The URL can be used to link to this page

4.4. SR 03-16-2020Request for Action To Item Number Mayor and City Council 4.4 Agenda Section Meeting Date Prepared by Consent March 16, 2020 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 estimate detailed below. Background/Discussion The following pay estimate has been reviewed and found to be accurate and in accordance with the approved contracts. Financial Impact PROJECT Multi -purpose Facility & Lions Park Attachments ■ Pay Estimates The Elk River Vision Pay Est. # Contractor 8-Partial RJM Construction LLC Amount $2,040,214.86 A welcoming community with revolutionary and spirited resourcefulness, exceptional,` O� e service, and community engagement that encourages and inspires pi ospei l_ y INAMIRE1 #--IAIADocument G702 -1992 Ci of Elk River Publi orks Director Date Application and Certificate for Payment Code: 420-4-8540-4^ TO OWNER: City of Elk River PROJECT: Elk River Multi -Purpose Facility and APPLICATION NO: 008-9520003308 Distribution to: Attn: Justin Femrite Lion John Weicht park PERIOD T0: OWNER: 13065 Orono Parkway 1000 School Street NW Elk River, MN 55330 FROM RJM Construction, LLC CONTRACTOR: 830 Boone Ave N Golden Valley, MN 55427 Elk River, MN 55330 VIA 292 Design Group, Inc ARCHITECT: 3533 East Lake Street 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 0703, is attached. 1. ORIGINAL CONTRACT SUM „..„».»..„ ........ »...... „.............................................. S25 772,257.00 2. NET CHANGE BY CHANGE ORDERS .... ...................................................... $398.559.40 3. CONTRACT SUM TO DATE (Line 1 t 2)„»„.,...»......»..„.»»».»,......,$26.170,816.40 4. TOTAL COMPLETED & STORED TO DATE (Column G on G703) .».............. $15,561,863.24 5. RETAINAGE: a. 4.63 % of Completed Work (Column D + E on G703) $721,068.53 b. 0 % of Stored Material (Column F on G703) S0.00 Total Retainage (Lines 5a + 5b or Total in Column I of G703) --- „„»»...... S721.068.53 6. TOTAL EARNED LESS RETAINAGE »,».»..»».».............»....----.„,„„„,»,..»,,. (Line 4 Less Line 5 Total) T. LESS PREVIOUS CERTIFICATES FOR PAYMENT ... .„............ »»... »».... „....... „. (Line.6 from prior Certificate) CONTRACT FOR: General Construction ARCHITECT: CONTRACT DATE: CONTRACTOR: ❑ PROJECT NOS: / RJM Construction, LLC / FIELD: ❑ OTHER: ❑ The undersigned Contractor certifies that to the best of the Contractor's knowledge, information .and belief the Work coveredby 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 receivedTNin the Owner, and that current payment shown herein is now due. CONTRACTO By: Date: State of: ,m .tirn County of: Aan n Subscribeswo{nto before me thisday of k . ZtW Notary Public: ,� l' RILEY DOUGLAS GARDNER My Commission expires: Ot*mbl/W Notary Public -Minnesota $14.840,794.71 ARCHITECT'S CERTIFICATE FOR P $12,800,579.85 8. CURRENT PAYMENT DUE.......................................................................... $2.040.214.86 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) $11.330 021.69 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner S410,520.44 $11,961.06 Total approved this Month S0.01 $0.00 TOTALS S410,520.4 $11,961.06 NET CHANGES by Clianae Order I S398,559.40 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 ............ »..»..»..»»..».„..»....»...„.....„.„...»»„..„,„..».».. $2,040,214.9 (Attach explanation if amount cert fed dffers 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: Me��.! Y Vim. L 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. AU1 Document G702TM —1992. Copyright ®1953.1963,1965,1971,1978,1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA°° D"u.meM is protected by U.s: py Coright Law and International Treaties. Unauthorized reproduction or distribution of this AIAO Data any portion of it; may result in seven chill,and, criminal psnalljes,'and will be prosecuted, to the maximum extent possibte under the law. This document was produced by MA'software at 10.44:56 ET on 03105/2020 under Order No. 6896726545 which expires on 08/0812020, and Is not for resale. User Notes: (309ADA62) CONTINUATION SHEET Page 2of3 Application and Certification for Payment, containing Application No.: 8 Contractor's signed certification is attached. Application Date : 02/29/20 In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. To: 02/29/20 Invoice # : 9520003308 Contract: 19520-0033 Elk River Multi -Purpose Facility and Lion John Weicht Park Architect's Project No.: A_ Rem B C Description of Work Scheduled D E F G H I Work Com leted Materials Total % Balance Retainage From Previous This Period No. Value Presently Completed (G / C) To Finish Application In Place Stored and Stored (C-G) (D+E) To Date Not in D or E D+E+F 1 Elk River MultWurpose 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 1 0.00% 80,651.00 0.00 1 B Survey 41,280.00 11,309.00 0.00 0.00 11,309.00 27.40% 29,971.00 565.45 2A Building Demolition 169,158.51 162,199.51 0.00 0.00 162,199.51 95.89% 6,959.00 8,109.98 2B Selective Demolition 216,124.40 10,493.00 2,865.00 0.00 13,358.00 6.18% 202,766.40 667.90 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 2,997,318.65 2,091,476.28 474,204.37 0.00 2,565,680.65 85.60% 431,638.00 128,284.03 5A Structural Material 1,339,286.43 1,084,189.00 0.00 0.00 1,084,189.00 80.95% 255,097.43 54,209.45 5B Structural Labor 434,223.85 228,201.00 66,171.00 0.00 294,372.00 67.79% 139,851.85 14,718.60 6A Carpentry 1,306,926.43 190,719.32 72,613.29 0.00 263,332.61 20.15% 1,043,593.82 13,166.63 7A Waterproofing&WB 38,902.00 20,132.00 10,660.00 0.00 30,792.00 79.15% 8,110.00 1,539.60 7B Roofing Systems 1,026,478.00 880,980.00 26,980.00 0.00 907,960.00 88.45% 118,518.00 45,398.00 7C Metal Wall Panel 191,460.00 0.00 0.00 0.00 0.00 0.00% 191,460.00 0.00 8A Aluminum Entrances/Storefronts 644,100.00 24,168.00 0.00 0.00 24,168.00 3.75% 619,932.00 1,208.40 8B Overhead Coiling and Sectional 53,260.00 0.00 0.00 0.00 0.00 0.000/0 53,260.00 0.00 Doors 9A Gypsum Board 332,608.52 6,000.00 0.00 0.00 6,000.00 1.80% 326,608.52 300.00 9B Tiling 138,480.00 0.00 0.00 0.00 0.00 0.00% 138,480.00 0.00 9C Acoustical Ceilings 134,305.00 2,250.00 0.00 0.00 2,250.00 1.68% 132,055.00 112.50 9D Flooring 103,900.00 0.00 0.00 0.00 0.00 0.00% 103,900.00 0.00 9E Painting 413,000.00 34,000.00, 0.00 0.00 34,000.00 8.23% 379,000.00 1,700.00 10A Signage 50,340.00 0.001 0.00 0.00 0.00 0.00% 50,340.00 0.00 11 A Athletic Equipment 173,574.91 41,987.50 0.00 0.00 41,987.50 24.19% 131,587.41 2,099.38 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 0.000/0 27,886.00 0.00 13B Ice Rink Systems 2,162,742.00 899,742.00 244,000.00 0.00 1,143,742.00 52.88% 1,019,000.00 57,187.10 13C Leg Truss System 125,797.00 125,797.00 0.00 0.00 125,797.00 100.00% 0.00 6,289.85 14A Elevators 79,500.00 39,750.00 0.00 0.00 39,750.001 50.00% 39,750.00 1,987.50 21A Fire Protection 268,440.00 161,178.00 21,928.50 0.00 183,106.50 68.21% 85,333.50 9,155.34 22A Plumbing Systems 1,242,801.00 432,112.00 157,741.00 0.00 589,853.00 47.46% 652,948.00 29,492.65 23A HVAC 1,834,699.93 961,640.00 46,470.00 0.00 1,008,110.00 54.95% 826,589.93 50,405.50 26A Electrical Systems 1,763,420.75 288,992.07 421,700.00 0.00 710,692.07 40.30% 1,052,728.68 35,534.60 31A Multipurpose Earthwork 688,715.30 458,005.00 70,000.00 0.00 528,005.00 76.67% 160,710.30 26,400.25 CONTINUATION SHEET Page 3of3 Application and Certification for Payment, containing Application No.: 8 Contractor's signed certification is attached. Application Date : 02129120 In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. To: 02129/20 Architect's Project No.: Invoice # : 9520003308 Contract: 19520-0033 Elk River Multi -Purpose Facility and Lion John Weicht Park _ A Item No. B_ Description of Work _ C Scheduled Value D E Work Completed From Previous This Period Application In Place (D+E) F Materials Presently Stored Not in D or E _ G Total Completed and Stored To Date D+E+F _ % (G 1 C) H Balance To Finish (C-G) Retainage 31 B Lions Earthwork 518,472.62 471,689.77 0.00 0.00 471,689.77 90.98% 46,782.85 23,584.49 32A Asphalt Paving 331,364.00 120,225.00 0.00 0.00 120,225.00 36.28% 211,139.00 6,011.25 32B Concrete/Sidewalk/Curb/Gutter 386,054.93 49,045.58 0.00 0.00 49,045.58 12.70% 337,009.35 2,452.28 32C Multipurpose Landscaping 39,800.00 0.00 0.00 0.00 0.00 0.000/0 39,800.00 0.00 32D Lions Landscaping 96,500.00 0.00 0.00 0.00 0.00 0.00% 96,500.00 0.00 32E Chain Link Fence 145,543.00 60,615.75 0.00 0.00 60,615.75 41.65% 84,927.25 3,030.79 33A Utilities 619,037.15 603,128.00 0.00 0.00 603,128.00 97.43% 15,909.15 30,156.40 3B.1 Precast Concrete 1,190,000.00 1,130,500.00 0.00 0.00 1,130,500.00 95.00% 59,500.00 56,525.00 3B.2 Precast Concrete 930,000.00 880,506.00 0.00 0.00 880,506.00 94.68% 49,494.00 44,025.30 3B.3 Precast Raker/Plank/Stadia 1,048,025.00 636,555.00 411,470.00 0.00 1,048,025.00 100.000/0 0.00 52,401.25 01-00 General Conditions/Requirements 1,166,842.48 740,743.47 73,411.81 0.00 814,155.28 69.77% 352,687.20 0.00 90-50 General Liability Insurance 262,882.47 262,693.11 189.36 0.00 262,882.47 100.00% 0.00 0.00 90-60 Construction Contingency 609,027.62 0.00 0.00 0.00 0.00 0.00% 609,027.62 0.00 90-70 Value Engineering 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 90-80 Builders Risk Insurance 63,455.19 63,396.38 58.81 0.00 63,455.19 100.009/6 0.00 0.00 99-99 Contractors Fee 478,302.26 243,726.75 43,254.61 0.00 I 286,981.36 I I 60.00% 191,320.90 14,349.06 Grand Totals_ _ 26,170,816.40 13,418,145.49 2,143,717.75 0.00 15,561,863.24 59.46% 10,608,953.16 721,068.53 INVOICE From: RJM Construction, LLC Invoice: 9520003308 830 Boone Ave North Invoice Date: 02129/20 Golden Valley, MN 55427 Due Date: 03/30/20 952-837-8600 Disc Date: To: City of Elk River Attn: Justin Femrite 13065 Orono Parkway Elk River, MN 55330 Contract : 1952MO33 Elk River Multi Purpose Facility and Lion John Weicht Park Selective Demolition MATERIAL PURCHASES Veit Disposal Systems Inv# 576315 565.00 Total MATERIAL PURCHASES 565.00 SUBCONTRACTS Ebert Construction Demolition Inv# 195200033-04 2,300,00 Total SUBCONTRACTS 2,300.00 Selective Demolition Sub -Total: 2,865.00 Masonry Systems MATERIAL PURCHASES CenterPoint Energy-Minnegasco Inv# 200702 11,050.80 Tioga Air Heaters, LLC 83314 9,282.57 Total MATERIAL PURCHASES 20,333.37 SUBCONTRACTS Crosstown Masonry, Inc Concrete/Masonry Inv# 195200033-07 453,871.00 Total SUBCONTRACTS 453,871.00 Masonry Systems Sub -Total: 474,204.37 Structural Labor SUBCONTRACTS High Five Erectors II, Inc Structural Steel Erection Inv# 22540 66,171.00 Total SUBCONTRACTS 66,171.00 Structural Labor Sub -Total: 66,171.00 Carpentry MATERIAL PURCHASES Home Depot Credit Services Inv# 201002 1,296.87 Brock White Company 13764067-00 127.68 Brock White Company 13776546-00 417.97 Construction Midwest, Inc 66828500 325.46 Shaw/Stewart Lumber Co. 875442-001 521.05 Shaw/Stewart Lumber Co. 876306-001 651.30 Tioga Air Heaters, LLC 83216 966.38 Tioga Air Heaters, LLC 83222 322.13 United Rentals (North America), Inc. 177215548-003 2,530.75 United Rentals (North America), Inc. 179114783-001 1,610.28 Total MATERIAL PURCHASES 8,769.87 SUBCONTRACTS H & B Specialized Products Gymnasium Equipment Inv# 30078 3,816.00 Ebert Construction Carpentry 195200033-046A 44,010.00 INVOICE From: RJM Construction, LLC Invoice: 9520003308 830 Boone Ave North Invoice Date: 02/29/20 Golden Valley, MN 55427 Due Date: 03/30/20 952-837-8600 Disc Date: To: City of Elk River Attn: Justin Femrite 13065 Orono Parkway Elk River, MN 55330 Contract: 19520-0033 Elk River MultWurpose Facility and Lion John Weicht Park Total SUBCONTRACTS 47,826.00 LABOR Apprentice Carpenter Regular Earnings 96.00 HRS @ 62.93 6,041.28 Carpenters Regular Earnings 75.00HRS @ 83.90 6,292.50 Carpenter Foreman Regular Earnings 30.00 HRS @ 8690 2,607.00 Apprentice Laborer Regular Earnings 8.00HRS @ 57.68 461 44 Laborer Regular Earnings 8.00HRS @ 76.90 615.20 Total LABOR 16,017.42 Carpentry Sub -Total: 72,613.29 Waterproofing &WB SUBCONTRACTS RAM Construction Services of Minne: Waterproofing Inv# 32966A 10,660.00 Total SUBCONTRACTS 10,660.00 Waterproofing &WB Sub -Total: 10,660.00 Roofing Systems SUBCONTRACTS Top -All Roofing, Inc Roofing Inv# 195200033-04 26,980.00 Total SUBCONTRACTS 26,980.00 Roofing Systems Sub -Total: 26,980.00 Ice Rink Systems SUBCONTRACTS Rink-Tec International. Inc. Ice Systems Inv# 195200033-07 244,000.00 Total SUBCONTRACTS 244,000.00 Ice Rink Systems Sub -Total: 244,000.00 Fire Protection SUBCONTRACTS Summit Companies Fire Protection Inv# 195200033-06 21,928.50 Total SUBCONTRACTS 21,928.50 Fire Protection Sub -Total: 21,928.50 Plumbing Systems SUBCONTRACTS Weidner Plumbing & Heating Co. Plumbing Inv# 195200033-07 157,741.00 Total SUBCONTRACTS 157,741.00 Plumbing Systems Sub -Total: 157,741.00 HVAC SUBCONTRACTS Sentra-Sota Sheet Metal Inc. HVAC Inv# 195200033-06 46,470.00 INVOICE (From: RJM Construction, LLC Invoice: 9520003308 830 Boone Ave North Invoice Date: 02129I20 Golden Valley, MN 55427 Due Dare: 03130/20 952.837-3600 Disc Date: TO: City or Elk River Attn: Justin Fernrite 13065 Orono Parkway Elk River, MN 55330 Contract: 1,152+ 00.13 Elk River Mufti-Porpose Facility and Lion John Weicht Park Total SUBCONTRACTS 46,470.00 HVAC Sub -Total: 46,470.00 Electrical Systems SUBCONTRACTS Design Electric, Inc Electrical Inv# 195200033-06 421,700.00 Total SUBCONTRACTS 421,700.00 Electrical Systems Sub -Total: 421,700.00 Multipurpose Earthwork SUBCONTRACTS Minnesota Utilities & Excavating, LLC Multipurpose Earthwork Inv# 195200033-08 70,000.00 Total SUBCONTRACTS 70,000.00 Multipurpose Earthwork Sub -Total: 70,000.00 Precast Raker/Plank/Stadia SUBCONTRACTS Molin Concrete Products Co. 036.3 Precast Plank/Stadia/Raker Beams Inv# 195200033-03 411,470.00 Total SUBCONTRACTS 411,470.00 Precast Raker/Plank/Stadia Sub -Total: 411,470.00 General Conditions/Requirements MATERIAL PURCHASES Spee Dee Delivery Service Inv# 3930838 21.95 Premium Waters, Inc. 853364-01-20 19.62 Veit Disposal Systems 575677 1,160.00 Veit Disposal Systems 575992 610.00 Veit Disposal Systems 576589 335.00 Bills Inc. 879016A -161.06 Biffs Inc. 879413 1,449.56 Biffs Inc. 879446 748.13 Biffs Inc. 879465 1,449.56 Biffs Inc. 879472 1,771.69 Biffs Inc. 879478 1,771.69 Biffs Inc. 879504 1,449.56 Biffs Inc. 879507 1,449.56 Bills Inc. 879560 1,449.56 Biffs Inc. 879570 1,610.63 Biffs Inc. 879579 1,771.69 Biffs Inc. W754424 634.84 Biffs Inc. W754426 389.03 Biffs Inc. W754427 126.11 INVOICE From: RJM Construction, LLC Invoice: 9520003308 830 Boone Ave North Invoice Date: 02/29/20 Golden Valley, MN 55427 Due Date: 03/30/20 952-837-8600 Disc Date: To: City of Elk River Attn: Justin Femrite 13065 Orono Parkway Elk River, MN 55330 !Contract : 19520-0033 Elk River MuI&Purpose Facility and Lion John Weicht Park General Conditions/Requirements MATERIAL PURCHASES WEX Bank Verizon Wireless PCM Sales, Inc. Brett Sillerud ALLOCATED EXPENSES LABOR General Superintendent Quality Assurance & Control Safety Superintendent Apprentice Laborer Laborer Laborer Foreman BIM Coordinator MEP Engineer Project Administrator Project Engineer Project Manager Project Executive P&PBond General Liability Insurance GENERAL LIABILITY INSURANCE Builders Risk Insurance BUILDERS RISK INSURANCE Contractors Fee CONTRACTOR'S FEE Inv# 64006718 9848896645 B13530420101 EXP 02/07/20 Total MATERIAL PURCHASES Total ALLOCATED EXPENSES Regular Earnings 4.00 HRS @ Regular Earnings 13.00HRS @ Regular Earnings 6.00HRS @ Regular Earnings 160.00 HRS @ Regular Earnings 8 00 HRS @ Regular Earnings 16.00HRS @ Regular Earnings 16.00HRS @ Regular Earnings 3.00HRS @ Regular Earnings 3 00 HRS @ Regular Earnings 14.00HRS @ Regular Earnings 120.00HRS @ Regular Earnings 40.00 HRS @ Regular Earnings 71 00 HRS @ Total LABOR General Conditions/Requirements Sub -Total: General Liability Insurance Sub -Total: Builders Risk Insurance Sub -Total: Contractors Fee Sub -Total: 114.90 114.90 114.90 109.90 57.68 76.90 80.90 97.40 80.40 56.40 80.40 106.40 13840 477.01 237.54 195.42 63.80 4,875.00 23,905.89 724.00 724.00 459.60 1,493.70 689.40 17,584 00 461.44 1,23040 1,294.40 292.20 241.20 789.60 9,648.00 4,256.00 515.58 73,411.81 189.36 189.36 58.81 58.81 43,254.61 43,254.61 INVOICE Summary 2B Selective Demolition 2,865.00 Retainage 2,142,954.00@ 5.00% (143.25) 4A Masonry Systems 474,204.37 Retainage 2,142,954.00@ 5.00% (23,710.22) 513 Structural Labor 66,171.00 Retainage 2,142,954.00@ 5.00% (3,308.55) 6A Carpentry 72,613.29 Retainage 2,142,954.00@ 5.00% (3,630.66) 7A Waterproofing &WB 10,660.00 Retainage 2,142,954.00@ 5.00% (533.00) 713 Roofing Systems 26,980.00 Retainage 2,142,954.00@ 5.00% (1,349.00) 13B Ice Rink Systems 244,000.00 Retainage 2,142,954.00@ 5.00% (12,200.00) 21A Fire Protection 21,928.50 Retainage 2,142,954.00@ 5.00% (1,096.43) 22A Plumbing Systems 157,741.00 Retainage 2,142,954.00@ 5.00% (7,887.05) 23A HVAC 46,470.00 Retainage 2,142,954.00@ 5.00% (2,323.50) 26A Electrical Systems 421,700.00 Retainage 2,142,954.00@ 5.00% (21,085.00) 31A Multipurpose Earthwork 70,000.00 Retainage 2,142,954.00@ 5.00% (3,500.00) 313.3 Precast Raker/Plank/Stadia 411,470.00 Retainage 2,142,954.00@ 5.00% (20,573.50) 01-00 General Conditions/Requirements 73,411.81 Retainage 2,142,954.00@ 0.00% 0.00 90-50 General Liability Insurance 189.36 90-80 Builders Risk Insurance 58.81 99-99 Contractors Fee 43,254.61 Retainage 2,142,954.00@ 5.00% (2,162.73) CURRENT DUE : 2,040,214.86 APPLICATION AND CERTIFICATE FOR PAYMENT Page 1 of 2 SUBMITTED TO: RJM Construction, LLC PROJECT: Elk River Multi Purpose Facility & John Lion Weicht Park APPLICATION NO: 3 830 Boone Avenue North APPLICATION DATE: 2/19/2020 Golden Valley, MN 55427 PERIOD FROM: 2/1/2020 SUBMITTED FROM: Ebert Inc dba Ebert Construction ARCHITECT: 292 Design Group PERIOD TO: 2/29/2020 PROJECT NO: CONTRACT DATE: 7/10/2019 CONTRACT FOR: 2B: Demolition 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 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. COMMITMENT: Yes ORIGINAL CONTRACT SUM.................................................................. $ 223,800.00 NET CHANGE BY CHANGE ORDERS TO ................................................ $ (3,866.00) CONTRACT SUM TO DATE................................................................... $ 219,934.00 TOTAL COMPLETED AND STORED TO DATE .......................................... $ 10,553.00 5 % OF COMPLETED WORK $ 527.65 5 % OF STORED MATERIAL $ - TOTALRETAINAGE............................................................................. $ 527.65 TOTAL EARNED LESS RETAINAGE....................................................... $ 10,025.35 LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER ........................ $ - LESS PREVIOUS CERTIFICATES FOR PAYMENT .................................... $ 7,840.35 CURRENT PAYMENT DUE.................................................................... $ 2,185.00 BALANCE TO FINISH INCLUDING RETAINAGE........................................ $ 209,908.65 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 to before me this Ebert Inc dba Ebert Construction SIGNED: "Wlv�_�� PRINTED, TITLE Jottfi Redepenning - Project Manager 19th day of NOTARY P LIC: �, : f CANDACE LEE GREEN n :s�91 NOTARY PUBLIC -�J ' '"` MINNESOTA Jan. 31. 2022 Signed: :' c? : tviy Cemrrissicn Expires My Commission Expires: 31-Jan-22 From: PLEASE SUBMIT PAYMENT APPLICATIONS TO: ACCOUNTING-MN@RJMCONSTRUCTION.COM To: RJM Construction, LLC 830 Boone Avenue North Golden Valley, MN 55427 Schedule of Valu Invoice No. Avul. No.: # 3 Appl. Date: 02/19/20 From: Ebert Construction To: RJM Construction ITEM NO. DESCRIPTION General Conditions / Bond Selective Demolition CURRENT CONTRACT CURRENT APPLICATION PREVIOUS WORK IN APPS. PLACE I TOTAL MATERL. APPS. ON SITE TO DATE PERCENT COMPLETE BALANCE TO COMPLETE RETAIN TO DATE 1 $9,888.00 $2,659.00 $800.00 $3,459.00 34.98 $6,429.00 $172.95 2 $193 912.00 $20,000 00 $6 666.001 $1.500.00 $2.794.001 $0.000 I $8.166.00 $2 794.00 4.21 13.97 $185,746.00 $17 206.00 $408.30 $139.70 3 Allowance 4 Chan a Order #1 -$3 866 00 -$3,866.00' $0.000 -$3 866.00 100 -$193.30 5 6 7 I 1 8 9 10 11 I I 12 13 14 15 16 I 17 18 19 20 21 I I 22 23 24 25 TOTAL $219,934 00 $8,253.001 $2,300.001 $10,553 00 4.80% $209,381.001 $527.65 Page 1 of 1 APPLICATION AND CERTIFICATE FOR PAYMENT SUBMITTED TO: RJM Construction, LLC 830 Boone Avenue North Golden Valley, MN 55427 SUBMITTED FROM: Crosstown Masonry, Incorporated 1322 159th Ave NE Ham Lake, MN 55304 CONTRACT FOR: Concrete &Masonry PROJECT: Elk River Ice Arena & Lion's Park 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. 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. Crosstown Masonry, Incorporated 1322 159th Ave NE Ham Lake, MN 5530 SIGNED: PRINTED, TITLE Tammy Braastad, President 1000 School Street NW Elk River. MN 55330 Page 1 of 3 APPLICATION NO: 7 APPLICATION DATE: 2/24/2020 PERIOD FROM: 2/1/2020 PERIOD TO: 2/29/2020 PROJECT NO: CONTRACT DATE: COMMITMENT: YES/NO ORIGINAL CONTRACT SUM.................................................................. $ 2,935,000.00 NET CHANGE BY CHANGE ORDERS TO ................................................ $ 21,864.00 CONTRACT SUM TO DATE................................................................... $ 2,956,864.00 TOTAL COMPLETED AND STORED TO DATE .......................................... $ 2,525,226.00 5 % OF COMPLETED WORK $ 126,261.30 5 % OF STORED MATERIAL $ TOTAL RETAINAGE............................................................................. $ 126,261.30 TOTAL EARNED LESS RETAINAGE....................................................... $ 2,398,964.70 LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER ........................ $ - LESS PREVIOUS CRTIFIC EATES FOR PAYMENT .................................... $ 1,967,787.25 CURRENT PAYMENT DUE.,.., ........ 116 ....... M ........................... 4 ................ $ 4313177.45 BALANCE TO FINISH INCLUDING RETAINAGE........................................ $ 557,899.30 State of: Minnesota County of: Anoka Subscribed and sworn to before me this t� • •• 1fy ~ • FJ • • •FX1 1 AIA Type Document Application and Certification for Payment Page 2 of 3 TO (OWNER): City of Elk River PROJECT: Elk River Ice Arena & Lions Pk APPLICATION NO: 7 DISTRIBUTION 13065 Orono Parkway NW 1000 School Street NW TO: Elk River, MN 55330 Elk River, MN 55330 PERIOD T0:2/29/2020 _ OWNER _ ARCHITECT CONTRACTOR FROM (CONTRACTOR): Crosstown Masonry, Incorporated VIA (ARCHITECT): ARCHITECT'S 1322 159th Ave NE PROJECT NO: Ham Lake, MN 55304 CONTRACT FOR: Concrete &Masonry CONTRACT DATE: SCHEDULE PREVIOUS COMPLETED STORED COMPLETED ITEM DESCRIPTION VALUE APPLICATIONS THIS PERIOD MATERIAL STORED % BALANCE RETAINAGE LIONS PARK LIONS PARK 0.00 0,00 0.00 0.00 0,00 0.00 0.00 0.00 1 Footings & Foundation Labor 30,000.00 30,000,00 0.00 0.00 30,000.00 100.00 0.00 11500,00 2 Footings & Foundation Material 81000.00 8,000.00 0.00 0.00 81000.00 100.00 0.00 400,00 3 Above Grade CMU Labor 847000.00 743000.00 0.00 0,00 74,000.00 88.10 10,000.00 3,700.00 4 Above Grade CMU Material 26,000.00 261000.00 0,00 0.00 26,000.00 100.00 0.00 1,300.00 5 Slab on Grade Labor 51300,00 0.00 0.00 0.00 0.00 0,00 5,300.00 0,00 6 Slab on Grade Material 4200.00 0.00 0,00 0.00 0.00 0.00 4,200.00 0.00 7 Stone Piers Labor 17,000.00 0.00 0.00 0.00 0.00 0.00 17,000.00 0.00 8 Stone Piers Material 10,000.00 0,00 0.00 0.00 0.00 0.00 107000.00 0.00 g Dug Outs / Batting Cage Labor 41,000.00 15,000.00 20,000.00 0.00 35,000.00 85,37 6,000.00 11750,00 10 Dug Outs / Batting Cage Material 28,000.00 101000,00 14,000.00 0.00 243000.00 85,71 41000.00 19200.00 RINK RINK 0.00 0,00 0.00 0.00 0.00 0,00 0.00 0.00 12 Footings & Foundation Labor 4152000,00 415,000.00 0.00 0.00 415,000.00 100.00 0.00 201750.00 13 Footings & Foundation Material 2101000.00 210,000.00 0.00 0.00 2102000.00 100.00 0.00 10,500.00 14 Above Grade CMU Labor 812,000.00 605,000.00 160,000.00 0.00 765,000.00 94,21 47,000,00 381250.00 15 Above Grade CMU Material 3485000.00 3101000,00 31,000.00 0.00 3413000,00 97,99 71000.00 173050,00 16 Slab on Grade Labor 236,000.00 121,000.00 60,000.00 0,00 181,000.00 76.69 551000,00 91050,00 17 Slab on Grade Material 210,000.00 64,000.00 100,000.00 0.00 1641000.00 78,10 46,000,00 8,200.00 18 Slab on Deck Labor 140,000.00 79,000.00 30,000.00 0,00 109,000.00 77.86 31,000.00 51450.00 19 Slab on Deck Material 69,000.00 48,000.00 10,000.00 0.00 58,000.00 84.06 11,000.00 21900.00 20 Stoops Labor 85000.00 0.00 0.00 0.00 0,00 0,00 81000.00 0,00 AIA Type Document Application and Certification for Payment Page 3 of 3 TO (OWNER): City of Elk River PROJECT. Elk River Ice Arena & Lions Pk APPLICATION NO: 7 DISTRIBUTION 13065 Orono Parkway NW 1000 School Street NW TO: Elk River, MN 55330 Elk River, MN 55330 PERIOD TO: 2/29/2020 _ OWNER _ ARCHITECT .CONTRACTOR FROM (CONTRACTOR): Crosstown Masonry, Incorporated VIA (ARCHITECT): ARCHITECT'S 1322 159th Ave NE PROJECT NO: Ham Lake, MN 55304 CONTRACT FOR: Concrete &Masonry CONTRACT DATE: ITEM DESCRIPTION 21 Stoops Material 22 Stone at Fireplace Labor 23 Stone at Fireplace Material 24 Concrete Allowance 25 Masonry Allowance 26 Field House Labor 27 Field House Material 28 Bond 29 Change Order #1 30 Change Order #2 31 Change Order #3 32 Change Order #4 33 Change Order #5 34 Change Order #6 35 Change Order #7 REPORT TOTALS SCHEDULE PREVIOUS VALUE APPLICATIONS 21000,00 0.00 81000.00 0,00 21000,00 0,00 50,000.0O 71145,00 403000.00 0.00 70,000.00 0.00 18,000,00 0.00 431500.00 437500.00 697,00 697.00 331996.00 243000.00 -31778.00 -31778.00 689.00 0,00 -152209.00 -153209.00 13,969.00 0,00 -8,500.00 0.00 COMPLETED STORED THIS PERIOD MATERIAL 0.00 0.00 0.00 0.00 0.00 0,00 171484,00 0.00 51229.00 0,00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 0.00 689.00 0.00 0.00 0.00 13,969.00 0.00 -81500.00 0.00 $2,956,864.00 $2,071,355.00 $453,871.00 COMPLETED STORED o 0.00 0,00 0.00 0.00 0.00 0,00 24,629.00 49.26 57229.00 13.07 0.00 0,00 0.00 0.00 43,500.00 100,00 697.00 100.00 24,000.00 70.60 -31778.00 100,00 689.00 100.00 15,209.00 100.00 13, 969.00 100.00 -81500.00 100.00 f�T 2,000.00 8,000.00 2,000.00 25,371.00 34,771.00 70, 000.00 18, 000.00 0.00 0.00 9, 996.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,231.45 261.45 0.00 0.00 2,175.00 34.85 1, 200.00 -188.90 34.45 -760.45 698.45 -425.00 $0.00 $2,525,226.00 85.40 $431,638.00 $126,261.30 ERECTERS 11 3005 4th Avenue East • P.O. Box 477 • Shakopee, MN 55379. 952-496-4000 • Fax: 952-496-I 650 #1250 SOLD TO: RJM Construction, LLC 830 Boone Avenue N. Golden Valley, MN 55427 accouting-mn@rjmconstruction.com INVOICE No. 22540 DATE: 02/20/20 JOB: Elk River Ice Arena & Lion John Weicht Job #2598 RJM Project # DESCRIPTION OF WORK PERFORMED AMOUNT BILLING #4 Work Completed Through 02/28/20 - (See Attached Summary) $294,372.00 Less Previous Billings 228,201.00 TOTAL DUE THIS INVOICE1 $66,171.001 APPLICATION AND CERTIFICATE FOR PAYMENT (AIA DOCUMENT G702/CMa) TO OWNER: PROJECT: APPLICATION NO: FOUR (4) Distribution to: City of Elk River Elk River Ice Arena & Lion John Weicht Park Facilities OWNER ❑ 13065 Orono Parkway NW 1000 School Street NW PERIOD TO: 02-28-20 Elk River, MN 55330 Elk River, MN 55330 CONSTRUCTION MANAGER ❑ CONTRACT DATE: 07-10-19 VIA CONSTRUCTION MANAGER: ARCHITECT ❑ FROM CONTRACTOR: RJM Construction, LLC PROJECT NO: 0 High Five Erectors II, Inc. CONTRACTOR ❑ 3005 4th Avenue East, P.O. Box 477 VIA ARCHITECT: Shakopee, MN 55379 292 Design Group CONTRACT FOR: Install Steel & Misc. Metals Li CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Application is made for payment, as shown below, in connection with the Contract. Work covered by this Application for Payment has been completed in accordance with the Contract Documents, Continuation Sheet, AIA Document G703, is attached. that all amounts have been paid by the Contractor for Work for wich previous Certificates for Payment were 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. 5% of Completed Work (Column D + E on G703) $ 14,718.60 b. 0% 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 RETAINAGE ...... (Line 3 less Line 6) $ 435,750.00 issued and payments received from the Owner, and that rrent payment shown herein is now due. $ (2,198.15) CONTRACTOR: / $ 433,551.85 B _1 Date: � %� $ 294,372.00 $ 14,718.60 $ 279,653.40 ... $ 216,790.95 $ 62,862.45 $ 153,898.45 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total Changes approved in previous months by Owner $ - $ - Total approved this Month 4,190.00 500.00 6,888.15 CO #1 - PR 2 Lease Space CO #2 - Deduct from Allowance CO #3 - ASI 35 add column/weld plates TOTALS $ 4,690.00 1 $ 6,888.15 NET CHANGES by Change Orders 1 $ (2,198.15) State of: Minnesota County of: Scott Subscribed and sworn to before me this day of bt.0(,f Notary cv - My Commission expires: a I '_71 a—S KIM A STOCK Notary Public - Minnesota My Commission Expires 0113112025 CERTIFICATE FOR PAYMENT 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 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 ................... ..................................$ (Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) CONSTRUCTION MANAGER: ARCHITECT: By: Date: 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. JOB# 2598 ELK RIVER ICE ARENA RJM CONSTRUCTION CONTINUATION SHEET (A/A Document G703) APPLICATION NO: FOUR (4) APPLICATION DATE: 02-20-20 PERIOD FROM: 02-01-20 TO: 02-28-20 PROJECT NO: 0 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE FROM PREVIOUS ITEM DESCRIPTION OF WORK SCHEDULED PRESENTLY COMPLETED AND % TO 5% NO. VALUE APPLICATIONS THIS PERIOD STORED STORED TO DATE (G _ C) FINISH (D + E) (NOT IN D or E) (D+E+F) (C - G) RETAINAGE 1 051200 Structural Steel 129.841.00 90,889.00 38,952.00 - 129,841.00 100% - 6,492.05 2 052100 Steel Joists 100,523.00 90,470.00 10,053.00 - 100,523.00 100% - 5,026.15 3 053100 Steel Decking 45,888.00 34,416.00 11,472.00 - 45,888.00 100% - 2,294.40 4 055000 Metal Fabrications 8,508.00 - - - - 0% 8,508.00 - 5 055100 Metal Pan Stairs 43,996.00 - - - - 0% 43,996.00 - 6 055213 Pipe & Tube Railings 71,614.00 - - - - 0% 71,614.00 - 7 Allowance 30,000.00 13,934.15 1,504.00 - 15,438.15 51% 14,561.85 771.91 8 Bond 5,380.00 5,380.00 - - 5,380.00 100% - 269.00 9 CO #1 - PR 2 Lease Space 4,190.00 - 4,190.00 - 4,190.00 100% - 209.50 10 CO #2 - Deduct from Allowance (6,888.15) (6,888.15) - - (6,888.15) o 100% _ (344.41) 11 CO #3 - ASI 35 add column/weld plates 500.00 - - - - 0% 500.00 - TOTALS 1 433,551.85 1 228,201.00 1 66,171.00 - 1 294,372.00 1 68%1 139,179.85 1 14,718.60 APPLICATION AND CERTIFICATE FOR PAYMENT Page of SUBMITTED TO: RJM Construction, LLC PROJECT: Elk River Ice Arena & Lion John Weicht Park Facilities APPLICATION NO: 4 830 Boone Avenue North 1000 School Street NW APPLICATION DATE: 2/20/2020 Golden Valley, MN 55427 Elk River, MN 55330 PERIOD FROM: 2/1/2020 SUBMITTED FROM: High Five Erectors II, Inc. ARCHITECT: 292 Design Group PERIOD TO: 2/28/2020 3005 4th Avenue East Shakopee, MN 55379 CONTRACT FOR: 5B Structural & Misc. Steel Installation 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 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. High Five Erectors II, Inc. 3005 4th Avenue East Shakopee, MN 5537 SIGNED: PRINTED, TITLE Tara Thompson, President ORIGINAL CONTRACT SUM ......................... NET CHANGE BY CHANGE ORDERS TO........ CONTRACT SUM TO DATE .......................... TOTAL COMPLETED AND STORED TO DATE. 5 % OF COMPLETED WORK 5 % OF STORED MATERIAL TOTAL RETAINAGE............. PROJECT NO: CONTRACT DATE: 7/10/2019 COMMITMENT: YES/NO .................................. $ 435,750.00 $ 14,718.60 TOTAL EARNED LESS RETAINAGE................... LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER. LESS PREVIOUS CERTIFICATES FOR PAYMENT ............. CURRENT PAYMENT DUE ............................................. BALANCE TO FINISH INCLUDING RETAINAGE................. State of: Minnesota County of: Scott Subscribed and sworn to before me this .......... $ (2,198.15) $ 433,551.85 .......... $ 294,372.00 ......... $ 14,718.60 .......... $ 279,653.40 ......... $ 216,790.95 ......... $ 62,862.45 ......... $ 153,898.45 f* day of lc7Q )(�IY L'tarN 20 NOTARY PUBLIC: Signed: M mmission Expires: KIM A STOCK Notary Public - Minnesota ,ommission Expires 01131/2025 APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENTG702 PAGE ONE OF 1 PAGES TO OWNER: PROJECT: APPLICATION NO: 1 Distribution to: City of Elk River Elk River Ice Arena & Lion John Weicht Park Facilities X OWNER 13065 Orono Parkway NW 1000 School St NW Inv #30078 X ARCHITECT Elk River, MN 55330 Elk River, MN 55330 PERIOD TO: 02/29/2020 X CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: 292 Design Group H&B Specialized Products, Inc. 6560 Edenvale Blvd PROJECT NOS: Eden Prairie, MN 55346=2502 CONTRACT FOR: CONTRACT DATE: November 25, 2019 CONTRACTORS APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment, as shown below, in connection with the Contract. information and belief the Work covered by this Application for Payment has been Continuation Sheet, AIA Document G703, is attached. 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. 1. ORIGINAL CONTRACT SUM 2. Net change by Change Orders 3. CONTRACT SUM TO DATE (Line 1 f 2) 4, TOTAL COMPLETED & STORED TO DATE (Column G on G703) 5. RETAINAGE: a. 5% of Completed Work (Column D + E on G703) b. % 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 RETAINAGE (Line 3 less Line 6) 0 $ 96,582.00 $ 96,582.00 35816,00 $ 190.80 $ 3,625.20 $ 3,625,20 $ 92,956.80 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner Total approved this Month TOTALS $0,00 $0,00 NET CHANGES by Change Order $0.00 CONTRACTOR: H Specialized Products Inc By: Date: Gary Schultz, Proj Mgr State of: Minnesota Gs? my s Subscribed and s vornzto before me this 17t �V # . ul Notary Public: lq r _ r e° My Commission pi es: ` 301/21/223 \\' 02/17/2020 y20M aNcor. NOT/\i MINI 6 A My Commission E • Jan. 21 In accordance with the Contract Documents, based on on -site observations 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 progressed as indicated, the duality 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 antoullt certified differs fi•o»� the a»romlt applied bzitial all figtmes o�1 this Application and o�ltlze Continuation Sheet that are changed to confo»�r lvith the a»ro:nit certified.) 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 or Contractor under this Contract. AIA DOCUMENT G702 •APPLICATION AND CERTIFICATION FOR PAYMENT • 1992 EDITION, AIAO, ©1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006-5292 Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee. CONTINUATION SHEET AIA DOCUMENTG703 PAGE OF PAGES AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing APPLICATION NO: 1 Contractor's signed certification is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. APPLICATION DATE: PERIOD TO ARCHITECT'S PROJECT NO: 02/17/2020 02/29/2020 A B C D IE F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE NO, VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G _ C) TO FINISH (IF VARIABLE APPLICATION STORED AND STORED (C - G) RATE) (D + E) (NOT IN TO DATE D ORE) (D+E+F) 5% I Material $72,188.00 0,00% $723188400 2 Labor $20,578.00 0,00% $20,578.00 3 Shops/Engineering/Misc $3,816.00 $3,816.00 $3,816.00 100,00% $190,80 GRAND TOTALS $96,582.00 $0.00 $3,816.00 $0,00 $3,816.00 3,95% $92,766.00 $190480 Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity AIA DOCUMENT G703 •CONTINUATION SHEET FOR G702 1992 EDITION •AIA®©1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORKAVENUE, N.W., WASHINGTON, D.C. 20006-5232 G703-1992 APPLICATION AND CERTIFICATE FOR PAYMENT Page 1 of 2 SUBMITTED TO: RJM Construction, LLC PROJECT: Elk River Multi Purpose Facility and Lion John Weicht Park APPLICATION NO: 4 830 Boone Avenue North APPLICATION DATE: 2/21/2020 Golden Valley, MN 55427 PERIOD FROM: 2/1/2020 SUBMITTED FROM: Ebert Inc dba Eb ert Construction ARCHITECT: 292 Design Group PERIOD TO: 2/29/2020 23350 County Rd 10 PROJECT NO: 6979 Corcoran, MN 55357 CONTRACT DATE: CONTRACT FOR: 6A: Carpentry CONTRACT NO.: COMMITMENT: I hereby certify that the work performed and the material supplied to date, as shown here, ORIGINAL CONTRACT SUM ..................................... 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- NET CHANGE BY CHANGE ORDERS TO ................... 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 CONTRACT SUM TO DATE ...................................... 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 TOTAL COMPLETED AND STORED TO DATE ............. 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 ............................. S 546.800.00 .........I ................... $ ....................... $ 546,800.00 ....................... $ 166,532.39 (sub -subcontractors) and 2) for all material and labor used in or in connection with the 5 % OF COMPLETED WORK $ 8,326.62 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 5 % OF STORED MATERIAL $ - Compensation laws insofar as applicable to the performance this contract. TOTAL RETAINAG E.................................................................. ........ $ 8,326.62 TOTAL EARNED LESS RETAINAGE....................................................... $ 158,205.77 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 .................................... $ 116,396.27 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.................................................................... $ 41,809.50 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........................................ $ 388,594.23 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 Ebert Inc dba Eb ert C ion 23350 County 0 Corcoran, M 55357 SIGNED: PRINTED, TITLE Caleb Pelkey - Project Mana er 21st day of February NOTARY PUBLIC: Signed: _ _: A I .j LIU � MyCommission Expires: � 43 o -.,,1[ 20 20 From: Ebert Inc dba Ebert Construction 23350 County Rd 10 Corcoran, MN 55357 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. Appl. No.: #4 Aool. Date: 02/21/20 From: Ebert Inc To: RJM Construction ITEM NO. DESCRIPTION CURRENT CONTRACT CURRENT APPLICATION TOTAL PREVIOUS I WORK IN MATERL. I APPS. APPS. PLACE ON SITE TO DATE PERCENT COMPLETE BALANCE TO COMPLETE RETAIN TO DATE 1 Bonds, Insurance, Mobilize $5,000.00 $5,000.00' $5,000.00 100.00% $250.00 2 General Conditions $21,000.00 $6,300.00: $3 150.00 $9,450.00 45.00% $11,550.00 $472.50 3 Allowance $50,000.00 $12,882.39 $12,882.39 25.76% $37,117.61 $644.12 4 061000 Rough Ca en M $59,700.00 $41,790.001 $17 910.00 I $59,700.00 100.00% $2,985.00 5 061000 Rough Carpentry L $153,000.00 $53 550.00i $22,950.00 $76,500.00 50.00% $76 500.00 $3,825.00 6 061753 Shop Fam. Wood Trusses $3'000.00i $3.000.00; $3 000.00 100.00% $150.00 7 064216 Wood Paneling $135,000.00 $135 000.00 8 072119 Foamed -In -Place Insulation $17,000.00 1 $17 000.00 9 081113 HM Doors and Frames $81,000.00 1 $81 000.00 10 097733 FRP $4,500.00 $4,500.00 11 101100 Visual Display Boards $7,800.00 $7,800.00 12 102600 Wall and Comer Guards $7,000.00 $7,000.00 13 105113 Metal Lockers $2,800.00 I I $2,800.00 14 15 16 17 18 I I 19 20 21 22 1 23 24 25 TOTAL $546,800.001 $122,522.39. $44,010.001 $166,532.391 30.46%1 $380,267.611 $8,326,62 tURAM' CONSTRUCTION SERVICES 9937 Goodhue Street NE • Blaine, MN 55449 Phone (763) 792-6713 • Fax (763) 792-6601 Remit To: 13800 Eckles Road Livonia, MI 48150 MONTHLY REQUISITION FOR PAYMENT Sold To: RJM Construction 830 Boone Ave N, Golden Valley, MN 55427 Attention: Eric Sonnenberg Project: Elk River Multi Purpose Facility Location: Elk River, MN ORIGINAL CONTRACT Previous Change ADDITIONS DEDUCTIONS Orders $ _ $ _ Number $ - $ 8,000.00 1 $ - 5 - $ - 5 - $ - S TOTALS ,$ - $ 8,000.00 Net Change by Change Orders -$8,000.00 Invoice No. 32966 Requisition No. 2 Date: 02/25/2020 Our Job No. 401132 AMOUNT $39,630.00 ADDITIONS OR DEDUCTIONS TO DATE ..................... .............. $ (8.000.00) TOTAL ADJUSTED CONTRACT PRICE........................................................... $ 31,630.00 VALUE OF CONTRACT WORK PERFORMED TO DATE_. ......................................... $ 23,520.00 Less 5% Retained $ 1,176.00 NET AMOUNT EARNED ON CONTRACT TO DATE .......... I ........ I ............... $ 22,344.00 Less Previous Requests ................. .............. --.. .... ..... --$ 12.217.00 NET AMOUNT OF THIS REQUEST........................................................................ $ 10,127.00 APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 (Instructions on reverse side) TO (OWNER): RJM Construction PROJECT: Elk River Multi Purpose Facility APPLICATION NO: 2 Distribution to: 830 Boone Ave N, _ OWNER Golden Valley, MN 55427 Elk River, MN PERIOD TO: 29-Feb-20 ARCHITECT CONTRACTOR FROM (CONTRACTOR): RAM Construction Services of Minnesota, Inc. OWNER'S PROJECT # 0 _ 9937 Goodhue Street NE _ Blaine, MN 55449 VIA (ARCHITECT): 292 Design Group RAM PROJECT # 401132 3533 East Lake Street CONTRACT FOR Waterproofing Minneapolis, MN 55406 CONTRACT DATE: July 11, 2019 CONTRACTOR'S APPLICATION FOR PAYMENT Application is made ,AIA Document as shown below, in connection with the Contract. Continuation Sheet, AIA Document G703, is attached. CHANGE ORDER SUMMARY Change Orders approved in previous months by Owner TOTAL ADDITIONS DEDUCTIONS Approved this Month $ $ 8,000.00 Number Date Approved 1 01/17/2020 TOTALS1 $ - $ 8,000.00 Net Change by Change Orders $ (8,000.00) 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 herein is now due By RAM Construction Services of Minnesota, Inc. • Date: ARCHITECT'S CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on -site observations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, 1- ORIGINAL CONTRACT SUM $ 39,630.00 2. Net change by Change Orders $ (8,000.00) 3. CONTRACT SUM TO DATE (Line 1+/-2) $ 31,630,00 4. TOTAL COMPLETED & STORED TO DATE $ 23,520.00 (Column G on G703) 5. RETAINAGE: a. 5% of Completed Work $ 1,176.00 (Column D + E on G703) b. _ 5% of Stored Material $ - (Column F on G703) Total Retainage (Line 5a + 5b or Total in Column I of G703) $ 1,176.00 6. TOTAL EARNED LESS RETAINAGE $ 22,344-00 (Line 4 less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 1221700 (Line 6 from prior Certificate) 8 CURRENT PAYMENT DUE $ 10,127,00 9 BALANCE TO FINISH, PLUS RETAINAGE $ 9.286.00 (Line 3 less One,6) �N Subscribed 5 orn �V to this 5 0 �ru R r E %1 - . • u RA NotaryPub'c: - ■ aiy ,s,lic Sole of Minnesota My Commission expires:January 31, 2022 P,. Cumn:!ssion Ex�pii es AMOUNT CERTIFIED 5 (Attach explanation if amount certified differs from the amount applied for.) ARCHITECT: information and belief, the Work has progressed as indicated, the quality of the Work is in accordance with By: Date: the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. 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 (Instructions on reverse side) PAGE 1 of 1 PAGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO.: 2 containing Contractor's signed Certification, is attached. APPLICATION DATE: February 25, 2020 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: February 29, 2020 Use Column I on Contracts where variable retainage for line items may apply. OWNER'S PROJECT NO.: 0 RAM PROJECT NO.: 401132 RJM Construction, Elk River Multi Purpose Facility A B C D I E F G H WORK COMPLETED MATERIALS TOTAL BALANCE FROM PRESENTLY COMPLETED RETAINAGE ITEM DESCRIPTION OF WORK SCHEDULED PREVIOUS STORED AND STORED o /o TO (IF VARIABLE NO VALUE APPLICATION THIS PERIOD (NOT IN TO DATE (G / C) FINISH RATE) (C G) (D+E) DORE) (D+E+F) 1 Bentonite Waterproofing - Elevators 4,360.00 4,360.00 0.00 0.00 4,360.00 100% 0.00 218.00 2 Cold Fluid Applied Waterproofing - Foundations 22,970.00 8,500.00 6,470.00 0.00 14,970.00 65% 8,000.00 748.50 3 Fluid Applied Waterproofing - Ice Melt Pit 4,190.00 0.00 4,190.00 0.00 4,190.00 100% 0.00 209.50 4 Weather Barrier 8,110.00 0.00 0.00 0.00 0.00 0% 8,110.00 0,00 5 CO#1- Elimination of the western elevation below grade waterproofing (8,000.00) 0.00 0.00 0.00 0.00 0% (8,000.00) 0.00 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0% 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0,00 0.00 0,00 0,00 0% 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 0.00 0.00 0= 0% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 31,630.00 12,860.00 10,660.00 0.00 23,520.00 74% 8,110.00 1.176.00 APPLICATION AND CERTIFICATE FOR PAYMENT Page of SUBMITTED TO: RJM Construction, LLC PROJECT: Elk River Multi Purpose Facility APPLICATION NO: 2 830 Boone Avenue North APPLICATION DATE: 01/30/2020 Golden Valley, MN 55427 Elk River, MN PERIOD FROM: 25-Feb SUBMITTED FROM: RAM Construction Services of Minnesota, LLC ARCHITECT: 292 Design Group PERIOD TO: 29-Feb 9937 Goodhue Street NE 3533 East Lake Street PROJECT NO: 401132 Blaine, MN 55449 Minneapolis, MN 55406 CONTRACT DATE: 07/11/2019 CONTRACT FOR: Waterproofing CONTRACT NO.: 0 COMMITMENT: YES I hereby certify that the work performed and the material supplied to date, as shown here, ORIGINAL CONTRACT SUM .......................... ._.._.........._........ $ 39,630.00 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- NET CHANGE BY CHANGE ORDERS TO ......................... $ (8,000.00) 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 CONTRACT SUM TO DATE... ......................... ......... ........... $ 31,630.00 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:....:.;.,.:..., TOTAL COMPLETED AND STORED TO DATE... ::...:.:....... .,..:. $ 23,520.00 application. I also certify that payments, less applicable retention, have been made through the 5 % OF COMPLETED WORK $ 1,176,00 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 5 % OF STORED MATERIAL $ - 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 TOTAL RETAINAGE............................... ....... ............................. .......... $ 1,176.00 Compensation laws insofar as applicable to the performance this contract. TOTAL EARNED LESS RETAINAGE..__.,_,,.,.....,..._. .................................. $ 22,344.00 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. LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER ....................... $ - LESS PREVIOUS CERTIFICAES FOR PAYMENT .................................:,_.. $ 12,217.00 CURRENT PAYMENT DUE .......................................................... $ 10,127.00 BALANCE TO FINISH INCLUDING RETAINAGE........................ :......... :...:... $ 9,286.00 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: Ramsey instrument. Subscribed and sworn to before me this RAM Construction Services of Minnesota, LLC 9937 Goodhue Street NE Blaine, MN 55449 SIGNED:f� J PRINTED, TITLE Jeff Holmgren, Regional Manager 30th l-aav of — J y,n�■�� LAURIE M VANCURA NOTA Y PU IC_ 4 Notary Public State of Minnesota My Commission Expires Signs a Januaiy31,2022 My Commission Expires: 31-Jan-22 20 From: RANI Construction Services of Minnesota, LLC 9937 Goodhue Street NE Blaine, MN 55449 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. 32699 Appl. No.: #2 Appl. Date: 02/25/20 From: 02/01 /20 To: 02/29/20 ITEM NO DESCRIPTION CURRENT CONTRACT CURRENT APPLICATION I TOTAL PREVIOUS I WORK IN MATERL. I APPS. APPS PLACE ON SITE TO DATE PERCENT COMPLETE BALANCE TO COMPLETE RETAIN TO DATE 1 Bentonite Waterproofing - Elevators $4,360 $4.360' $0 $4.360 100 00% $0 $218 2 Cold Fluid Applied Waterproofing - Foundations $22.970 $8.500' $6,470 $0' $14.970 93.00% $8,000 $749 3 Fluid Applied Waterproofing - Ice Melt Pit $4,190 1 $4,190 1 $4,190 100.00% $0 $210 4 Weather Barrier $8.110 $0 0.00% $8,110 $0 5 CO#1 -Elimination of the Western Elevation below grade waterproofing $8,000 $0 0.00% -$8.000 $0 6 $0 0.00% $0 $0 7 I I $0 0.00% $0 $0 8 1 1 $0 0.00% $0 $0 9 $0 0.00% $0 $0 10 $0 0.00% $0 $0 11 $0 0.00% $0 $0 12 I I $0 0.00% $0 $0 13 $0 0.00% $0 $0 14 $0 0,00% $0 $0 15 $0 0.00% $0 $0 16 $0 0.00% $0 $0 17 I I $0 0.00% $0 $0 18 j $0 0.00% $0 $0 19 ' $0 0.00% $0 $0 20 $0 0.00% $0 $0 21 $0 0.00% $0 $0 22 I 1 $0 0.00% $0 $0 23 $0 0.00% $0 $0 24 $0 0.00% $0 $0 25 ' $0 0.00% $0 $0 TOTAL $31.6301 $12,8601 $10,660 $01 $23t5201 74.36%1 $8,110 $1,176 Page 1 of 1 APPLICATION AND CERTIFICATE FOR PAYMENT Page 1 of 2 SUBMITTED TO: RJM Construction, LLC PROJECT: Elk River Ice Arena & Lion John Weicht Facilities APPLICATION NO: Four (4) 1000 School Street NW 830 Boone Avenue North Elk River, MN 55330 APPLICATION DATE: 2/20/2020 Golden Valley, MN 55427 SUBMITTED FROM: Top -All Roofing, Inc. ARCHITECT: 2231 Edgewood Ave. South Minneapolis, MN 55426 CONTRACT FOR: Roofing & Sheet Metal 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 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. PERIOD FROM: 2/1/2020 PERIOD TO: 2/29/2020 PROJECT NO: 19005.00 CONTRACT DATE: 10/23/2019 COMMITMENT: YES/NO ORIGINAL CONTRACT SUM.................................................................. $ 1,020,690.00 NET CHANGE BY CHANGE ORDERS TO ............................... I ............ .... $ (9,940.00) CONTRACT SUM TO DATE . ............................................ ......... $ 1,010,750.00 TOTAL COMPLETED AND STORED TO DATE ........................................... $ 897,210.00 5 % OF COMPLETED WORK $ 44,860.50 0 % OF STORED MATERIAL 5 - TOTAL RETAINAGE........................................................ ......... $ 44,860.50 TOTAL EARNED LESS RETAINAGE........................................................ $ 852,349.50 LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER ................. $ LESS PREVIOUS CERTIFICATES FOR PAYMENT ................................ $ 826,718.50 CURRENT PAYMENT DUE................................................................... $ 25,631.00 BALANCE TO FINISH INCLUDING RETAINAGE......................................... $ 158,400.50 State of: nv2tcfL" The person signing below does hereby cerify that he/she is fully authorized and empowered to ' I n execute this instrument and to bind the undersigned hereto, and does in fact so execute this County of: Fie_"0P_N t Yt< instrument. Subscribed and sworn to before me this Top -All Roofing, Inc. day of 20 2C 2231 Edgewood Ave. South Minneapolis, MN 55426 NOTARY PUBLI ANDREW R HAGEN ��s {r�� Notary Public State of Minnesota SIGNED: S , .•_ Signed: n Expires Jan a 4 PRINTED, TITLE Lori Stevens, Project Accountant My Commission Expires: o1k From: Top -All Roofing, Inc. 2231 Edgewood Ave. South Minneapolis, MN 55426 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. 1-19-0033-4 Appl. No.: #4 - (Four) Appl. Date: 02/20/20 From: 02/01 /20 To: 02/29/20 ITEM NO. DESCRIPTION CURRENT CONTRACT , CURRENT APPLICATION TOTAL PREVIOUS I WORK IN MATERL. I APPS. APPS. PLACE ON SITE TO DATE PERCENT COMPLETE BALANCE TO COMPLETE RETAIN TO DATE 1 Material Insulation $384,950 $384,950 $0 $0 $384.950 100.00% $0 $19,247.50 2 Material Vapor Barrier $50,600 $50.600' $0 $0' $50,600 100.00% $0 $2,530.00 3 Material EPDM & Accessories $195,960 $195,960, $0 $0. $195,960 100.00% $0 $9,798.00 4 Material Sheet Metal $32,040 $0• $0 $32,040 $0.00 5 Labor Insulation $80,070 $60,053, $8,007 $68,060 85.00% $12,010 $3,403.00 6 Labor Vapor Barrier $21,1101 $15,833 $2,107 $17,940 85.00% $3,170 $897.00 7 Labor EPDM & Accessories $148,060 $111,045 $14,806 $125,851 85.00% $22,209 $6,292.55 8 Labor Sheet Metal $29,900 $01 I $0 $29,900 $0.00 9 Allowance for Conditions $33,000 $18.7891 $0 $18.789 56.90% $14.211 $939.45 10 Bonding $33.0001 $33.000' $0 $33,000 100.00% $0 $1.650.00 11 Change Order #1 $2,060 $0• $2.060 $2.060 100.00% $0 $103.00 12 13 i 14 15 16 17 18 I I 19 20 21 22 23 I I 24 25 TOTAL $1,010,7501 $870.2301 $26.980 $0 $897,2101 1 $113,5401 $44,860.50 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: 7 830 Boone Avenue North Lion John Weicht Park Facilities APPLICATION DATE: 2/20/2020 Golden Valley, MN 55427 1000 School Street N.W PERIOD FROM: 2/1/2020 SUBMITTED FROM: Rink-Tec International, Inc. ARCHITECT: 292 Design Group PERIOD TO: 2/29/2020 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: YESlNO I hereby certify that the work performed and the material supplied to date, as shown here, ORIGINAL CONTRACT SUM.................................................................. $ 2,162,742.00 represent the actual value of accomplishment under the terns of the contract (and all authorized changes hereto) between the undersigned and RJM Construction relating to the above- NET CHANGE BY CHANGE ORDERS TO ................................................ $ referenced project. I further certify that no labor or materials have been supplied under CONTRACT SUM TO DATE$ 2,162,742.00 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 TOTAL COMPLETED AND STORED TO DATE ........................................ S 1,143,742.00 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 5 % OF COMPLETED WORK $ 57,187.10 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 0 % OF STORED MATERIAL $ - 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 TOTAL RETAINAGE............................................................................. $ 57,187,10 Compensation laws insofar as applicable to the performance this contract. TOTAL EARNED LESS RETAINAGE....................................................... $ 1,086,554.90 LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER ....................... $ - PARTIAL WAIVER OF LIEN Now therefore, upon receipt of the payment of the current payment due on this application the LESS PREVIOUS CERTIFICAES FOR PAYMENT ...................................... $ 854,754.90 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.................................................................... $ 231,800.00 for any of the: materials and/or labopr therefore furnished or performed in connection with this BALANCE TO FINISH INCLUDING RETAINAGE$ 1,076,187,10 project, reserving, however, all lien rights for labor and/or materials furnished after said date. ........................................ 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: Ramsey instrument. Subscribed and sworn to befor me this Rink-Tec International, Inc. 20 day 20-Faim u KATHY VARY BARTON 3485 Willow Lake Blvd. Suite # 500 Vadnais Heights, MN 55110 NOTAR P Notary Public t_r Minnesota �j F My Commission Expires SIGNED: /l [t/A /Ii �B/e /� /1 Signed: �j•'� .•.b'° Jan 31, 2ff23 PRINTED, T17LE Kyle Gillespie - President My Cop(mission f-yfiires: 31-Jan-23 From: Rink -Tee International Inc. 3495 Willow Lake Blvd., Suite A500 Vadnais Heights, MN 55117 PLEASE SUBMIT PAYMENT APPLICATIONS TO: ACCOUNTING-MEN@RJMCONSTRUCTION.COM To: RJM Construction, LLC 830 Boone Avenue North Golden Valley, MN 55427 Page 1 of 1 Schedule of Values Invoice No. Appl. No.: # 7 Appl. Date: 2/2012020 From: 2/112020 To: 2/2912020 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: 6 830 Boone Avenue North 1000 School St. NW APPLICATION DATE: 2/21/2020 Golden Valley, MN 55427 Elk River, MN 55330 PERIOD FROM: 2/1/2020 SUBMITTED FROM: Summit Fire Protection ARCHITECT: 292 Design Group PERIOD TO: 2/29/2020 575 Minnehaha Avenue West 3533 East Lake Street PROJECT NO: 0 St. Paul, MN 55103 Minneapolis, MN 55406 CONTRACT DATE: 7/11/2019 CONTRACT FOR: Fire Sprinklers CONTRACT NO.: 0 COMMITMENT: YES/NO I hereby certify that the work performed and the material supplied to date, as shown here, ORIGINAL CONTRACT SUM.................................................................. $ 256,485.00 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- NET CHANGE BY CHANGE ORDERS TO ................................................ $ 11,955.00 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 CONTRACT SUM TO DATE................................................................... $ 268,440.00 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 TOTAL COMPLETED AND STORED TO DATE ......................................... $ 183,106.50 application. I also certify that payments, less applicable retention, have been made through the 5 % OF COMPLETED WORK $ 9,155.34 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 5 % OF STORED MATERIAL $ - 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 TOTAL RETAINAGE............................................................................. $ 9,155.34 Compensation laws insofar as applicable to the performance this contract. TOTAL EARNED LESS RETAINAGE....................................................... $ 173,951.16 LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER ....................... $ - PARTIAL WAIVER OF LIEN Now therefore, upon receipt of the payment of the current payment due on this application the LESS PREVIOUS CERTIFICAES FOR PAYMENT ..................................... $ 153,119.09 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.................................................................... $ 20,832.07 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........................................ $ 94,488.84 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 instrument. Summit Fire Protection 575 Minnehaha Avenue West St. Paul, MN 55103 SIGNED: \ \ q PRINTED, TITLE County of: Washington Subscribed andd sworn to before methis `"C' ,anday of 20 NOTARY PUBLIC: Signed: My Commission Expires: CARRIE MARIE GERMAN NOTARY PUBLIC MINNESOTA My commission Expims 173112022 From: Summit Fire 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 Schedule of Values Invoice No. A15019563300006 Appl. No.: #6 Appl. Date: 02/21/20 From: 02/01 /20 To: 02/29/20 ITEM NO. DESCRIPTION CURRENT CONTRACT CURRENT APPLICATION TOTAL PREVIOUS I WORK IN I MATERL. I APPS. APPS. I PLACE ON SITE TO DATE PERCENT COMPLETE BALANCE I TO COMPLETE RETAIN TO DATE 1 Labor $87,885.00 $43,942.50' $8,788.50 $52,731.00 60.00% $35,154.00 $2,636.56 2 Material $111,200.00 $66,720.00: $11,120.00 $77,840.00 70.00% $33,360.00 $3,892.00 3 Design $31,200.00 $31,200.00 $31,200.00 100.00% $0.00 $1,560.00 4 Fabrication $20,200.00 $12,120.001 $2,020.00 1 $14,140.00 70.00% $6,060.00 $707.00 5 Bonds $6,000.00 $6,000.00; $6,000.00 100.00% $0.00 $300.00 6 Chan eOrder#1 $11,955.00 $1,195.50' $1,195.50 10.00% $10,759.50 $59.78 7 $0.00 0.00% $0.00 $0.00 8 1 1 $0.00 0.00% $0.00 $0.00 9 1 $0.00 0.00% $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 I $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 $0.00 0.00% $0.00 $0.00 21 $0.00 0.00% $0.00 $0.00 22 I I $0.00 0.00% $0.00 $0.00 23 $0.00 0.00% $0.00 $0.00 24 $0.00 0.00% $0.00 $0.00 25 $0.00 0.00%1 $0.00 TOTAL 1 $268,440.001 $161,178.00. $21,928.501 $0.001 $183,106.501 68.21%1 $85,333.501 $9,155.34 Page 1 of 1 APPLICATION AND CERTIFICATE FOR PAYMENT Page 1 of 3 SUBMITTED TO: RJM Construction, LLC PROJECT: ELK RIVER MULTI PURPOSE APPLICATION NO: 7 830 Boone Avenue North ELK RIVER, MN APPLICATION DATE: 2/20/2020 Golden Valley, MN 55427 0 PERIOD FROM: SUBMITTED FROM: Weidner Plumbing & Heating Company ARCHITECT: 0 PERIOD TO: PO Box #1087 0 PROJECT NO: 0 St. Cloud, MN 56302 0 CONTRACT DATE: 7/15/2019 CONTRACT FOR: PLUMBING WORK CONTRACT NO.: 0 COMMITMENT: YES/NO I hereby certify that the work performed and the material supplied to date, as shown here, ORIGINAL CONTRACT SUM ............................ 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- NET CHANGE BY CHANGE ORDERS TO........... 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 CONTRACT SUM TO DATE .............................. than the contract duly authorized and executed change orders and the undersigned does hereby ............................... $ 1,206,000.00 ...................... $ 13,720.00 ............................... $ 1,219,720.00 TOTAL COMPLETED AND STORED TO DATE ..................... 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 5 % OF COMPLETED WORK $ 29,492.65 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 5 % OF STORED MATERIAL $ - performance of this contract. I further certify that 1 have complied with Federal, State, and local tax laws, including Social Security laws, Unemployment Compensation Laws and Workman's TOTAL RETAINAGE......................................................... Compensation laws insofar as applicable to the performance this contract. TOTAL EARNED LESS RETAINAGE........................................ 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 CERTIFICAES 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 ....................................................... 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 ........................... 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: PRINTED, TITLE 47,t 0 2- ........ $ 589,853.00 ............ $ 29,492.65 ............ $ 560,360.35 ............. $ - ............. $ 410,506.40 ............ $ 149,853.95 ............. $ 659,359.65 State of: /2") % County of: ✓J-e n �v n Subscribed and sworn to before me this day of �t 20 o-;2C7 NOTARY PUBLIC: Signed: My Commission Expires: KAREN A SCHENK Notary Public State of Minnesota My Commission Expires d nuary 31, 2024 Document G703TM -1992 Continuation Sheet AIA Document G702TM-1992, Application and Certificate for Payment, or G732TM-2009, APPLICATION NO: 7 Application and Certificate for Payment, Construction Manager as Adviser Edition, APPLICATION DATE: 2/18/2020 containing Contractor's signed certification is attached. In tabulations below, amounts are in US dollars. PERIOD TO: 2/20/2020 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: Page 2 A B C D I E F G H 1 WORK COMPLETED ITEM NO. DESCRIPTION OF WORK SCHEDULED MATERIALS PRESENTLY TOTAL COMPLETED AND % BALANCE TO FINISH RETAINAGE FROM PREVIOUS VALUE APPLICATION THIS PERIOD STORED STORED TO DATE (G + C) (C G) (If variable rate) (D + E) (Not in D or E) (D+E+F) PIPING MATERIAL 1 10.105: BOND 10,333.00 10,333.00 0.00 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 235,689.00 137,000.00 25,000.00 0.00 162,000.00 69 73,689.00 8,100.00 4 10.119: DRAINS & CARRIERS 47,196.00 40,000.00 7,000.00 0.00 47,000.00 100 196.00 2,350.00 5 10.123: PUMPS & TANKS 5,400.00 4,000.00 1,400.00 0.00 5,400.00 100 0.00 270.00 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 9,500.00 8,000.00 0.00 17,500.00 22 61,504.00 875.00 8 10.139: MISC PLUMBING 42,488.00 6,200.00 7,500.00 0.00 13,700.00 32 28,788.00 685.00 510,349.00 207,033.00 48,900.00 0.00 255,933.00 50 254,416.06 12,796.65 PIPING LABOR 9 11.185: LABOR - PLUMBING 560,753.00 153,600.00 87,000.00 0.00 240,600.00 43 320,153.00 12,030.00 560,753.00 153,600.00 87,000.00 0.00 240,600.00 43 320,153.00 12,030.06 SUBCONTRACTS 10 30.300: DIGGING/BACKFILL 37,034.00 37,000.00 0.00 0.00 37,000.00 100 34.00 1,850.00 11 30.325: RENTALS 13,000.00 10,100.00 1,500.00 0.00 11,600.00 89 1,400.00 580.00 12 30.360: PIPE COVERING 84,864.00 21,000.00 10,000.00 0.00 31,000.00 37 53,864.00 1,550.00 134,898.00 68,100.06 11,500.00 0.00 79,600.00 59 55,298.00 3,980.00 13 40.300: CH ORDER #3 -2,980.00 0.00 -2,980.00 0.00 -2,980.00 100 0.00 -149.00 GRAND TOTAL 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 G70311 - 1992. Copyright © 1963, 1965, 1966, 1967, 1970, 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 International 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, copyright@aia.org. 101210ACDe o Document G703TM -1992 Continuation Sheet AIA llocument G702TM-1992, Application and Certificate for Payment, or G732Tm-2009, APPLICATION NO: 7 Application and Certificate for Payment, Construction Manager as Adviser Edition, APPLICATION DATE: 2/18/2020 containing Contractor's signed certification is attached. In tabulations below, amounts are in US dollars. PERIOD TO: 2/20/2020 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: Page 3 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM NO. DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE TO FINISH RETAINAGE VALUE APPLICATION THIS PERIOD STORED STORED TO DATE G = C ( ) (C _ G) (/f variable rate) (D + E) (Not in D or E) (D+E+F) 14 40.400: CH ORDER #4 2,506.00 0.00 2,506.00 0.00 2,506.00 100 0.00 125.30 15 40.500: CH ORDER #5 10,815.00 0.00 10,815.00 0.00 10,815.00 100 0.00 540.75 16 40.600: CH ORDER #6 3,379.00 3,379.00 0.00 0.00 3,379.00 100 0.00 168.95 GRAND TOTAL 1,219,720.00 432,112.00 157,741.00 0.00 589,853.00 48 629,867.00 29,492.65 CAU I It)N: 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 G7031"^ — 1992. Copyright @ 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This Ale Document is protected by U.S. Copyright Law and International 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, copyright@aia.org. 101210ACD44 APPLICATION AND CERTIFICATE FOR PAYMENT Page of SUBMITTED TO: RJM Construction, LLC PROJECT: &LK kwok MaLn-paw-loc5 APPLICATION NO: b 830 Boone Avenue North l A,-d 45it) Jo RA) WfflCttr b4i-• APPLICATION DATE: - _;?z zz, Golden Valley, MN 55427 PERIOD FROM: SUBMITTED FROM: qOAbi 14 - 3oTn ARCHITECT: Z RZ _0(:;516 ) 6VLOLIP4 PERIOD TO: l yG_gDD-2y-iCi7zs PO f3t 'U11>d T�,� pA1UL� �N Stu ��% PROJECT NO: � CY3�c�L� 1 CONTRACT DATE: 7—iC --% CONTRACT FOR: ?-'34 l y-ljl C -sm-7--a 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. 1 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. COMMITMENT: YES/NO ORIGINAL CONTRACT SUM.................................................................. % -. 1 • 0_1, NET CHANGE BY CHANGE ORDERS TO .............................. .................. CONTRACT SUM TO DATE................................................................... TOTAL COMPLETED AND STORED TO DATE....`., .................................... (FYI, •�� 5 % OF COMPLETED WORK $ 5 % OF STORED MATERIAL $ TOTAL RETAINAGE............................................................................. $ -�� TOTAL EARNED LESS RETAINAGE....................................................... $SV —$ LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER ........................ LESS PREVIOUS CERTIFICATES FOR PAYMENT .................................... rJJ CURRENTPAYMENT DUE.................................................................... $ BALANCE TO FINISH INCLUDING RETAINAGE........................................ $ 0-'A, 1�5��, — State of: ��•�� ,,�j al�-- 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 CONTINUATION SHEET AIA DOCUMENT G703 (I11S(1'ucllU11s Oil reverse SIt.le) IAti12 u3 unties AIA DOCUillent G702, APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO,; contalning Contractor's signed Cerdflcittlon, N mincilecl, PROJECT: 23A- HVAC Systems APPLICATION DATE: 02/21/2020 In tabulations below, anlounts are stared to the nearest doll,n•, Elk River Multi -Purpose Facility and Lion John PERIOD TO: 02/28/2020 Use Column I On Contracts where Var,lable remInage for Ilse Items ma t>>l Weicht Park Y � I I Y AItCI•I1'l'1rCT'S P1ZOlI:C1' NO.: A R C D E F Ci I I I WORK COMPLETED MATERIALS TOTAL ITEM NO, DESCRIPTION OF WORK RCFIEDLILED VALUE I RESENTLY COMPLETED AND STORED % BALANCE l'O ItETAINAGE (Ir VARIAM,E) FROM PREVIOUS APPLICATION THIS PERIOD (NUT IN (NOT IN 'ro DATE tG -` C=) FINISH Itn'I'li) (D + F) U U11 L•) (U+I:+I') 1 CEARENA $0.0 2 obilization-labor $5,000.00 $1,000.00 $1,500.00 $0.00 $2,500.00 50% $2,500.00 $125.00 3 lobilization-mat'I $2,500.00 $1,500.00 $0.00 $0.00 $1,500.00 60% $1,000.00 $75.00 4 VAC Demo -labor $15,000.00 $2,500.00 $0.00 $0.00 $2,500.00 17% $12,500.00 $125.00 5 VAC Demo-mat'I $5,000.00 $1,000.00 $0.00 $0.00 $1,000.00 20% $4,000.00 $50.00 6 30593 Test and Balance $22,000.00 $0.00 $0.00 $0.00 $0.00 0% $22,000.00 $0.00 7 30700Insulation $32,000.00 $0.00 $0.00 $0.00 $0.00 0% $32,000.00 $0.00 8 32300 Refrigeration Piping $55,000.00 $0.00 $0.00 $0.00 $0.00 0% $55,000.00 $0,00 9 50900 Controls $230,000.00 $59,543.00 $0.00 $0.00 $59,543.00 26% $170,457.00 $2,977.15 10 33000 Ductwork -labor $75,000.00 $15,000.00 $15,000.00 $0.00 $30,000.00 40% $45,000.00 $1,500.00 11 33000 Ductwork-mat'I $23,300.00 $5,825.00 $3,495.00 $0.00 $9,320.00 40% $13,980.00 $466.00 12 33000 Misc Round -labor $8,000.00 $0.00 $0.00 $0.00 $0.00 0% $8,000.00 $0.00 13 33000 Misc Round-mat'I $4,500.00 $0.00 $0.00 $0.00 $0.00 0% $4,500.00 $0.00 14 33000 Spiral Pipe -labor $84,500.00 $29,575.00 $12,675.00 $0.00 $42,250.00 50% $42,250.00 $2,112.50 15 33000 Spiral Pipe-mat'I $45,000.00 $22,500.00 $11,250.00 $0.00 $33,750.00 75% $11,250.00 $1,687.50 16 33000 Fabric Duct -labor $2,500.00 $0.00 $0.00 $0.00 $0.00 0% $2,500.00 $0.00 17 33000 Fabric Duct-mat'I $4,000.00 $4,000.00 $0.00 $0.00 $4,000.00 100% $0.00 $200.00 18 33423 Fans/Hoods-labor $10,000.00 $2,000.00 $0.00 $0.00 $2,000.00 20% $8,000.00 $100.00 19 33423 Fans/Hoods-mat'I $22,000.00 $19,800.00 $0.00 $0.00 $19,800.00 90% $2,200.00 $990.00 20 33616 VAV Boxes -labor $8,000.00 $0.00 $0.00 $0.00 $0.00 0% $8,000.00 $0.00 21 33616 VAV Boxes-mat'I $24,000.00 $q.00 $0.00 $0.00 $0.00 0% $24,000.00 $0.00 22 33713 Grilles/Registers-labor $17,000.00 $0.00 $2,550.00 $0.00 $2,550.00 15% $14,450.00 $127.50 23 33713 Grilles/Registers-mat'I $30,000.00 $0.00 $0.00 $0.00 $0.00 0% $30,000.00 $0.00 24 36213 ACCU-labor $4,000.00 $0.00 $0.00 $0.00 $0.00 0% $4,000.00 $0.00 25 36213 ACCU-mat'I $80,000.00 $72,000.00 $0.00 $0.00 $72,000.00 90% $8,000.00 $3,600.00 26 37400 Rooftop Units -labor $44,000.00 $5,000.00 $0.00 $0.00 $5,000.00 11% $39,000.00 $250.00 27 �37400 Rooftop Units-mat'I $445,500.00 $400,950.0 , -. 46 470.00 1 $0.00 $688,663.00 53% $609,137.00 $34,433.15 �.. AIA DOCUMENT Wrin - r(1NTINILIT!0N VLET ann iti „ vivvs • i lU ANWRICAN INSI'll't IT UP NlChil'I'L'C:1'S, 1735 NEW YORK - \__TTNN`` AVIINUC, N,W,, WASHINGTON. D.C. 20006.5291 1 WARNING; Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution, G703-1992 CAUTION: You should use an original AIA document which has this caution printed In red, An original assures that changes will not be obscured as may occur when documents are reproduced. CONTINUATION SHEET AIA DOCUMENT G703 (lnsu'uctltlnti Oil VCVel'se SILIC) ,',,,;3 u3 rAre, AIA DOC1.1inent G702, APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO,: contalning Cantrector's signed Certlflcatlon, Is attachecl, PROJECT: 23A - HVAC Systems 02/21/2020 APPLICATION LIGATION DATE; • In tabulations below, amounts are stated to the nearest clollaP02/28/2020 , Elk River Multi -Purpose Facility and Lion John PERIOD Use Coltlnln 1 on COnu;lcts where var.lable retalnage FC�r Ilne Items play ;II)l)IyWeicht Park ARCHITECT'S CT'S PROJECT NO.: 'I'U: NO.: A 8 C. D E F C; I I I WORIC COMPLETED NIA'I•ERIALS TOTAL ITEM NO. DESCRIPTION OP WORK tiCFIEDEILED VALIIE I RESENTLY STORE:) C OMP1.r•.TL•'D AND S'1'OICF.D �' BALANCE 10 IEI:'fAINACiI? (IP VARIABLE) FROM PREVIOUS , '1 APl LICNVION HIS PERIOD (NOT IN 'fin DATE t G y C;) f1NISl1 RATE) (D + F) U UR L• (U+Ii+I) 28 38100 Paackaged AC Units -labor $6,000.0 $0.00 29 38100 Packaged AC Units -mat': $25,000.00 $0.00 $0.00 $0.00 $0.00 0% $25,000.00 30 38419 Desiccant Dehumid Units- $40,000.00 $5,000.00 $0.00 $0.00 $5,000.00 13% $35,000.00 $250.00 I abor 31 38419 Desiccant Dehumid Units- $300,000.00 $270,000.00 $0.00 $0.00 $270,000.00 90% $30,000.00 $13,500.00 at'I 32 232100 Hydronic Piping $80,000.00 $22,447.00 $0.00 $0.00 $22,447.00 28°io $57,553.00 $1,122.35 33 LIONS PARK $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 34Mobilization-labor $1,000.00 $0.00 $0.00 $0.00 $0.00 0°i6 $1,000.00 $0.00 35Mobilization-mat': $500.00 $0.00 $0.00 $0.00 $0.00 0% $500.00 $0.00 36Ductwork-labor $2,500.00 $0.00 $0.00 $0.00 $0.00 0% $2,500.00 $0.00 37 uctwork-mat': $500.00 $0.00 $0.00 $0.00 $0.00 0% $500.00 $0.00 38 - rilles/Registers-labor $500.00 $0.00 $0.00 $0.00 $0.00 0% $500.00 $0.00 39 'rilles/Registers-mat': $200.00 $0.00 $0.00 $0.00 $0.00 0% $200.00 $0.00 40 ans-labor $1,000.00 $0.00 $0.00 $0.00 $0.00 0% $1,000.00 $0.00 41 ans-mat': $1,000.00 $0.00 $0.00 $0.00 $0.00 0% $1,000.00 $0.00 42 ermit $20,000.00 $20,000.00 $0.00 $0.00 $20,000.00 100% $0.00 $1,000.00 43 hange Order $7,692.93 $0.00 $0.00 $0.00 $0.00 0% $7,692.93 $0.00 44 hange Order 2 $2,751.00 $0.00 $0.00 $0.00 $0.00 00i10 $2,751.00 $0.00 45 hange Order 3 $49,987.00 $0.00 $0.00 $0.00 $0.00 0% $49,987.00 $0.00 46 hange Order 5 $7,784.00 $0.00 $0.00 $0.00 $0.00 0% $7,784.00 $0.00 47 hange Order 6 $4,485.00 $0.00 $0.00 $0.00 $0.00 0% $4,485.00 $0.00 48 hange Order 4 ($17,750.00) $0.00 $0.00 $0.00 $0.00 0% ($17,750.00) $0.00 49 hange Order 7 $3,750.00 $0.00 $0.00 $0.00 $0.00 0% $3,750.00 $0.00 46470.00 $0.00 $1,008,110.00 55% $826,589.93 $50,405.50 „M...d- ., AIA DOCUMENT G703 • CONTIN(IATION SHVrl' rnrl rti., . iuu•, itnimr�w _ .,,,,, _ �...,._ _ ._.... _..... _ _ v[Trs • I nu Anu:¢K:AN IN.M1 IVIT' Olt ARCHITECTS, 17.15 NL'w )'OI(K AVENUC, N,W,, 1VASIiINGTON, D•C, ?()(10G•52'J? • WARNING: Unlicensed photocopying vlolaies U.S. copyright laws and will subject the violator to legal prosecution. G703-1992 o V o� CAUTION: You should use an original AIA document which has this caution printed In red, An original assures that changes will not be obscured as may occur when documents are reproduced. APPLICATION AND CERTIFICATE FOR PAYMENT Page of SUBMITTED TO: RJM Construction, LLC PROJECT: APPLICATION NO: 830 Boone Avenue North APPLICATION DATE: Golden Valley, MN 55427 PERIOD FROM: SUBMITTED FROM: ARCHITECT: PERIOD TO: PROJECT NO: CONTRACT DATE: CONTRACT FOR: CONTRACT NO.: COMMITMENT: 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. 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. SIGNED: PRINTED, TITLE ORIGINAL CONTRACT SUM NET CHANGE BY CHANGE ORDERS TO CONTRACT SUM TO DATE. TOTAL COMPLETED AND STORED TO DATE. % OF COMPLETED WORK % OF STORED MATERIAL TOTAL RETAINAGE. TOTAL EARNED LESS RETAINAGE................................ LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER LESS PREVIOUS CERTIFICATES FOR PAYMENT............ CURRENT PAYMENT DUE ............................................ BALANCE TO FINISH INCLUDING RETAINAGE................ State of County of: Subscribed and sworn to before me this day of NOTARY PUBLIC: Signed: My Commission Expires: 20 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. Appl. No.: # Date: From: To: ITEM NO. DESCRIPTION CURRENT CONTRACT CURRENT APPLICATION I TOTAL PREVIOUS I WORK IN MATERL. I APPS. APPS. PLACE ON SITE TO DATE PERCENT COMPLETE BALANCE TO COMPLETE RETAIN TO DATE 1 2 3 I I 4 5 6 7 I I 8 9 10 11 12 I I 13 14 15 16 17 18 19 20 I I 21 22 23 24 25 I I TOTAL Page 1 of 1 APPLICATION AND CERTIFICATE FOR PAYMENT 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. The person signing below does hereby cerify that he/she is fully authorized and empowered to execute this instrument and to bind the u ereto, and does in fact so execute this instrument. JODI LYNN Russ Minnesota Utilities &Excavating NOTARY • MINNESOTA 13932 Lake Drive C"'ISSIOn ExPlres Jan. 31, 2021 Page Of o? APPLICATION NO: 8 APPLICATION DATE: 2/19/2020 PERIOD FROM: 2/1/2020 PERIOD TO: 2/29/2020 PROJECT NO: 0 CONTRACT DATE: 1/0/1900 COMMITMENT: YES/NO ORIGINAL CONTRACT SUM .................................... $ 572,787.00 NET CHANGE BY CHANGE ORDERS TO ................................................ $ 88,954.30 CONTRACT SUM TO DATE................................................................... $ 661,741.30 TOTAL COMPLETED AND STORED TO DATE ......................................... $ 531,575.00 5 % OF COMPLETED WORK $ 26,578.75 5 % OF STORED MATERIAL $ - TOTAL RETAINAGE............................................................................. $ 26,578.75 TOTAL EARNED LESS RETAINAGE....................................................... $ 504,996.25 LESS OWNER DIRECT PAYMENT BY PURCHASE ORDER ........................ $ - LESS PREVIOUS CERTIFICAES FOR PAYMENT ...................................... $ 438,496.25 CURRENT PAYMENT DUE ................................................ I................... $ 66,500.00 BALANCE TO FINISH INCLUDING RETAINAGE........................................ $ 156,745.05 State of: County of:f�Q Subscribed and sworn to before me this day of AQ9�! 20 WV Forest Lake, MN 55025 NOTARY PUBLIC: SIGNED: ! �146, I Signed: PRINTED, TITLE fn Gar I ,� My Commission Expires: From: Minnesota Utilities & Excavating, LLC 13932 Lake Drive Forest Lake, MN 55025 Schedule of Values Invoice No. Awl. No.: #8 Appl. Del,.: 02/19120 From: 02/01 /20 PLEASE SUBMIT PAYMENT APPLICATIONS TO: ACCOUNTING-MN@RJMCONSTRUCTION.COM To: 02/29/20 To: RJM Construction, LLC 830 Boone Avenue North Golden Valley, MN 55427 ITEM NO. DESCRIPTION CURRENT CONTRACT • CURRENT APPLICATION TOTAL PREVIOUS WORK IN MATERL. APPS APPS. I PLACE I ON SITE I TO DATE PERCENT COMPLETE BALANCE TO COMPLETE RETAIN TO DATE 1 Earthwork $572,787.00 $394,349.70 $70,000.00 $464,349.70 0.00% $108,437.30 $23,217.49 2 $0.00 0.00% $0.00 $0.00 3 $0.00 0.00% $0.00 $0.00 4 $0.00 0.00% $0.00 $0.00 5 I I $0.00 0.00% $0.00 $0.00 6 CO #1 $43 459.00 $21,730.00i $0.00 $21,730.00 0.00% $21,729,00 $0.00 7 CO #2 $26.672.30 $26.672.30' $0.00 $26,672.30 0.00% $0,00 $0.00 8 CO #3 $3 570.00 $3.570.00• $0.00 $3 570,00 0.00% $0.00 $0.00 9 CO#4 $3,157.00 $3,157.00 $0.00 $3,157.00 0.00% $0.00 $0.00 10 CO#5 $11,096.00 $11,096.001 $0.00 $11,096.00 0.00% $0,00 $0.00 11 CO #6 -$1,338.00 -$1.338.00; $0.00 -$1,338.00 0.00% $0.00 $0.00 12 CO#7 $2,338,00 $2,338.00• $0.00 $2,338.00 0.00% $0.00 $0.00 13 $0.00 0.00% $0.00 $0.00 14 I I $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 1 1 $0.00 0.00% $0.00 $0.00 19 I I $0.00 0.00% $0.00 $0.00 20 $0.00 0.00% $0.00 $0.00 21 $0.00 0.00% $0.00 $0.00 22 $0.00 0.00% $0.00 $0.00 23 $0 00 0.00% $0.00 $0.00 24 $0.00 0.00% $0.00 $0.00 25 $0.00 0.00% $0.00 $0.00 TOTAL $661,741.301 $461,575.00' $70,000.001 $0.00' $531,575.001 80.33%1 $130,166.30 $0.00 Page 1 of 1 APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 (Instructions on reverse side) PAGE ONE OF PAGES TO OWNER: RJM CONST PROJECT: ELK RIVER ICE ARENA 830 BOONE AVE N 1000 SCHOOL ST NW GOLDEN VALLEY, MN 55427 ELK RIVER MN FROM CONTRACTOR: Molin Concrete Products Co VIA ARCHITECT: 415 Lilac Street Lino Lakes, MN 55014-1005 CONTRACT FOR APPLICATION NO.: BFXS9211E-00%� tribution to: PERIOD TO: 2/29/2020 ❑ OWNER PROJECT NOS.: ❑ ARCHITECT ❑ CONTRACTOR CONTRACT DATW.19/2019 ❑ 19-9211 ❑ The undersigned Contractor certifies that to the best of the Contractor's knowledge, infor- �i®NTRA\iTOR'S APPLICATION FOR PAYMENTApplication is made for payment, as shown below, in connection with the Contract. inacorn dancceandlief with thethen onto act Doby this Application for Paymentcuments, that all amounts ha eab been been pad byethee Continuation Sheet, AIA Document G703, is attached. Contractor for Work for which previous Certificates for Payment were issued and pay- 1 ORIGINAL CONTRACT SUM ... ..... , . $ 1 013 283.00 ments received from the Owner, and that current payment shown herein is now due. 2. Net change by Change Orders _ ....... $ CONTRACTOR: Molin Concrete Products Co 3. CONTRACT SUM TO DATE (Line 1 ± 2) ........ $ 1,060 925.00 4, TOTAL COMPLETED & STORED TO DATE ...... $ 1,048,025.00 (Column G on G703) — 5. RETAINAGE: a• % of Completed Work (CA inns D + E on G703) State of: MINNESOTA County of: ANOKA Subscribed and sworn to before 52,401.28 me this day of b• % of Stored Material $ (Column F on G703) Total Retainage (Line 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) ................. $ 604,727.22 8, CURRENT PAYMENT DUE ................. $ 39Q.50 896 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) $ ._65,301.28 CHANGE ORDER SUMMARY Total changes approved in previous months by Owner Total NET CHANGES Notary Public: My Commission expires: 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 .............................. . (Attach explanation if amount certified differs from the amount applied for. Initial ADDITIONS DEDUCTIONS all J.igures on this Application and on the Continuation Sheet that are changed to 47,642.00 conform to the amount certified.) ARCHITECT: By: Date: This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Con- tractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702 • APPLICATION AND CERTIFICATE FOR PAYMENT • 1992 EDITION • O • c AVENUE, NW, WASHINGTON, D.C. 20006-5292 • WARNING: Unlicensed photocopying A>A S. co • THE lawsAMEand INSTITUTE the ARCHITECTS, gal NEW YORK �d� m p pyin violates U $. copyright laws and will subject the violator to legal prosecution. G702_1992 CAUTION: You should use an original AIA document which has this caution printed in red. An original assures that changes will not be obscured as may occur when documents are reproduced_ this Month TOTALS by Change Order LIA Document G703TM ®199 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION N®': " containing Contractor's signed. certification is attached. 2/25/2020 In tabulations below, amounts are stated to the nearest dollar. APPLICATION DATE: 2/21211 Use Column I on Contracts where variable retainage for line items may apply, PERIOD TO: ARCHITECT'S PROJECT N�9-9211 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL PRESENTLY COMPLETED BALANCE ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS STORED AND STORED % TO RETAINAGE IF VARIABLE NO. VALUE APPLICATION THIS PERIOD (G _ C) FINISH (D + E) (NOT IN TO DATE (C G) RATE) D ORE) (D+E+F) ` 7100 Precast Plank 7200 Precast Beams 7500 Precast Stadia 8100 Labor - Plank 820 Labor - Beams 840 Labor - Stadia 860 Misc(Trucking Totals 316, 319.00 189, 791.40 126, 527.60 7,838.00 4,702.801 3,135.20 347,040.00 208,224.00 138,816.00 117, 851.00 70, 710.60 47,140.40 1,964.00 1,178.40 785.60 94,282.00 56,569.20 : 37,712.80 175,631.00 105,378.60 57,352.40 1,060,925.001 636,555.00 1 411,470.00 I 316,319.00 '100.00 ' 15,815.96 7,838.00 100.00 391.90 347,040.00 100.00 17,352.00 117, 851.00 100.00 5,892.56 1,964.00 100.00 98.20 94,282.00 100.00 4,714.10 162,731.00 92.66 12,900.00 8,136.56 1,048,025.00 198.78 1 12,900.00 52,401.28 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 G703TM —1992. Copyright© 1963, 1965, 1966, 1967, 1970, 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 International Treaties. Unauthorized reproduction or distribution of this A10Document, 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, copyright@aia.org.