. $43,1721 7.54%1 $529,615 $0 Page 1 of 1 APPLICATION AND CERTIFICATE FOR PAYMENT Page of SUBMITTED TO: RJM Construction, LLC PROJECT: Elk River Ice Arena & Lion John Weichl Park Facilities APPLICATION NO: 1 830 Boone Avenue North 1000 School Street NW; Elk River, MN 55330 APPLICATION DATE: Golden Valley, MN 55427 104 Lions Park Drive; Elk River, MN 55330 PERIOD FROM: SUBMITTED FROM: Ebert Construction ARCHITECT: 292 Design Group 23350 County Road 10 Corcoran, MN 55357 CONTRACT FOR: 32B: .Concrete Sidewa!t;s l Curb & Gutter CONTRACT NO.: Ebert Job #6308 I hereby certify that the work performed and the material supplied to date, as shown here, represent the actual value of accomplishment under the terms of the contract (and all authorized changes hereto) between the undersigned and RJM Construction relating to the above - referenced project. I further certify that no labor or materials have been supplied under contracts, agreements, verbal or written, or any other arrangement of any type whatsoever,other than the contract duly authorized and executed change orders, and the undersigned does hereby releases RJM Construction from any claim or liability therefor for the period covered by this application. I also certify that payments, less applicable retention, have been made through the period covered by previous payments received from the contractor to 1) all my subcontractors (sub -subcontractors) and 2) for all material and labor used in or in connection with the performance of this contract I further certify that I have complied with Federal, State, and local tax laws, including Social Security laws, Unemployment Compensation Laws and Workman's Compensation laws insofar as applicable to the performance this contract. PARTIAL WAIVER OF LIEN New therefore, upon receipt of the payment of the current payment due on this application the undersigned does hereby irrevocably release and waive any and all niechanic's liens or rights to claim any and all mechanic's liens or other liens against the above real estate ur any part thereof for any of the materials and/or labopr therefore furnished or performed in connection with this project, reserving, however, all lien rights for labor and/or materials furnished after said date. ORIGINAL CONTRACT SUM... ....................................... PERIOD TO: PROJECT NO: #6966 CONTRACT DATE: 7110/2019 COMMITMENT: ... $ 387,400.00 NET CHANGE BY CHANGE ORDERS TO ........................ ..:.................. ". CONTRACT SUM TO DATE ............................ $ 387,40D.00 TOTAL COMPLETED AND STORED TO DATE .......................................... $ 10,303.52 5 % OF COMPL FTED WORK $ 515.18 5 % OF STORED MATERIAL S TOTAL RETAINAGE .... ........... ............................. ___ ......................... S 515.18 TOTAL EARNED LESS RETAINAGE ............................................. ...._..... $ 9,788.34 LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER .......... :.............. $ - LESS PREVIOUS CERTIFICATES FOR PAYMENT .......................:._...._..... CURRENT PAYMENT DUE ....... ........................................ ,....•__... $ 9.788.34 BALANCE TO FINISH INCLUDING RETAINAGE ....... $ 377,61168 State of: Minnesota The person signing below does hereby cerify that he/she is fully authorized and empowered to execute this instrument and to bind the undersigned hereto, and does in fact so execute this County of: Hennepin instrument. Sub ibed and sworn to before me this Ebert Construction ' ,, �' BRENDA M, SCHULTZ r day of^ 20 19 23350 County Road 10 J"� f� NoTARYPUBLIC -MINt{E5UTA Corcoran, MN 55357'u! _,+ M; Commlesion Expires Jan, 31, X11 Zy PUBLIC�,,.,1t. , • r�J[Y'ti SIGNED PRINTED, TITLE David Swanson. Project Signed: Brenda M Schultz My Commission Expires: 1131/2021 from: Ebcrt Construction 23350 County Road 10 Corcoran, MN 55357 763-498-7844 PLEASE SUBMIT PAYMENT APPLICATIONS TO: ACCOUNTING-MN@RJMCONSTRUCTION.COM To: RJM Construction, LLC 830 Boone Avenue North Golden Valley, MN 55427 Schedule of Values Invoice No. j Appl- No.: # ANS. --•-- From: _ To: ITEM NO. DESCRIPTION CURRENT CONTRACT PREVIOUS I APPS,PLACE CURRENT APPLICATION WORK IN I MATFRI-_ J ON SITE 1 TOTAL APPS I TO DATE PERCENT COMPLETE BALANCE TO COMPLETE RETAIN TO DATE Conditions $14,70U ' $3,644 ' $3,644 24.79% $11,056 $182 r62General MPB _ Walks - Matenats MPS - Walks - Labor :MPB - Curb - Materials $30.617 $44082 $1B273 _ I $744 $1071 $2.180 I $744 51.,071 S2180 2.43% 243% 1193% 529,873 $43-011 16093 $37 $54 $109 MPB -Curb -Labor $22333 $2664 7664 93°/ $19669 $133 Lon - Walks - Materials $83,053 0.QO% $83,053 $0 7 Lion - Walks - Labor $123318 .$D--- $U 0.00°1° $123,318 $0 Lion - Curb - Materials ,. $18,461 $0 0.00% $18,461 $U Eon'- Curb - Labor - $22,563 $0 0.00% $2256 $0 r112 Allowance $10,000 $0 $0 0.00% 000% $161000 $0 $C $0 $o 0.00%$D $0 — _T I 1 $0 T 6.00°/ U $ 14 15 16 17 — _ ._ — ---- — T -- -- t - I -- $U 0 $C $0 0.00% 0.00% O.DDI 0,00% $0 $D .;0 $0 $0 $6 ;10 $0 18 ► I $0000% $0 $0 19 $0 0.00% sol $0 20 $6 0.00% $0 SO 21 _ p$01 0,00% $0 $0 22 _ $0 0.00% $0 $0 23 $0 0.00% $C $0 24 $0 0.00% $0 $0 25 $0 0.00% $6 $0 TOTAL $387,406 $0. $10,304 s0. $10,304 2.66%1 $377.096 $0 Page 1 of 1 APPLICATION AND CERTIFICATE FOR PAYMENT Page 1 of 2 SUBMITTED TO: RJM Construction, LLC PROJECT: Elk River Ice Arena and Lion John Weicht Park Facilities APPLICATION NO: 1 830 Boone Avenue North 1000 School Street NW APPLICATION DATE: 7/2612019 Golden Valley, MN 55427 Elk River, MN 55330 PERIOD FROM: 7/1/2019 SUBMITTED FROM: METRO UTILITIES, INC. ARCHITECT: 292 Design Group PERIOD TO: 7/3112019 9656 161st Avenue NW 3533 East Lake Street PROJECT NO: Elk River, MN 55330 Minneapolis, MN 55406 CONTRACT DATE: 7/11/2019 CONTRACT FOR: SITE UTILITIES (33A: Utilities) CONTRACT NO.: COMMITMENT: YES(NO I hereby certify that the work performed and the material supplied to date, as shown here, represent the actual value of accomplishment under the terms of the contract (and all authorized changes hereto) between the undersigned and RJM Construction relating to the above - referenced project. I further certify that no labor or materials have been supplied under contracts, agreements, verbal or written, or any other arrangement of any type whatsoever, other than the contract duly authorized and executed change orders, and the undersigned does hereby releases RJM Construction from any claim or liability therefor for the period covered by this application. I also certify that payments, less applicable retention, have been made through the period covered by previous payments received from the contractor to 1) all my subcontractors (sub -subcontractors) and 2) for all material and labor used in or in connection with the performance of this contract. I further certify that I have complied with Federal, State, and local tax laws, including Social Security laws, Unemployment Compensation Laws and Workman's Compensation laws insofar as applicable to the performance this contract. PARTIAL WAIVER OF LIEN Now therefore, upon receipt of the payment of the current payment due on this application the undersigned does hereby irrevocably release and waive any and all mechanic's liens or rights to claim any and all mechanic's liens or other liens against the above real estate or any part thereof for any of the materials and/or labopr therefore furnished or performed in connection with this project, reserving, however, all lien rights for labor and/or materials furnished after said date. ORIGINAL CONTRACT SUM ............................ :.....:....... ........... _:..,......... $ 586,000.00 NET CHANGE BY CHANGE ORDERS TO ........... :...... :....... ,,................. ,.. CONTRACT SUM TO DATE ............................. ............ .:...................... ::... $ 586,000.00 TOTAL COMPLETED AND STORED TO DATE .............. :...... :.................... $ 14,665.00 5 % OF COMPLETED WORK $ 733.25 5 % OF STORED MATERIAL $ TOTAL RETAINAGE ................................. -............................... :....... ... $ 733.25 TOTAL EARNED LESS RETAINAGE....................................................— $ 13,931.75 LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER ........................ S - LESS PREVIOUS CERTIFICATES FOR PAYMENT...........:..... ................... CURRENT PAYMENT DUE ................... :....:.....:.:........:... I......... -I .... ,...... $ 13,931.75 BALANCE TO FINISH INCLUDING RETAINAGE.................:...,..............I. $ 572,068.25 State of: Minnesota The person signing below does hereby cerify that he/she is fully authorized and empowered to execute this instrument and to bind the undersigned hereto, and does in fact so execute this County of: Hennepin instrument, Subscribed and sworn to before me this METRO UTILITIES, INC. 26th day of Ju 9656 161st Avenue NW Elk River, MN 55330 /J NOTARY PUBLIC: SIGNED: r/ v Signed: PRINTED, TITLE Ryan VanNurden /President My Commission Expires: 20 19 STEVEN J. CROSBY Hnf lv Publio.MinneWa MyCommWsi m Fires Jan 91, 2020 From: MTTRO UTILITIES, INC. 9656 161st Avenue NW Project: Schedule of Values Elk River, MN 55330 ELK RIVER MULTI-PURPOSE FACILITY & Invoice No. 191847.1 LION JOH WEIGHT PARK Appl. No.: #1 1000 School Street NW, Elk River MN 55330 PLEASE SUBMIT PAYMENT APPLICATIONS TO: ACCOUNTING-MN@RJMCONSTRUCTION.COM To: RJM Construction, LLC 830 Boone Avenue North Golden Valley, MN 55427 I. caro: 07/26/19 From: 07/01/19 To: 07131119 ITEME NO. DESCRIPTION -7 CURRENT CONTRACT CURRENT APPLICATION 0 PREVIOUS i WORT{ }N MATERL. . APPS. I PLACE ON SITE C TOTAL APPS. TO DATE PERCENT COMPLETE BALANCE TO COMPLETE RETAIN TO DATE 7 Mobilization/Bond $24,500 $14,665 $14,665 60.00%1 S9,835 $733 2 Watermain $75,800 3 Sanila Sewer $37,200 4 Storm Sewer $446,500 5 6 7 8 I I S 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 TOTAL $586,000 $01,$14,8G5 $0 $i4,SG5 60,00%1 $571,335 $733 Page 1 of 1 APPLICATION AND CERTIFICATE FOR PAYMENT Page / of 2 SUBMITTED TO: RJM Construction, LLC PROJECT: Elk River Ice Arena and Lion John Weicht Park Facilities APPLICATION NO: 2 630 Boone Avenue North 1000 School Street NW APPLICATION DATE: 8/26/2019 Golden Valley, MN 55427 Elk River, MN 55330 PERIOD FROM: 8/112019 SUBMITTED FROM: METRO UTILITIES, INC. ARCHITECT: 292 Design Group PERIOD TO: 8131/2019 9656 161st Avenue NW Elk River, MN 55330 CONTRACT FOR: SITE UTILITIES (33A: Utilities) CONTRACT NO I hereby certify that the work performed and the material supplied to date, as shown here, represent the actual value of accomplishment under the terms of the contract (and all authorized changes hereto) berimren the undersigned and RJM Construction relating to the above - referenced project. I further certify that no labor or materials have been supplied under contracts, agreements, verbal or written, or any other arrangement of any type whatsoever,other than the contract duly authorized and executed change orders, and the undersigned does hereby releases RJM Construction from any claim or liability therefor for the period covered by this application. I also certify that payments, less applicable retention, have been made through the period covered by previous payments received from the contractor to 1) all my subcontractors (sub -subcontractors) and 2) for all material and labor used in or in connection with the performance of [his contract, I further certify that l have complied with Federat. State, and local tax laws, including Social Security laws, Unemployment Compensation Laws and Workman's Compensation laws insofar as applicable to the performance this contract. PARTIAL WAIVER OF LIEN Now therefore, upon receipt of the payment of the current payment due on this application the undersigned does hereby Irrevocably release and waive any and all mechanic's liens or rights to claim any and all mechanic's liens or other liens against the ahove real estate or any part thereof for any of the materials and/or labopr therefore furnished or performed in connection with this project, reserving, however, all lien rights for labor and/or materials furnished after said date. 3533 East Lake Street Minneapolis, MN 55406 0 PROJECT NO: 0 CONTRACT DATE: 7/11)2019 COMMITMENT: YES/NO ORIGINAL CONTRACT SUM ...................... .....:.;..;..................... ... ........ J 586,000.00 NET CHANGE BY CHANGE ORDERS TO ............................ :......... :....:.... $ - CONTRACT SUM TO DATE .............. •...........,:.:....:.......................... $ 586,000.00 TOTAL COMPLETED AND STORED TO DATE ........ ............ ....................... $ 319,080.00 5 % OF COMPLETED WORK $ 15,954.00 5 % OF STORED MATERIAL $ TOTAL RETAINAGE .......................... ;...... .............................. ........... ... $ 15,954,00 TOTAL EARNED LESS RETAINAGE ......................... .........1.1.................. $ 303,126.00 LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER......, ..................- $ LESS PREVIOUS CERTIFICAES FOR PAYMENT .................. :................... $ 13,931.75 CURRENT PAYMENT DUE .......................... ................... ......... I............. S 289,194.25 BALANCE TO FINISH INCLUDING RETAINAGE ........................................ $ 282,874.00 State of: Minnesota The person signing below does hereby verify that he/she is fully authorized and empowered to execute this instrument and to bind the undersigned hereto, and does in fact so execute this County of: Hennepin instrument. Subscribed and swom to before me this METRO UTILITIES, INC. 26th day of August 20 19 9656 161st Avenue NW Elk River, MN 55330 NOTARY PUBLIC: . STEVEN I CROSBY Notary Public-Nnnesota �— «. tWDnExptrmJan91_22Si Signed: e�V�_ - --- PRINTED, TITLE Rvan VanNurden (President My Commission Expires: 1/31/2020 From: METRO UTILITIES, INC. 9656 161st Avenue NW Elk River, MN 55330 Project: ELK RIVER MULTI-PURPOSE FACILITY & LION JOH WEICHT PARK 1000 School Street NW, Elk River MN 55330 PLEASE SUBMIT PAYMENT APPLICATIONS TO: ACCOUNTING-MN@RJMCONSTRUCTION.COM To: RJM Construction, LLC 830 Boone Avenue North Golden Valley, MN 55427 Schedule of Values Invoice No. 191847.2 Appl. No.: #2 Appl. Date: 08126119 From: 08101/19 To: 08/31/19 ITEM NO. DESCRIPTION CURRENT CONTRACT PREVIOUS APPS. I CURRENT APPLICATION WORK IN MATERL. PLACE ON SITE I TOTAL APPS. TO DATE PERCENT COMPLETE BALANCE TO COMPLETE RETAIN TO DATE 1 (Mobilization/Bond $24.500 $14 665 $9,835 I $24,500 100.00% $0 $1,225 2 Watermain $75,800 $36,740 $36,740 48.50% $39,060 $1,837 3 Sanitary Sewer $37,200 $0 0.00% $37,200 $C 4 Storm Sewer $448.500 $257,840 $257,840 57.50% $190,660 $12,892 5 6 7 8 I q 10 11 12 13 14 15 16 17 ' 18 19 20 21 22 23 24 25 TOTAL $586,0001 $14.19651 $304,415 $0 $319.0601 64.50%1 $266,920 $15,954 Page 1 of 1 -n < > ID CO b 66 ,C> 0 d <D. X CA Ln O LI C) c C:13 cy to E; Z W 4ci =7 cx 0) IV M MM ;o L;q 57 5 a rn CD m z e CD —o Q CD . . .... .... . ........ S :N ' :-4A 1V cc -1 b M co Cr 0 C3 co -4 !Q! pp C C) CI ck i fa Q C]. . ... . ....... PE #1- Final Lions Park Drive - Storm Sewer Contractor: Metro Utilities, Inc. 9656161st Avenue Northwest Elk River, MN 55330 Date of Work Performed: August 2019 :.:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ............................................................................................................... . g. :.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.... ..... Q..................-........... .:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:. 1 New Storm Sewer (12" RCP, 1 12" RCP FES & 2 2x3 CBs) LS 1 1 17,100.00 $17,100.00 2 Connect into Storm Sewer (MPF MH #31) EA 1 1 300.00 $300.00 3 Modify Structure (MPF MH#32) LS 1 1 1,200.00 $1,200.00 Total Earned $18,600.00 Less Previous Payments 0.00 TOTAL PE 1- FINAL - LPD Storm Sewer $18,600.00 Original Quote: $18,600.00 Previous Payments: $ - Approved by: City of Elk River