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4.5 SR 12-21-2020Request for Action To Item Number Mayor and Ci T Council 4.5 Agenda Section Meeting Date Prepared by Consent December 21, 2020 Ryan Sandhoefner, Engineer 1 Item Description Reviewed by Pay Estimates Justin Femrite P.E., Public Works Director Reviewed by Cal Portner, City Administrator Action Requested Approve, by motion, the pay estimates detailed below. Background/Discussion The following pay estimates have been reviewed and found to be accurate and in accordance with approved contracts. Financial Impact PROJECT Multi -Purpose Facility & Lions Park Multi -Purpose Facility & Lions Park Multi -Purpose Facility & Lions Park Public Safety Expansion/Fire Station #3 Mission/Policy/Goal Opportunity to live, work, and play. Attachments ■ Pay Estimate 17 — RJM Construction LLC ■ Pay Estimate 18 — RJM Construction LLC ■ Pay Estimate 19 — RJM Construction LLC ■ Pay Estimate 2 — Terra Construction Pay Est. # 17 - Partial 18 - Partial 19 - Partial 2- Partial Contractor Amount RJM Construction LLC $13,195.24 RJM Construction LLC $9,621.58 RJM Construction LLC $620,942.80 Terra Construction $334,433.29 The Elk River Vision P 0 W E e E 0 0 V A welcoming community rvitb revolutionary and spirzted resourcefulness, exceptional NATURE service, and community engagement that encourages and inspires prosperz[ Updated. August 2020 code: 4207-8540-4520 signature: ' Please Remit Payment to: RJM Construction, LLC 830 Boone Ave North Golden Valley, MN 55427 APPLICATION AND CERTIFICATE FOR PAYMENT To City of Elk River Project:19520-0033 Elk River Multi -Purpose Facility and Lion John Invoice #: 9520003317 Distribution to ; Owner: Attn: Justine Femrite VANIs Street NW Application No.: 17 Owner 13065 Orono Parkway Elk River, MN 55330 Architect Elk River, MN 55330 Application Date: 10/3112020 Contractor Architect: Period From: 10/1/2020 To: 10131 /2020 CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractors knowledge, information, and belief, the work covered by this Application for Payment has been completed in Application is made for payment, as shown below, in connection with the Contract. accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for Continuation Sheet is attached. 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 ............... . .......... $25,934,028.00 2. Net Change By Change Order .............. . ..... . $567,579.40 3. Contract Sum To Date ............. . . ...... . . ... $26,501,607.40 4. Total Completed and Stored To Date ........ < .... , . $26,417,658.23 5. Retainage: a. 2.35% of Completed Work $620,598.87 b. 0.00% of Stored Material $0.00 Total Retainage ................... $620,598.87 6. Total Earned Less Retainage ......... , .. . _ ... $25,797,059.36 7. Less Previous Certificates For Payments . a . $25,783,864.12 8. Current Payment Due ................ 9. Balance To Finish, Plus Retainage ................. $704,548.04 CHANGE ORDER SUMMARY Ad iti n Deductions Total changes approved to previous rnonths b Owner $956,343.73 $388,764.33 Total Approved this Month $0.00 $0.00 TOTALS $956,343.73 $388,764.33 Net Changes By Change Order $567,579.40 RJM Construction LLC State of: /P1 *n Subscribed and fore me this Notary Public: My Commission a p County of: - /06 day of —. , ZO O In accordance with the Contract Documents, based on on -site observati r comprising the above application, the Architect certifies to the Owner that to o Architect's knowledge, information, and belief, the Work has progressed as indicate ,��' the quality of the Work is in accordance with the Contract Documents, and the Contractor c7 is entitled to payment of the AMOUNT CERTIFIED.04 ARCHITECT'S CERTIFICATE FOR PAYMENT' AMOUNT CERTIFIED $ 13,195.24 (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.) ARCHITECT: 11/11/20 By: Date:. This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. CONTINUATION SHEET Page 2of3 Application and Certification for Payment, containing Application No.: 17 Contractor's signed certification is attached. In tabulations below, amounts are stated to the nearest dollar. Application Date : 10/31/20 Use Column I on Contracts where variable retainage for line items may apply. To: 10/31/20 Architect's Project No.: Invoice # : 9520003317 Contract: 19520-0033 Elk River Multi -Purpose Facility and Lion John Weicht Park A B C D E F j G H Item Description of Work Scheduled Work Com leted Materials Total % Balance Retainage No. Value From Previous This Period Presently I Completed (G I C) To Finish Application IIn Place Stored and Stored (C-G) (D+E)1 To Date Not in D or E 1 D+E+F 1 Elk River MuItikF'urpose Facility and 0.00. 000 0.00 j 0.00 0.00 = 0.00% 0.00 - 0.00 Lion John Weicht Park 1A Final Cleaning 81,315.00 81,315.00 0.00 0.00' 81,315.00 100.00% = 0.001 2,032.96 1 B Survey 25,568.00 25,568.001 0.00 0.00E 25,568.00 100.00% 0.00 j 639.20 2A Building Demolition 166,199.51 166,199.513 0.00 0 00 166,199 51 1 100.00% 0.00' 4,154.99 2B Selective Demolition 236,477.21 236,477.21 0.00 _ 0.00 236,477.21 100.00% 0.00 5,911.93 3C Concrete Floor Finishes 135,699.62 135,699.62 0.00 ' 0.00 135,699.62 100.00% 0.00' 3,392.49 4A Masonry Systems 2,982,936.83 2,982,936.83 0.00 ' 0.00 2,982,936.83 100.00% 1 0.00 _ 74,573.42 5A Structural Material 1,342,525.131 1,361,847 77'. -19,322.64 0.00 1,342,525.13 100.00% 0.00 33,080.06 5B Structural Labor 457,855.00 457,489 00' 366.00 0.00 ; 457,855.00 100.00% ' 0.00. 11,455 52 6A Carpentry 1,656,489 71 1,654,767.03' 1,722.68 0.00 1,556,489.71 100.00% 0.00 41,455 30 ; 7A Waterproofing&WB 40,342.00 40,342.00 0.00 0.00' ] 40,342.001 100.00% 0.00 1,008.55 7B Roofing Systems 1,067,619 73 1,067,619.73 0.00 0.00 1,067,619.73 100.00% ( 0.00 ' 26,690 49 7C Metal Wall Panel 186,172 61 186,172.61 0.00 0.00 186,172.61 100.000/0 - 0.00 4,654.31 j 8A Aluminum Entrances/Storefronts 642,926 46 : 642,926.46 0.00 = 0.00 642,926.46 100.00% : 0.001 16,073.16 8B 'Overhead Coiling and Sectional 53,610 00 , 53,610.00 0.00 0.00 53,610.00 100.00% 0.001 1,340.25 Doors 9A Gypsum Board 349,769.37 349,769.371 0.00 ` 0.00 349,769.37 100.00% 0.00 8,744.23 9B Tiling 175,149.90 175,149.901 0.00 0.00 175,149.90 , 100.00% 0.00 4,378.75 9C Acoustical Ceilings 147,905.95 147,905.95 0.00 0.00 147,905.95 - 100.00% 0.00 3,697.65 9D Flooring 132,262.50 132,262.501 0.00 _ 0.00 132,262.50 , 100.00% 0.00 3,306.56 9E Painting 444,499.00 438,719.001 5,180.00 - 0.00 444,499.00 100.00% = 0.00 11,256.97 i 10A Signage 10,807.14 10,807.14; 0.00 . 0.00 10,807.14 100.00% _ 0.00 270.18 11A Athletic Equipment 175,176.84 175,176.84�i 0.00 0.00 175,176.84 E 100.00% 0.001 4,379.43 11 B Concessions j 101,991.83 101,991.83' 0.00 0.00- 101,991.83 100.00% 0.00 2,549.80 12A Roller Shades 3 28,659.10 28,659.10 0.00 0.00- 28,659.10- 100.00% 0.00 716.48 13B Ice Rink Systems 2,162,742.00 2,162,742.00, 0.00 _ 0.00. 2,162,742 00 100.00% 0.00 . 54,068.55 13C Leg Truss System 125,797.001 125,797.00 0.00 0.00 ` 125,797.00 ss 100.00% 0.001 3,144.92 14A Elevators 71,700.001 71,700.00 0.00 0.00 71,700 00 100.00% 0.00 1,792 50 21A Fire Protection 282,544.001 282,144.00, 400.00 0.00 282,544.00 100.00% 0.00 _ 7,073.61 22A Plumbing Systems 1,323,097.00' 1,323,097.00 0.00 10.00 1,323,097.00 100.00% 0.001 33,07742 23A HVAC 1,875,065.33 1,875,065.33 0.00 % 0.00 1,875,065.33 100.00% = 0.00 46,876.63 26A Electrical Systems 1,876,978.67 , 1,874,010 43 2,968.24 0.00 1,876,978.67 100.00% 0.00. 46,998 67 3 31A Multipurpose Earthwork 714,137.301 711,384.30 2,753.00 0.00' 714,137.30 100.00% j 0.00 17,922.26 CONTINUATION SHEET Page 3of3 Application and Certification for Payment, containing Application No.: 17 Contractor's signed certification is attached. In tabulations below, amounts are stated to the nearest dollar. Application Date : 10/31/20 Use Column I on Contracts where variable retainage for line items may apply. To: 10/31/20 Architect's Project No.: Invoice # : 9520003317 Contract: 19520-0033 Elk River Multi -Purpose Facility and Lion John Weicht Park A B C_ D E F G H € Item Description of Work Scheduled I. Work Completed Materials Total % Balance Retainage No. Value From Previous I This Period 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 31 B Lions Earthwork 508,490.671 510,815.67 -2,325.00 0.00 . 508,490 67 100.00% 0.00' _ 12,654.14 32A Asphalt Paving 294,509.00' 293,489 00' 1,020.00 0.00, 294,509.00 100.00% 0.00 - 7,388.22 32B Concrete/Sidewalk/Curb/Gutter 389,142.50 384,713.41' 4,429.09 0.00. 389,142.50 . 100.00% . 0.00 9,839.28 32C Multipurpose Landscaping 27,000.00 27,000.00 0.00 " 0.00 . 27,000.00 . 100.00% 0.00 675.00 32D Lions Landscaping 94,480.00 94,480.001 0.00 10.00 1 94,480.00 100.00% 0.00 2,362 00 32E Chain Link Fence 150,325.79 150,325 79- 0.00 0.00 150,325.79 100.00% 0.00' 3,758.15 33A Utilities 635,496.55. 635,496.55 0.00 0.001 635,496 55 1 100.00% 0.00'. 15,887 41 3B.1 Precast Concrete 1,182,922.00 , 1,182,922.00' 0.00 0.00 1,182,922.00 100.00% 0.00 29,573.05 313.2 Precast Concrete 930,000.00 , 930,000.00. 0.00 0.00 930,000.00 100.00% i 0.00 23,250.00 3B.3 Precast Raker/Plank/Stadia 1,048,02500 1,048,025.00 0.00 0.00 1,048,025.00 100.00% 0.00 26,200.62 01-00 General Conditions/Requirements 1,262,663 36 1,247,337.68 12,969.24 10.00 1,260,306.92 99.81% 2,356.44 0.00 90-50 General Liability Insurance 268,451 52 268,451.52 0.00 0.00 268,451.52 ' 100.00% 0.00 0.00 90-60 Construction Contingency 81,592.73.0.00 0.00 0.00 0.00 0.00% 81,592.73 0.00 90-80 Builders Risk Insurance 65,184.58 65,184 58 0.00 . 0.00 65,184.58 100.00% 0.00 0.00 i 99-99 Contractors Fee 489,303 96 . I 486,857 44 2,446.52 . 0.00 489,303.96 100.00% 1 0.00 i i 12,293.76 � i Grand Totals 126,501,607.40 26,404,451.10 13,207.13 0.00 26,417,658.23 99.68% 83,949.17 620,598.87 INVOICE Survey SUBCONTRACTS Hakanson Anderson Associates Structural Material SUBCONTRACTS Distinctive Iron, LLC Structural Labor SUBCONTRACTS High Five Erectors II, Inc Carpentry MATERIAL PURCHASES Home Depot Credit Services Veit Disposal Systems SUBCONTRACTS Building Material Supply Inc Kendell Doors & Hardware, Inc Survey Inv# 19520-003310 Total SUBCONTRACTS Survey Sub -Total: Structural Steel Inv# 19520-00337 Total SUBCONTRACTS Structural Material Sub -Total: Structural Steel Erection Inv# 19520-003313 Total SUBCONTRACTS Structural Labor Sub -Total: Inv# 20201210 592416 Total MATERIAL PURCHASES Toilet Partitions and Accessories Inv# 19520-00335 Hollow Metal Doors & Frames 19520-003310 Total SUBCONTRACTS Carpentry Sub -Total: Painting SUBCONTRACTS Sunrise Painting & Wallcovering, Inc. Painting Fire Protection SUBCONTRACTS Summit Companies Inv# 19520-003310 Total SUBCONTRACTS Painting Sub -Total: Fire Protection Inv# 19520-003313 Total SUBCONTRACTS Fire Protection Sub -Total: 0.00 -19,322.64 -19,322.64 -19,322.64 366.00 88.35 469.11 667.46 357.00 808.22 5,780.00 400.00 400.00 Electrical Systems INVOICE Electrical Systems SUBCONTRACTS Design Electric, Inc Electrical Inv# 19520-003314 2,260.09 Electrical 19520-003315 708.15 Total SUBCONTRACTS 2,968.24 Electrical Systems Sub -Total: 2,968.24 Multipurpose Earthwork SUBCONTRACTS Minnesota Utilities & Excavating, LLC Multipurpose Earthwork Inv# 19520-00338 2,753.00 Total SUBCONTRACTS 2,763.00 Multipurpose Earthwork Sub -Total: 2,753.00 Lions Earthwork SUBCONTRACTS US SiteWork, Inc. Lions Park Earthwork Inv# 19520-00334 -2,325.00 Total SUBCONTRACTS -2,326.00 Lions Earthwork Sub-Total: -2,325.00 Asphalt Paving SUBCONTRACTS Bituminous Roadways Inc Asphalt Paving Inv# 19520-00337 1,020.00 Total SUBCONTRACTS 1,020.00 Asphalt Paving Sub -Total: 1,020.00 Concrete/Sidewalk/Curb/Gutter SUBCONTRACTS Ebert Construction Site Concrete Inv# 19520-00339C 4,429.09 Total SUBCONTRACTS 4,429.09 Concrete/Sidewalk/Curb/Gutter Sub -Total: 4,429.09 General Conditions/Requirements MATERIAL PURCHASES SparkleWash Inv# 458622 1,031.55 WEX Bank 68212796 191.66 Verizon Wireless 9865442744 68.50 Tom Druk EX 10/18/20 469.80 Elk River Municipal Utilities 1217 2,223.53 Total MATERIAL PURCHASES 3,986.04 PICKUP TRUCK O.00HRS @ 0.00 64.00 Total PICKUP TRUCK 64.00 INVOICE General Conditions/Requirements LABOR Carpenters Regular Earnings 6.00 HRS @ 83.90 503.40 General Superintendent Regular Earnings 4.00 HRS @ 114.90 459.60 Superintendent Regular Earnings 16.00 HRS @ 109.90 1,758.40 Laborer Foreman Regular Earnings 4.00 HRS @ 80.90 323.60 Project Manager Regular Earnings 24.00 HRS @ 106.40 2,553.60 Project Executive Regular Earnings 24.00 HRS @ 138.40 3,321.60 Total LABOR 8,920.20 P&P Bond 0.00% 0.00 General Conditions/Requirements Sub -Total: 12,969.24 General Liability Insurance GENERAL LIABILITY INSURANCE 0.00% 0.00 General Liability Insurance Sub -Total: 0.00 Builders Risk Insurance BUILDERS RISK INSURANCE 0.00% 0.00 Builders Risk Insurance Sub -Total: 0.00 Contractors Fee CONTRACTOR'S FEE 0.00% 2,446.52 Contractors Fee Sub -Total: 2,446.52 INVOICE (Summary ' 1 B Survey Retainage 13,207.13@ 5.00% 0.00 5A Structural Material -19,322.64 Retainage 13,207.13@ 5.00% 966.13 5B Structural Labor 366.00 Retainage 13,207.13@ 5.00% (18.30) 6A Carpentry 1,722.68 Retainage 13,207.13@ 5.00% (86.13) 9E Painting 6,780.00 Retainage 13,207.13@ 5.00% (289.00) 21A Fire Protection 400.00 Retainage 13,207.13@ 5.00% (20.00) 26A Electrical Systems 2,968.24 Retainage 13,207.13@ 5.00% (148.41) 31A Multipurpose Earthwork 2,763.00 Retainage 13,207.13@ 5.00% (137.66) 31 B Lions Earthwork -2,326.00 Retainage 13,207.13@ 5.00% 116.26 32A Asphalt Paving 1,020.00 Retainage 13,207.13@ 5.00% (61.00) 32B Concrete/Sidewalk/Curb/Gutter 4,429.09 Retainage 13,207.13@ 5.00% (221.46) 01-00 General Conditions/Requirements 12,969.24 Retainage 13,207.13@ 0.00% 0.00 90-50 General Liability Insurance Retainage 13,207.13@ 0.00% 0.00 90-80 Builders Risk Insurance Retainage 13,207.13@ 0.00% 0.00 99-99 Contractors Fee 2,446.62 Retainage 13,207.13@ 5.00% (122.33) CURRENT DUE : 13,196.24 APPLICATION FOR PAYMENT To: RJM Construction, LLC. 830 Boone Avenue North Golden Valley, MN 55427 From: Distinctive Iron LLC 19128 Elk River, MN 55330 Contract For: 195200033-051205 - Structural Steel 1. ORIGINAL CONTRACT AMOUNT 2. NET CHANGE BY CHANGE ORDERS 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE (Column G) 5. RETAINAGE - of Completed Work (Columns D + E) - of Stored Materials (Columns F) Total Retainage (Line 5a + Line 5b OR Sum of Column 1) 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PRIOR CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) Project: Elk River Multi -Purpose Facility and Lion John Weicht Park $1,308,353.00 ($307,936.25) $1,000,416.75 $1,000,416.75 $0.00 $1,000,416.75 $968, 752.41 $31,664.34 $0.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months $47,305.39 $335,919.00 Total approved this month $19,061.24 $38,383.88 TOTALS $66,366.63 $374,302.88 NET CHANGES by Change Orders ($307,936.25) Application No.: 7 Period To: 10/31/20 Application Date: 11/03/20 Project No.: 19520-0033 Contract Date: 07/23/19 Commitment: 195200033-051205 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by the Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: By: Cynthia Hemmer Date: 11/03/20 State Of: County Of: Subscribed and sworn to before me this Notary Public: My commission expires: ARCHITECTS CERTIFICATE FOR PAYMENT day of In accordance with the Contract Documents, based on the on -site observations and the data compromising this application, the Architect certifies to the owner that to the best of the Architects knowledge, information and belief the Work under the Architect's Contract has progressed as indicated, the quality of Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED $31,664.34 (Attach explanation if amount certified differs from the amount applied for. Initial all figures on the Application for Payment and on the Continuation sheet that are changes to conform to the amount certified.) ARCHITECT By: Date: The 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. Page 1 of 1 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 7 containing Contractor's signed Certification is attached. APPLICATION DATE: 11/03/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 10/31/20 Distinctive Iron LLC PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE 1 Bond $22,896.00 $22,896.00 $22,896.00 100.00% 2 Start Up - Shop Drawings $75,000.00 $75,000.00 $75,000.00 100.00% 3 Steel: Structural $278,353.00 $278,353.00 $278,353.00 100.00% 4 Steel: Joist and Deck $767,104.00 $767,104.00 $767,104.00 100.00% 5 Steel: Misc $150,000.00 $150,000.00 $150,000.00 100.00% 6 Allowance $15,000.00 $15,000.00 $15,000.00 100.00% 1 Structural Steel (CO #1) $534.38 $534.38 $534.38 100.00% 1 Structural Steel (CO #2) $18,117.98 $18,117.98 $18,117.98 100.00% 1 Structural Steel (CO #3) $6,888.15 $6,888.15 $6,888.15 100.00% 1 Structural Steel (CO #4) $2,133.23 $2,133.23 $2,133.23 100.00% 1 Structural Steel (CO #6) $3,259.69 $3,259.69 $3,259.69 100.00% 1 Structural Steel (CO #7) ($332,879.00) ($332,879.00) ($332,879.00) 100.00% 1 Structural Steel (CO #8) $4,141.41 $4,141.41 $4,141.41 100.00% 1 Structural Steel (CO #9) $8,680.34 $8,680.34 $8,680.34 100.00% 1 Structural Steel (CO #10) $2,149.90 $2,149.90 $2,149.90 100.00% 1 Structural Steel (CO #10) $1,400.31 $1,400.31 $1,400.31 100.00% 1 Structural Steel (CO #5) - 1 Structural Steel (CO #11) ($3,040.00) ($3,040.00) ($3,040.00) 100.00% 1 Structural Steel (CO #12) $5,564.98 $5,564.98 $5,564.98 100.00% 1 Structural Steel (CO #13) $8,286.10 $8,286.10 $8,286.10 100.00% 1 Structural Steel (CO #14) $5,210.16 $5,210.16 $5,210.16 100.00% 1 Structural Steel (CO #15) ($38,383.88) ($38,383.88) ($38,383.88) 100.00% PAYMENT TOTALS $1,000,416.75 $1,019,739.39 ($19,322.64) $1,000,416.75 100.00% Page 1 of 1 APPLICATION FOR PAYMENT To: RJM Construction, LLC. Project: Elk River Multi -Purpose Facility and Lion Application No.: 13 830 Boone Avenue North John Weicht Park Golden Valley, MN 55427 Period To: 10/31/20 From: High Five Erectors 11, Inc. Application Date: 10/20/20 3005 4th Avenue East Project No.: 19520-0033 P.O. Box 477 Shakopee, MN 55379 Contract Date: 07/23/19 Contract For: 195200033-051210 - Structural Steel Erection Commitment: 195200033-051210 1. ORIGINAL CONTRACT AMOUNT 2. NET CHANGE BY CHANGE ORDERS 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE (Column G) 5. RETAINAGE - of Completed Work (Columns D + E) - of Stored Materials (Columns F) Total Retainage (Line 5a + Line 5b OR Sum of Column 1) 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PRIOR 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 $22,105.00 $457, 855.00 $457, 855.00 $0.00 $457, 855.00 $457,489.00 $366.00 $0.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months $28,931.00 $7,192.00 Total approved this month $366.00 $0.00 TOTALS $29,297.00 $7,192.00 NET CHANGES by Change Orders $22,105.00 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by the Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: By: Tara Thompson Date: 10/20/20 State Of: County Of: Subscribed and sworn to before me this Notary Public: My commission expires: ARCHITECTS CERTIFICATE FOR PAYMENT day of In accordance with the Contract Documents, based on the on -site observations and the data compromising this application, the Architect certifies to the owner that to the best of the Architects knowledge, information and belief the Work under the Architect's Contract has progressed as indicated, the quality of Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED $366.00 (Attach explanation if amount certified differs from the amount applied for. Initial all figures on the Application for Payment and on the Continuation sheet that are changes to conform to the amount certified.) ARCHITECT By: Date: The 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. Page 1 of 1 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 13 containing Contractor's signed Certification is attached. APPLICATION DATE: 10/20/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 10/31/20 High Five Erectors II, Inc. PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE 1 051200 Structural Steel $129,841.00 $129,841.00 $129,841.00 100.00% 2 052100 Steel Joists $100,523.00 $100,523.00 $100,523.00 100.00% 3 053100 Steel Decking $45,888.00 $45,888.00 $45,888.00 100.00% 4 055000 Metal Fabrications $8,508.00 $8,508.00 $8,508.00 100.00% 5 055100 Metal Pan Stairs $43,996.00 $43,996.00 $43,996.00 100.00% 6 055213 Pipe & Tube Railings $71,614.00 $71,614.00 $71,614.00 100.00% 7 Allowance $30,000.00 $30,000.00 $30,000.00 100.00% 8 Bond $5,380.00 $5,380.00 $5,380.00 100.00% 1 Structural Steel Erection (CO $4,190.00 $4,190.00 $4,190.00 100.00% #1) 1 Structural Steel Erection (CO ($6,888.15) ($6,888.15) ($6,888.15) 100.00% #2) 1 Structural Steel Erection (CO $500.00 $500.00 $500.00 100.00% #3) 1 Structural Steel Erection (CO $672.00 $672.00 $672.00 100.00% #4) 1 Structural Steel Erection (CO $3,000.00 $3,000.00 $3,000.00 100.00% #5) 1 Structural Steel Erection (CO $8,650.00 $8,650.00 $8,650.00 100.00% #6) 1 Structural Steel Erection (CO $600.00 $600.00 $600.00 100.00% #7) 1 Structural Steel Erection (CO $1,200.00 $1,200.00 $1,200.00 100.00% #7) 1 Structural Steel Erection (CO $3,040.00 $3,040.00 $3,040.00 100.00% #8) 1 Structural Steel Erection (CO $1,752.00 $1,752.00 $1,752.00 100.00% #9) 1 Structural Steel Erection (CO ($303.85) ($303.85) ($303.85) 100.00% #10) 1 Structural Steel Erection (CO $4,217.00 $4,217.00 $4,217.00 100.00% #10) 1 Structural Steel Erection (CO $844.00 $844.00 $844.00 100.00% Page 1 of 2 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 13 containing Contractor's signed Certification is attached. In tabulations below, amounts are stated to the nearest dollar. APPLICATION DATE: 10/20/20 PERIOD TO: 10/31/20 High Five Erectors II, Inc. PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE #11) 1 Structural Steel Erection (CO $266.00 $266.00 - $266.00 100.00% #12) 1 Structural Steel Erection (CO $366.00 - $366.00 $366.00 100.00% #13) PAYMENT TOTALS $457,855.00 $457,489.00 $366.00 $457,855.00 1 100.00% Page 2 of 2 APPLICATION FOR PAYMENT To: RJM Construction, LLC. Project: Elk River Multi -Purpose Facility and Lion Application No.: 5 830 Boone Avenue North John Weicht Park Golden Valley, MN 55427 Period To: 11/30/20 From: Building Material Supply, Inc. Application Date: 11/05/20 4555 W. 77th Street Project No.: 19520-0033 Edina, MN 55435 Contract Date: 11/13/19 Contract For: 195200033-102105 - Toilet Partitions and Commitment: 195200033-102105 Accessories 1. ORIGINAL CONTRACT AMOUNT 2. NET CHANGE BY CHANGE ORDERS 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE (Column G) 5. RETAINAGE - of Completed Work (Columns D + E) - of Stored Materials (Columns F) Total Retainage (Line 5a + Line 5b OR Sum of Column 1) 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PRIOR CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) $133, 323.00 $7,049.00 $140, 372.00 $140, 372.00 $0.00 $140, 372.00 $140, 015.00 $357.00 $0.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months $7,442.00 $750.00 Total approved this month $357.00 $0.00 TOTALS $7,799.00 $750.00 NET CHANGES by Change Orders $7,049.00 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by the Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: By: Heather Blanchet Date: 11/05/20 State Of: County Of: Subscribed and sworn to before me this Notary Public: My commission expires: ARCHITECTS CERTIFICATE FOR PAYMENT day of In accordance with the Contract Documents, based on the on -site observations and the data compromising this application, the Architect certifies to the owner that to the best of the Architects knowledge, information and belief the Work under the Architect's Contract has progressed as indicated, the quality of Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED $357.00 (Attach explanation if amount certified differs from the amount applied for. Initial all figures on the Application for Payment and on the Continuation sheet that are changes to conform to the amount certified.) ARCHITECT By: Date: The 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. Page 1 of 1 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 5 containing Contractor's signed Certification is attached. In tabulations below, amounts are stated to the nearest dollar. APPLICATION DATE: 11/05/20 PERIOD TO: 11/30/20 Building Material Supply, Inc. PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE Toilet Partitions -Material $41,131.00 $41,131.00 $41,131.00 100.00% Toilet Accessories -Material $44,545.00 $44,545.00 $44,545.00 100.00% Toilet Partitions -Install $26,700.00 $26,700.00 $26,700.00 100.00% Toilet Accessory -Install $14,925.00 $14,925.00 $14,925.00 100.00% Bike Racks -Material $4,887.00 $4,887.00 $4,887.00 100.00% Bike Racks -Install $750.00 $750.00 $750.00 100.00% Insurance -Additional $385.00 $385.00 $385.00 100.00% Endorsements 3 Lockers (CO #1) $3,448.00 $3,448.00 $3,448.00 100.00% 1 Toilet Partitions and $2,518.00 $2,518.00 $2,518.00 100.00% Accessories (CO #2) 1 Toilet Partitions and $1,476.00 $1,476.00 $1,476.00 100.00% Accessories (CO #3) 2 Bicycle Racks (CO #4) ($750.00) ($750.00) - ($750.00) 100.00% 1 Toilet Partitions and $357.00 $357.00 $357.00 100.00% Accessories (CO #5) PAYMENT TOTALS $140,372.00 $140,015.00 $357.00 $140,372.00 100.00% Page 1 of 1 APPLICATION FOR PAYMENT To: RJM Construction, LLC. Project: Elk River Multi -Purpose Facility and Lion Application No.: 10 830 Boone Avenue North John Weicht Park Golden Valley, MN 55427 Period To: 10/31/20 From: Kendell Doors & Hardware, Inc. Application Date: 10/19/20 1312 Northland Drive Project No.: 19520-0033 Suite 100 Mendota Heights, MN 55120 Contract Date: 11/13/19 Contract For: 195200033-081105 - Hollow Metal Doors & Commitment: 195200033-081105 Frames 1. ORIGINAL CONTRACT AMOUNT 2. NET CHANGE BY CHANGE ORDERS 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE (Column G) 5. RETAINAGE - of Completed Work (Columns D + E) - of Stored Materials (Columns F) Total Retainage (Line 5a + Line 5b OR Sum of Column 1) 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PRIOR CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) $92,614.00 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by the Application for Payment has been completed in accordance with the $202,189.13 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 $294,803.13 payment shown herein is now due. $294,803.13 CONTRACTOR: By: Jason Self Date: 10/19/20 State Of: County Of: $0.00 $294,803.13 $293,994.91 $808.22 $0.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months $202,703.41 $1,322.50 Total approved this month $808.22 $0.00 TOTALS $203,511.63 $1,322.50 NET CHANGES by Change Orders $202,189.13 Subscribed and sworn to before me this Notary Public: My commission expires: ARCHITECTS CERTIFICATE FOR PAYMENT day of In accordance with the Contract Documents, based on the on -site observations and the data compromising this application, the Architect certifies to the owner that to the best of the Architects knowledge, information and belief the Work under the Architect's Contract has progressed as indicated, the quality of Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED $808.22 (Attach explanation if amount certified differs from the amount applied for. Initial all figures on the Application for Payment and on the Continuation sheet that are changes to conform to the amount certified.) ARCHITECT By: Date: The 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. Page 1 of 1 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 10 containing Contractor's signed Certification is attached. APPLICATION DATE: 10/19/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 10/31/20 Kendell Doors & Hardware, Inc. PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE 1 Hollow Metal $84,079.00 $84,079.00 $84,079.00 100.00% 2 Finish Hardware $8,535.00 $8,535.00 $8,535.00 100.00% 1 Hollow Metal Doors & Frames $2,119.32 $2,119.32 $2,119.32 100.00% (CO #1) 1 Hollow Metal Doors & Frames $133,389.00 $133,389.00 $133,389.00 100.00% (CO #2) 1 Hollow Metal Doors & Frames $17,013.00 $17,013.00 $17,013.00 100.00% (CO #3) 1 Hollow Metal Doors & Frames $2,542.87 $2,542.87 $2,542.87 100.00% (CO #4) 1 Hollow Metal Doors & Frames $2,723.59 $2,723.59 $2,723.59 100.00% (CO #5) 1 Hollow Metal Doors & Frames $368.30 $368.30 $368.30 100.00% (CO #6) 1 Hollow Metal Doors & Frames $909.84 $909.84 $909.84 100.00% (CO #7) 1 Hollow Metal Doors & Frames $6,777.30 $6,777.30 $6,777.30 100.00% (CO #8) 1 Hollow Metal Doors & Frames $549.51 $549.51 $549.51 100.00% (CO #9) 1 Hollow Metal Doors & Frames $1,402.91 $1,402.91 $1,402.91 100.00% (CO #10) 1 Hollow Metal Doors & Frames $22,660.08 $22,660.08 $22,660.08 100.00% (CO #11) 1 Hollow Metal Doors & Frames $5,085.97 $5,085.97 $5,085.97 100.00% (CO #12) 1 Hollow Metal Doors & Frames $3,555.16 $3,555.16 $3,555.16 100.00% (CO #13) 1 Hollow Metal Doors & Frames $497.49 $497.49 $497.49 100.00% (CO #14) 1 Hollow Metal Doors & Frames ($350.00) ($350.00) ($350.00) 100.00% (CO #15) 1 Hollow Metal Doors & Frames ($972.50) ($972.50) ($972.50) 100.00% (CO #15) Page 1 of 2 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 10 containing Contractor's signed Certification is attached. In tabulations below, amounts are stated to the nearest dollar. APPLICATION DATE: 10/19/20 PERIOD TO: 10/31/20 Kendell Doors & Hardware, Inc. PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE 1 Hollow Metal Doors & Frames $959.07 $959.07 $959.07 100.00% (CO #16) 1 Hollow Metal Doors & Frames $1,200.00 $1,200.00 $1,200.00 100.00% (CO #17) 1 Hollow Metal Doors & Frames $950.00 $950.00 - $950.00 100.00% (CO #18) 1 Hollow Metal Doors & Frames $808.22 - $808.22 $808.22 100.00% (CO #19) PAYMENT TOTALS 1 $294,803.13 1 $293,994.91 $808.22 1 1 $294,803.13 1 100.00% Page 2 of 2 APPLICATION FOR PAYMENT To: RJM Construction, LLC. 830 Boone Avenue North Golden Valley, MN 55427 From: SUNRISE PAINTING 805 TOWER DRIVE MEDINA, MN 55340 Contract For: 195200033-099105 - Painting 1. ORIGINAL CONTRACT AMOUNT 2. NET CHANGE BY CHANGE ORDERS 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE (Column G) 5. RETAINAGE - of Completed Work (Columns D + E) - of Stored Materials (Columns F) Total Retainage (Line 5a + Line 5b OR Sum of Column 1) 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PRIOR CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) Project: Elk River Multi -Purpose Facility and Lion John Weicht Park $412, 750.00 $83,186.00 $495, 936.00 $495, 936.00 $0.00 $495, 936.00 $490,156.00 $5,780.00 $0.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months $98,269.00 $20,863.00 Total approved this month $5,780.00 $0.00 TOTALS $104,049.00 $20,863.00 NET CHANGES by Change Orders $83,186.00 Application No.: 10 Period To: 10/31/20 Application Date: 10/13/20 Project No.: 19520-0033 Contract Date: 07/23/19 Commitment: 195200033-099105 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by the Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: By: Kim Larson Date: 10/13/20 State Of: County Of: Subscribed and sworn to before me this Notary Public: My commission expires: ARCHITECTS CERTIFICATE FOR PAYMENT day of In accordance with the Contract Documents, based on the on -site observations and the data compromising this application, the Architect certifies to the owner that to the best of the Architects knowledge, information and belief the Work under the Architect's Contract has progressed as indicated, the quality of Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED $5,780.00 (Attach explanation if amount certified differs from the amount applied for. Initial all figures on the Application for Payment and on the Continuation sheet that are changes to conform to the amount certified.) ARCHITECT By: Date: The 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. Page 1 of 1 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 10 containing Contractor's signed Certification is attached. APPLICATION DATE: 10/13/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 10/31/20 SUNRISE PAINTING PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE 1 PAINTING $407,750.00 $407,750.00 $407,750.00 100.00% 2 BOND $5,000.00 $5,000.00 $5,000.00 100.00% 1 Painting (CO #1) $10,000.00 $10,000.00 $10,000.00 100.00% 1 Painting (CO #3) ($9,000.00) ($9,000.00) ($9,000.00) 100.00% 2 Prime + Paint Joists (CO #2) $63,800.00 $63,800.00 $63,800.00 100.00% 1 Painting (CO #4) ($1,863.00) ($1,863.00) ($1,863.00) 100.00% 1 Painting (CO #5) $13,100.00 $13,100.00 $13,100.00 100.00% 1 Painting (CO #6) $6,100.00 $6,100.00 $6,100.00 100.00% 1 Painting (CO #6) $5,269.00 $5,269.00 $5,269.00 100.00% 1 Painting (CO #7) ($10,000.00) ($10,000.00) ($10,000.00) 100.00% 1 Painting (CO #8) $5,780.00 $5,780.00 $5,780.00 100.00% PAYMENT TOTALS $495,936.00 $490,156.00 $5,780.00 $495,936.00 100.00% Page 1 of 1 APPLICATION FOR PAYMENT To: RJM Construction, LLC. 830 Boone Avenue North Golden Valley, MN 55427 From: Summit Companies 575 Minnehaha Avenue West St Paul, MN 55103 Contract For: 195200033-211005 - Fire Protection 1. ORIGINAL CONTRACT AMOUNT 2. NET CHANGE BY CHANGE ORDERS 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE (Column G) 5. RETAINAGE 0% of Completed Work (Columns D + E) 0% of Stored Materials (Columns F) Total Retainage (Line 5a + Line 5b OR Sum of Column 1) 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PRIOR CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) Project: Elk River Multi -Purpose Facility and Lion John Weicht Park $256,485.00 $26,059.00 $282, 544.00 $282, 544.00 N/A N/A $0.00 $282, 544.00 $282,144.00 $400.00 $0.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months $25,659.00 $0.00 Total approved this month $400.00 $0.00 TOTALS $26,059.00 $0.00 NET CHANGES by Change Orders $26,059.00 Application No.: 13 Period To: 10/31/20 Application Date: 10/22/20 Project No.: 19520-0033 Contract Date: 07/23/19 Commitment: 195200033-211005 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by the Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: By: Josh Scott Date: 10/22/20 State Of: County Of: Subscribed and sworn to before me this Notary Public: My commission expires: ARCHITECTS CERTIFICATE FOR PAYMENT day of In accordance with the Contract Documents, based on the on -site observations and the data compromising this application, the Architect certifies to the owner that to the best of the Architects knowledge, information and belief the Work under the Architect's Contract has progressed as indicated, the quality of Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED $400.00 (Attach explanation if amount certified differs from the amount applied for. Initial all figures on the Application for Payment and on the Continuation sheet that are changes to conform to the amount certified.) ARCHITECT By: Date: The 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. Page 1 of 1 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 13 containing Contractor's signed Certification is attached. APPLICATION DATE: 10/22/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 10/31/20 Summit Companies PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE 1 Labor $87,885.00 $87,885.00 $87,885.00 100.00% 2 Material $111,200.00 $111,200.00 $111,200.00 100.00% 3 Design $31,200.00 $31,200.00 $31,200.00 100.00% 4 Fabrication $20,200.00 $20,200.00 $20,200.00 100.00% 5 Bonds $6,000.00 $6,000.00 $6,000.00 100.00% 1 Fire Protection (CO #1) $11,955.00 $11,955.00 $11,955.00 100.00% 1 Fire Protection (CO #2) $5,952.00 $5,952.00 $5,952.00 100.00% 1 Fire Protection (CO #3) $3,955.00 $3,955.00 $3,955.00 100.00% 1 Fire Protection (CO #4) $1,475.00 $1,475.00 $1,475.00 100.00% 1 Fire Protection (CO #5) $2,322.00 $2,322.00 - $2,322.00 100.00% 1 Fire Protection (CO #6) $400.00 $400.00 $400.00 100.00% PAYMENT TOTALS $282,544.00 $282,144.00 $400.00 $282,544.00 100.00% Page 1 of 1 APPLICATION FOR PAYMENT To: RJM Construction, LLC. 830 Boone Avenue North Golden Valley, MN 55427 From: Design Electric, Inc PO Box 1252 St. Cloud, MN 56302 Contract For: 195200033-260105 - Electrical 1. ORIGINAL CONTRACT AMOUNT 2. NET CHANGE BY CHANGE ORDERS 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE (Column G) 5. RETAINAGE 5.00% of Completed Work (Columns D + E) 5.00% of Stored Materials (Columns F) Total Retainage (Line 5a + Line 5b OR Sum of Column 1) 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PRIOR CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) Project: Elk River Multi -Purpose Facility and Lion John Weicht Park $1,786,914.00 $113,917.52 $1,900,831.52 $1,900,831.52 $95,041.56 $95,041.56 $1,805,789.96 $1,803,642.87 $2,147.09 $95,041.56 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months $156,126.02 $44,468.59 Total approved this month $2,260.09 $0.00 TOTALS $158,386.11 $44,468.59 NET CHANGES by Change Orders $113,917.52 Application No.: 14 Period To: 10/31/20 Application Date: 10/19/20 Project No.: 19520-0033 Contract Date: 08/01/19 Commitment: 195200033-260105 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by the Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: By: Ashley Krueger Date: 10/19/20 State Of: County Of: Subscribed and sworn to before me this Notary Public: My commission expires: ARCHITECTS CERTIFICATE FOR PAYMENT day of In accordance with the Contract Documents, based on the on -site observations and the data compromising this application, the Architect certifies to the owner that to the best of the Architects knowledge, information and belief the Work under the Architect's Contract has progressed as indicated, the quality of Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED $2,147.09 (Attach explanation if amount certified differs from the amount applied for. Initial all figures on the Application for Payment and on the Continuation sheet that are changes to conform to the amount certified.) ARCHITECT By: Date: The 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. Page 1 of 1 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 14 containing Contractor's signed Certification is attached. APPLICATION DATE: 10/19/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 10/31/20 Design Electric, Inc PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE 1 BOND/PERMIT $35,908.00 $35,908.00 $35,908.00 100.00% $1,795.40 /MOBILIZATION 2 SITE WORK/UNDERGROUND $33,158.00 $33,158.00 $33,158.00 100.00% $1,657.90 3 DEMOLITION/TEMP WIRING $64,200.00 $64,200.00 $64,200.00 100.00% $3,210.00 4M CONDUIT -MATERIAL $122,167.00 $122,167.00 $122,167.00 100.00% $6,108.35 4L CONDUIT - LABOR $180,320.00 $180,320.00 $180,320.00 100.00% $9,016.00 5M BOXES/WIRE/DEVICES - $110,400.00 $110,400.00 $110,400.00 100.00% $5,520.00 MATERIAL 5L BOXES/WIRE/DEVICES - $67,200.00 $67,200.00 $67,200.00 100.00% $3,360.00 LABOR 6M FIXTURES - MATERIAL $425,654.00 $425,654.00 $425,654.00 100.00% $21,282.70 6L FIXTURES - LABOR $90,400.00 $90,400.00 $90,400.00 100.00% $4,520.00 7M GEAR - MATERIAL $145,168.00 $145,168.00 $145,168.00 100.00% $7,258.40 7L GEAR - LABOR $38,400.00 $38,400.00 $38,400.00 100.00% $1,920.00 8M LOW VOLTAGE ROUGH -IN - $46,722.00 $46,722.00 $46,722.00 100.00% $2,336.10 MATERIAL 8L LOW VOLTAGE ROUGH -IN - $73,120.00 $73,120.00 $73,120.00 100.00% $3,656.00 LABOR 9M EQUIPMENT CONNECTIONS $68,400.00 $68,400.00 $68,400.00 100.00% $3,420.00 - MATERIAL 9L EQUIPMENT CONNECTIONS $12,200.00 $12,200.00 $12,200.00 100.00% $610.00 -LABOR 10M FIRE ALARM - MATERIAL $84,697.00 $84,697.00 $84,697.00 100.00% $4,234.85 10L FIRE ALARM - LABOR $20,000.00 $20,000.00 $20,000.00 100.00% $1,000.00 11M SOFTBALL FIELD - $153,200.00 $153,200.00 $153,200.00 100.00% $7,660.00 MATERIAL 11L SOFTBALL FIELD - LABOR $15,600.00 $15,600.00 $15,600.00 100.00% $780.00 12 - - 1 Electrical (CO #1) $945.49 $945.49 $945.49 100.00% $47.27 1 Electrical (CO #2) $1,340.58 $1,340.58 $1,340.58 100.00% $67.03 1 Electrical (CO #3) $1,582.00 $1,582.00 $1,582.00 100.00% $79.10 Page 1 of 2 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 14 containing Contractor's signed Certification is attached. APPLICATION DATE: 10/19/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 10/31/20 Design Electric, Inc PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE 1 Electrical (CO #4) ($24,378.00) ($24,378.00) ($24,378.00) 100.00% ($1,218.90) 1 Electrical (CO #5) ($12,693.73) ($12,693.73) ($12,693.73) 100.00% ($634.69) 1 Electrical (CO #6) $396.52 $396.52 $396.52 100.00% $19.83 1 Electrical (CO #7) $2,162.06 $2,162.06 $2,162.06 100.00% $108.10 1 Electrical (CO #8) $7,694.97 $7,694.97 $7,694.97 100.00% $384.75 1 Electrical (CO #10) $5,773.48 $5,773.48 $5,773.48 100.00% $288.67 2 Joist Work - Electrical (CO #9) $24,561.00 $24,561.00 $24,561.00 100.00% $1,228.05 1 Electrical (CO #7) $1,035.41 $1,035.41 $1,035.41 100.00% $51.77 1 Electrical (CO #7) $12,342.68 $12,342.68 $12,342.68 100.00% $617.13 1 Electrical (CO #7) $1,170.60 $1,170.60 $1,170.60 100.00% $58.53 1 Electrical (CO #7) ($7,396.86) ($7,396.86) ($7,396.86) 100.00% ($369.84) 1 Electrical (CO #11) $42,232.20 $42,232.20 $42,232.20 100.00% $2,111.61 1 Electrical (CO #12) $12,952.00 $12,952.00 $12,952.00 100.00% $647.60 1 Electrical (CO #13) $1,677.13 $1,677.13 $1,677.13 100.00% $83.86 1 Electrical (CO #14) $9,491.86 $9,491.86 $9,491.86 100.00% $474.59 1 Electrical (CO #15) $1,044.26 $1,044.26 $1,044.26 100.00% $52.21 1 Electrical (CO #15) $5,221.53 $5,221.53 $5,221.53 100.00% $261.08 1 Electrical (CO #16) $3,536.88 $3,536.88 $3,536.88 100.00% $176.84 1 Electrical (CO #17) $2,741.41 $2,741.41 $2,741.41 100.00% $137.07 1 Electrical (CO #18) $1,389.62 $1,389.62 $1,389.62 100.00% $69.48 1 Electrical (CO #19) $356.00 $356.00 $356.00 100.00% $17.80 1 Electrical (CO #19) $1,759.00 $1,759.00 $1,759.00 100.00% $87.95 1 Electrical (CO #20) $2,591.14 $2,591.14 $2,591.14 100.00% $129.56 1 Electrical (CO #21) $12,128.20 $12,128.20 $12,128.20 100.00% $606.41 1 Electrical (CO #22) $2,260.09 $2,260.09 $2,260.09 100.00% $113.00 PAYMENT TOTALS $1,900,831.52 $1,898,571.43 $2,260.09 $1,900,831.52 100.00% $95,041.56 Page 2 of 2 APPLICATION FOR PAYMENT To: RJM Construction, LLC. 830 Boone Avenue North Golden Valley, MN 55427 From: Design Electric, Inc PO Box 1252 St. Cloud, MN 56302 Contract For: 195200033-260105 - Electrical 1. ORIGINAL CONTRACT AMOUNT 2. NET CHANGE BY CHANGE ORDERS 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE (Column G) 5. RETAINAGE - of Completed Work (Columns D + E) - of Stored Materials (Columns F) Total Retainage (Line 5a + Line 5b OR Sum of Column 1) 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PRIOR CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) Project: Elk River Multi -Purpose Facility and Lion John Weicht Park $1,786,914.00 $114,625.67 $1,901,539.67 $1,901,539.67 $0.00 $1,901,539.67 $1,805,789.96 $95,749.71 $0.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months $158,386.11 $44,468.59 Total approved this month $708.15 $0.00 TOTALS $159,094.26 $44,468.59 NET CHANGES by Change Orders $114,625.67 Application No.: 15 Period To: 10/31/20 Application Date: 10/22/20 Project No.: 19520-0033 Contract Date: 08/01/19 Commitment: 195200033-260105 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by the Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: By: Ashley Krueger Date: 10/27/20 State Of: County Of: Subscribed and sworn to before me this Notary Public: My commission expires: ARCHITECTS CERTIFICATE FOR PAYMENT day of In accordance with the Contract Documents, based on the on -site observations and the data compromising this application, the Architect certifies to the owner that to the best of the Architects knowledge, information and belief the Work under the Architect's Contract has progressed as indicated, the quality of Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED $95,749.71 (Attach explanation if amount certified differs from the amount applied for. Initial all figures on the Application for Payment and on the Continuation sheet that are changes to conform to the amount certified.) ARCHITECT By: Date: The 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. Page 1 of 1 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 15 containing Contractor's signed Certification is attached. In tabulations below, amounts are stated to the nearest dollar. APPLICATION DATE: 10/22/20 PERIOD TO: 10/31/20 Design Electric, Inc PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE 1 BOND/PERMIT $35,908.00 $35,908.00 $35,908.00 100.00% /MOBILIZATION 2 SITE WORK/UNDERGROUND $33,158.00 $33,158.00 $33,158.00 100.00% 3 DEMOLITION/TEMP WIRING $64,200.00 $64,200.00 $64,200.00 100.00% 4M CONDUIT -MATERIAL $122,167.00 $122,167.00 $122,167.00 100.00% 4L CONDUIT - LABOR $180,320.00 $180,320.00 $180,320.00 100.00% 5M BOXES/WIRE/DEVICES - $110,400.00 $110,400.00 $110,400.00 100.00% MATERIAL 5L BOXES/WIRE/DEVICES - $67,200.00 $67,200.00 $67,200.00 100.00% LABOR 6M FIXTURES - MATERIAL $425,654.00 $425,654.00 $425,654.00 100.00% 6L FIXTURES - LABOR $90,400.00 $90,400.00 $90,400.00 100.00% 7M GEAR - MATERIAL $145,168.00 $145,168.00 $145,168.00 100.00% 7L GEAR - LABOR $38,400.00 $38,400.00 $38,400.00 100.00% 8M LOW VOLTAGE ROUGH -IN - $46,722.00 $46,722.00 $46,722.00 100.00% MATERIAL 8L LOW VOLTAGE ROUGH -IN - $73,120.00 $73,120.00 $73,120.00 100.00% LABOR 9M EQUIPMENT CONNECTIONS $68,400.00 $68,400.00 $68,400.00 100.00% - MATERIAL 9L EQUIPMENT CONNECTIONS $12,200.00 $12,200.00 $12,200.00 100.00% -LABOR 10M FIRE ALARM - MATERIAL $84,697.00 $84,697.00 $84,697.00 100.00% 10L FIRE ALARM - LABOR $20,000.00 $20,000.00 $20,000.00 100.00% 11M SOFTBALL FIELD - $153,200.00 $153,200.00 $153,200.00 100.00% MATERIAL 11L SOFTBALL FIELD - LABOR $15,600.00 $15,600.00 $15,600.00 100.00% 12 - 1 Electrical (CO #1) $945.49 $945.49 $945.49 100.00% 1 Electrical (CO #2) $1,340.58 $1,340.58 $1,340.58 100.00% 1 Electrical (CO #3) $1,582.00 $1,582.00 $1,582.00 100.00% Page 1 of 2 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 15 containing Contractor's signed Certification is attached. APPLICATION DATE: 10/22/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 10/31/20 Design Electric, Inc PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE 1 Electrical (CO #4) ($24,378.00) ($24,378.00) ($24,378.00) 100.00% 1 Electrical (CO #5) ($12,693.73) ($12,693.73) ($12,693.73) 100.00% 1 Electrical (CO #6) $396.52 $396.52 $396.52 100.00% 1 Electrical (CO #7) $2,162.06 $2,162.06 $2,162.06 100.00% 1 Electrical (CO #8) $7,694.97 $7,694.97 $7,694.97 100.00% 1 Electrical (CO #10) $5,773.48 $5,773.48 $5,773.48 100.00% 2 Joist Work - Electrical (CO #9) $24,561.00 $24,561.00 $24,561.00 100.00% 1 Electrical (CO #7) $1,035.41 $1,035.41 $1,035.41 100.00% 1 Electrical (CO #7) $12,342.68 $12,342.68 $12,342.68 100.00% 1 Electrical (CO #7) $1,170.60 $1,170.60 $1,170.60 100.00% 1 Electrical (CO #7) ($7,396.86) ($7,396.86) ($7,396.86) 100.00% 1 Electrical (CO #11) $42,232.20 $42,232.20 $42,232.20 100.00% 1 Electrical (CO #12) $12,952.00 $12,952.00 $12,952.00 100.00% 1 Electrical (CO #13) $1,677.13 $1,677.13 $1,677.13 100.00% 1 Electrical (CO #14) $9,491.86 $9,491.86 $9,491.86 100.00% 1 Electrical (CO #15) $1,044.26 $1,044.26 $1,044.26 100.00% 1 Electrical (CO #15) $5,221.53 $5,221.53 $5,221.53 100.00% 1 Electrical (CO #16) $3,536.88 $3,536.88 $3,536.88 100.00% 1 Electrical (CO #17) $2,741.41 $2,741.41 $2,741.41 100.00% 1 Electrical (CO #18) $1,389.62 $1,389.62 $1,389.62 100.00% 1 Electrical (CO #19) $356.00 $356.00 $356.00 100.00% 1 Electrical (CO #19) $1,759.00 $1,759.00 $1,759.00 100.00% 1 Electrical (CO #20) $2,591.14 $2,591.14 $2,591.14 100.00% 1 Electrical (CO #21) $12,128.20 $12,128.20 $12,128.20 100.00% 1 Electrical (CO #22) $2,260.09 $2,260.09 - $2,260.09 100.00% 1 Electrical (CO #23) $708.15 $708.15 $708.15 100.00% PAYMENT TOTALS $1,901,539.67 $1,900,831.52 $708.15 $1,901,539.67 100.00% Page 2 of 2 APPLICATION FOR PAYMENT To: RJM Construction, LLC. 830 Boone Avenue North Golden Valley, MN 55427 From: Minnesota Utilities & Excavating, LLC 13932 Lake Drive Forest Lake, MN 55025 Contract For: 195200033-312205 - Multipurpose Earthwork 1. ORIGINAL CONTRACT AMOUNT 2. NET CHANGE BY CHANGE ORDERS 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE (Column G) 5. RETAINAGE - of Completed Work (Columns D + E) - of Stored Materials (Columns F) Total Retainage (Line 5a + Line 5b OR Sum of Column 1) 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PRIOR CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) Project: Elk River Multi -Purpose Facility and Lion John Weicht Park $572, 787.00 $144, 920.30 $717, 707.30 $717, 707.30 $0.00 $717, 707.30 $714, 954.30 $2,753.00 $0.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months $147,112.30 $4,945.00 Total approved this month $2,753.00 $0.00 TOTALS $149,865.30 $4,945.00 NET CHANGES by Change Orders $144,920.30 Application No.: 8 Period To: 11/30/20 Application Date: 11/05/20 Project No.: 19520-0033 Contract Date: 07/23/19 Commitment: 195200033-312205 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by the Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: By: Jodi Russ Date: 11/05/20 State Of: County Of: Subscribed and sworn to before me this Notary Public: My commission expires: ARCHITECTS CERTIFICATE FOR PAYMENT day of In accordance with the Contract Documents, based on the on -site observations and the data compromising this application, the Architect certifies to the owner that to the best of the Architects knowledge, information and belief the Work under the Architect's Contract has progressed as indicated, the quality of Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED $2,753.00 (Attach explanation if amount certified differs from the amount applied for. Initial all figures on the Application for Payment and on the Continuation sheet that are changes to conform to the amount certified.) ARCHITECT By: Date: The 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. Page 1 of 1 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 8 containing Contractor's signed Certification is attached. APPLICATION DATE: 11/05/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 11/30/20 Minnesota Utilities & Excavating, LLC PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE 1 Earthwork $572,787.00 $572,787.00 $572,787.00 100.00% 1 Multipurpose Earthwork (CO $43,459.00 $43,459.00 $43,459.00 100.00% #1) 1 Multipurpose Earthwork (CO $26,672.30 $26,672.30 $26,672.30 100.00% #2) 1 Multipurpose Earthwork (CO $3,157.00 $3,157.00 $3,157.00 100.00% #4) 1 Multipurpose Earthwork (CO $11,096.00 $11,096.00 $11,096.00 100.00% #5) 1 Multipurpose Earthwork (CO ($1,338.00) ($1,338.00) ($1,338.00) 100.00% #6) 2 Geogrid (CO #3) $3,570.00 $3,570.00 $3,570.00 100.00% 1 Multipurpose Earthwork (CO $2,338.00 $2,338.00 $2,338.00 100.00% #7) 1 Multipurpose Earthwork (CO $26,310.00 $26,310.00 $26,310.00 100.00% #8) 1 Multipurpose Earthwork (CO $4,234.00 $4,234.00 $4,234.00 100.00% #8) 1 Multipurpose Earthwork (CO $3,647.00 $3,647.00 $3,647.00 100.00% #9) 1 Multipurpose Earthwork (CO ($2,674.00) ($2,674.00) ($2,674.00) 100.00% #10) 1 Multipurpose Earthwork (CO ($933.00) ($933.00) ($933.00) 100.00% #11) 1 Multipurpose Earthwork (CO $16,156.00 $16,156.00 $16,156.00 100.00% #12) 1 Multipurpose Earthwork (CO $3,800.00 $3,800.00 $3,800.00 100.00% #13) 1 Multipurpose Earthwork (CO $2,376.00 $2,376.00 $2,376.00 100.00% #14) 1 Multipurpose Earthwork (CO $297.00 $297.00 - $297.00 100.00% #15) 1 Multipurpose Earthwork (CO $428.00 - $428.00 $428.00 100.00% #16) Page 1 of 2 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 8 containing Contractor's signed Certification is attached. In tabulations below, amounts are stated to the nearest dollar. APPLICATION DATE: 11/05/20 PERIOD TO: 11/30/20 Minnesota Utilities & Excavating, LLC PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE 1 Multipurpose Earthwork (CO $2,325.00 $2,325.00 $2,325.00 100.00% #17) PAYMENT TOTALS $717,707.30 $714,954.30 1 $2,753.00 $717,707.301 100.00% Page 2 of 2 APPLICATION FOR PAYMENT To: RJM Construction, LLC. 830 Boone Avenue North Golden Valley, MN 55427 From: US SiteWork, Inc 11040 183rd Circle NW Suite B Elk River, MN 55330 Contract For: 195200033-312255 - Lions Park Earthwork 1. ORIGINAL CONTRACT AMOUNT 2. NET CHANGE BY CHANGE ORDERS 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE (Column G) 5. RETAINAGE - of Completed Work (Columns D + E) - of Stored Materials (Columns F) Total Retainage (Line 5a + Line 5b OR Sum of Column 1) 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PRIOR CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) Project: Elk River Multi -Purpose Facility and Lion John Weicht Park $502,200.00 ($16, 596.50 ) $485,603.50 $485,603.50 $0.00 $485,603.50 $487, 928.50 ($2,325.00) $0.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months $5,065.50 $19,337.00 Total approved this month $0.00 $2,325.00 TOTALS $5,065.50 $21,662.00 NET CHANGES by Change Orders ($16,596.50) Application No.: 4 Period To: 11/30/20 Application Date: 11/09/20 Project No.: 19520-0033 Contract Date: 07/23/19 Commitment: 195200033-312255 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by the Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: By: Jennifer Dhein Date: 11/09/20 State Of: County Of: Subscribed and sworn to before me this Notary Public: My commission expires: ARCHITECTS CERTIFICATE FOR PAYMENT day of In accordance with the Contract Documents, based on the on -site observations and the data compromising this application, the Architect certifies to the owner that to the best of the Architects knowledge, information and belief the Work under the Architect's Contract has progressed as indicated, the quality of Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED ($2,325.00) (Attach explanation if amount certified differs from the amount applied for. Initial all figures on the Application for Payment and on the Continuation sheet that are changes to conform to the amount certified.) ARCHITECT By: Date: The 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. Page 1 of 1 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 4 containing Contractor's signed Certification is attached. APPLICATION DATE: 11/09/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 11/30/20 US SiteWork, Inc PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE 1 Allowance $20,000.00 $20,000.00 $20,000.00 100.00% 2 Erosion Control $26,989.00 $26,989.00 $26,989.00 100.00% 3 Site Clearing/Demolition $56,333.00 $56,333.00 $56,333.00 100.00% 4 Sitework $372,803.00 $372,803.00 $372,803.00 100.00% 5 Building Excavation $21,075.00 $21,075.00 $21,075.00 100.00% 6 Bond $5,000.00 $5,000.00 $5,000.00 100.00% 1 Lions Park Earthwork (CO #1) ($1,975.00) ($1,975.00) ($1,975.00) 100.00% 1 Lions Park Earthwork (CO #2) $4,075.00 $4,075.00 $4,075.00 100.00% 1 Lions Park Earthwork (CO #4) ($1,164.68) ($1,164.68) ($1,164.68) 100.00% 1 Lions Park Earthwork (CO #5) ($2,452.32) ($2,452.32) ($2,452.32) 100.00% 1 Lions Park Earthwork (CO #6) ($2,350.00) ($2,350.00) ($2,350.00) 100.00% 2 Geogrid (CO #3) $990.50 $990.50 $990.50 100.00% 1 Lions Park Earthwork (CO #1) ($3,868.65) ($3,868.65) ($3,868.65) 100.00% 1 Lions Park Earthwork (CO #7) ($7,526.35) ($7,526.35) ($7,526.35) 100.00% 1 Lions Park Earthwork (CO #8) ($2,325.00) ($2,325.00) ($2,325.00) 100.00% PAYMENT TOTALS $485,603.50 $487,928.50 ($2,325.00) $485,603.50 100.00% Page 1 of 1 APPLICATION FOR PAYMENT To: RJM Construction, LLC. 830 Boone Avenue North Golden Valley, MN 55427 From: Bituminous Roadways, Inc. 1520 Commerce Drive Mendota Heights, MN 55120 Contract For: 195200033-321205 - Asphalt Paving 1. ORIGINAL CONTRACT AMOUNT 2. NET CHANGE BY CHANGE ORDERS 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE (Column G) 5. RETAINAGE - of Completed Work (Columns D + E) - of Stored Materials (Columns F) Total Retainage (Line 5a + Line 5b OR Sum of Column 1) 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PRIOR CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) Project: Elk River Multi -Purpose Facility and Lion John Weicht Park $324,100.00 ($29,591.00) $294, 509.00 $294, 509.00 $0.00 $294, 509.00 $293,489.00 $1,020.00 $0.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months $7,264.00 $37,875.00 Total approved this month $1,020.00 $0.00 TOTALS $8,284.00 $37,875.00 NET CHANGES by Change Orders ($29,591.00) Application No.: 7 Period To: 11/30/20 Application Date: 11/05/20 Project No.: 19520-0033 Contract Date: 07/23/19 Commitment: 195200033-321205 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by the Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: By: Pam Hague Date: 11/05/20 State Of: County Of: Subscribed and sworn to before me this Notary Public: My commission expires: ARCHITECTS CERTIFICATE FOR PAYMENT day of In accordance with the Contract Documents, based on the on -site observations and the data compromising this application, the Architect certifies to the owner that to the best of the Architects knowledge, information and belief the Work under the Architect's Contract has progressed as indicated, the quality of Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED $1,020.00 (Attach explanation if amount certified differs from the amount applied for. Initial all figures on the Application for Payment and on the Continuation sheet that are changes to conform to the amount certified.) ARCHITECT By: Date: The 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. Page 1 of 1 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 7 containing Contractor's signed Certification is attached. APPLICATION DATE: 11/05/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 11/30/20 Bituminous Roadways, Inc. PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE 1 Mobilization $16,425.00 $16,425.00 $16,425.00 100.00% 2 Utility Patching $27,311.00 $27,311.00 $27,311.00 100.00% 3 Lion Park Drive Grading $8,850.00 $8,850.00 $8,850.00 100.00% 4 Lions Park Light Duty $21,107.00 $21,107.00 $21,107.00 100.00% Bituminous 5 Lions Park Medium Duty $106,732.00 $106,732.00 $106,732.00 100.00% Bituminous 6 Ice Arena Heavy Duty $97,750.00 $97,750.00 $97,750.00 100.00% Bituminous 7 Ice Arena Aggregate Surfacing $15,735.00 $15,735.00 $15,735.00 100.00% 8 Utility Adjustments in $8,250.00 $8,250.00 $8,250.00 100.00% Pavement 9 Striping & Lot Marking $1,500.00 $1,500.00 $1,500.00 100.00% 10 Traffic Signage $5,440.00 $5,440.00 $5,440.00 100.00% 11 Allowance $15,000.00 $15,000.00 $15,000.00 100.00% 1 Asphalt Paving (CO #1) $5,614.00 $5,614.00 $5,614.00 100.00% 1 Asphalt Paving (CO #2) $1,650.00 $1,650.00 $1,650.00 100.00% 1 Asphalt Paving (CO #3) ($26,095.00) ($26,095.00) ($26,095.00) 100.00% 1 Asphalt Paving (CO #4) ($11,000.00) ($11,000.00) ($11,000.00) 100.00% 1 Asphalt Paving (CO #5) ($780.00) ($780.00) ($780.00) 100.00% 1 Asphalt Paving (CO #6) $1,020.00 $1,020.00 $1,020.00 100.00% PAYMENT TOTALS $294,509.00 $293,489.00 $1,020.00 $294,509.00 100.00% Page 1 of 1 APPLICATION FOR PAYMENT To: RJM Construction, LLC. 830 Boone Avenue North Golden Valley, MN 55427 From: Ebert Construction 23350 County Road 10 Corcoran, MN 55357 Contract For: 195200033-321305 - Site Concrete 1. ORIGINAL CONTRACT AMOUNT 2. NET CHANGE BY CHANGE ORDERS 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE (Column G) 5. RETAINAGE 0% of Completed Work (Columns D + E) 0% of Stored Materials (Columns F) Total Retainage (Line 5a + Line 5b OR Sum of Column 1) 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PRIOR CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) Project: Elk River Multi -Purpose Facility and Lion John Weicht Park $387,400.00 ($2,911.15) $384,488.85 $384,488.85 N/A N/A $0.00 $384,488.85 $380,059.76 $4,429.09 $0.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months $14,547.62 $21,887.86 Total approved this month $4,429.09 $0.00 TOTALS $18,976.71 $21,887.86 NET CHANGES by Change Orders ($2,911.15) Application No.: 9 Period To: 11/30/20 Application Date: 11/05/20 Project No.: 19520-0033 Contract Date: 07/23/19 Commitment: 195200033-321305 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by the Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: By: Caleb Pelkey Date: 11/05/20 State Of: County Of: Subscribed and sworn to before me this Notary Public: My commission expires: ARCHITECTS CERTIFICATE FOR PAYMENT day of In accordance with the Contract Documents, based on the on -site observations and the data compromising this application, the Architect certifies to the owner that to the best of the Architects knowledge, information and belief the Work under the Architect's Contract has progressed as indicated, the quality of Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED $4,429.09 (Attach explanation if amount certified differs from the amount applied for. Initial all figures on the Application for Payment and on the Continuation sheet that are changes to conform to the amount certified.) ARCHITECT By: Date: The 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. Page 1 of 1 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 9 containing Contractor's signed Certification is attached. APPLICATION DATE: 11/05/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 11/30/20 Ebert Construction PROJECT NO.: 19520-0033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) + E) D OR E) DATE 1 General Conditions $14,700.00 $14,700.00 $14,700.00 100.00% 2 MPB - Walks - Materials $30,617.00 $30,617.00 $30,617.00 100.00% 3 MPB - Walks - Labor $44,082.00 $44,082.00 $44,082.00 100.00% 4 MPB - Curb - Materials $18,273.00 $18,273.00 $18,273.00 100.00% 5 MPB - Curb - Labor $22,333.00 $22,333.00 $22,333.00 100.00% 6 Lion - Walks - Materials $83,053.00 $83,053.00 $83,053.00 100.00% 7 Lion - Walks - Labor $123,318.00 $123,318.00 $123,318.00 100.00% 8 Lion - Curb - Materials $18,461.00 $18,461.00 $18,461.00 100.00% 9 Lion - Curb - Labor $22,563.00 $22,563.00 $22,563.00 100.00% 10 Allowance $10,000.00 $10,000.00 $10,000.00 100.00% 1 Site Concrete (CO #1) $3,311.40 $3,311.40 $3,311.40 100.00% 1 Site Concrete (CO #2) ($1,570.47) ($1,570.47) ($1,570.47) 100.00% 1 Site Concrete (CO #3) ($4,286.00) ($4,286.00) ($4,286.00) 100.00% 1 Site Concrete (CO #4) ($1,561.90) ($1,561.90) ($1,561.90) 100.00% 1 Site Concrete (CO #5) ($10,522.07) ($10,522.07) ($10,522.07) 100.00% 1 Site Concrete (CO #6) $3,937.50 $3,937.50 $3,937.50 100.00% 1 Site Concrete (CO #7) ($3,947.42) ($3,947.42) ($3,947.42) 100.00% 1 Site Concrete (CO #8) $6,032.25 $6,032.25 $6,032.25 100.00% 1 Site Concrete (CO #9) $1,266.47 $1,266.47 $1,266.47 100.00% 1 Site Concrete (CO #10) $4,429.09 $4,429.09 $4,429.09 100.00% PAYMENT TOTALS $384,488.85 $380,059.76 $4,429.09 $384,488.85 100.00% Page 1 of 1 Please Remit Payment to: RJM Construction, LLC 830 Boone Ave North Golden Valley, MN 55427 APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION To City of Elk River Project:19520-=3 Elk River Multi -Purpose Facility and Lion John Invoice * 9520003318 Distribution to : Owner. Attn: Justin Femrite ft"8019 Street NW Application No.: 18 0 Owner 13065 Orono Parkway Elk River, MN 55330 Application Date: 11i30/2020 Architect Contractor Elk River, MN 55330 Architect: Period From: 11/1/2020 To: 11/3012020 CONTRACTOR'S APPLICATION FOR PAYMENT The unders nad Corrhaotor certifies that to the best of the Contractor's knowledge Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached. 1.Original Contract Sum .......................... 2. Net Change By Change Order .................... 3. Contract Sum To Date .......................... 4. Total Completed and Stored To Date. . .. . . . .. . .. . 5. Retainage: a. 2.35% of Completed Work $620,942.80 b. 0,00% of Stared Material $0.00 Total Retainage .................. ........ . 6. Total Earned Less Retainage ...................... 7. Less Previous Certificates For Payments ............ 8. Current Payment Due ................. . . . .. . . 9. Balance To Finish, Plus Retainage ................ . $25,934,028.00 $567,579.40 $26,501,607.40 $26,427,823.74 $620,942.80 $25,806,680.94 $25,797,059.36 $9,621.58 $694,926.46 CHANGE ORDER SUMMARY Deductions p in prrievious mon! s Owner $956,343.73 $388,764.33 Total Approved this Month $0.00 $0.00 TOTALS $956,343.73 $388,764.33 Net Changes By Change Order $567,579.40 y 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. RJM Construction LLC State of: me this My Commissiodexpires:l -- County of, day of _ a In accordance with the Contract Documents, based on orrsite observatq W�9 comprising the above application, the Architect codifies to the Owner the r Architect's knowledge, information, and belief, the Work he- p_------ the quality of the Work is in accordance with the Contract Documents, and the Contractor Is entitled to payment of the AMOUNT CERTIFIED. ARCHITECTS CERTIFICATE FOR PAYMENT AMOUNTCERTIFIED $ 9,621.58 "' KING Nary Publio-Minnesota pcommbskn Eby Jan 31. 2022 (Attach explanation Hamount certified di/(ers f m the amount appliedindmi aff figures on dWsApphcation and on the Continuation Sheet that are changed to conform with the amount certified.) ARCHITECT: J-V�k" 12/7/20 By: Date:_ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. CONTINUATION SHEET Page 2of3 Application and Certification for Payment, containing Application No.: 18 Contractor's signed certification is attached. Application Date: 11/30120 In tabulations below, amounts are stated to the nearest dollar. To: 11130120 Use Column I on Contracts when: variable retalnage for line items may apply. Architect's Project No.: Invoice ik : 9520003318 Contract : 19520.0033 Elk River Multi -Purpose Facility and Lion John Weicht Park C _ D E _ F to H Item Description of Work Scheduled Work Completed Materials Total % Balance Retainage No. Value From Previous This Period Presently Completed (G 1 C) To Finish Application In Place Stored and Stored (C-0) (D+E) To Date Not in D or D+E+F 1 Elk River Multi -Purpose Facility and 0.00 0.001 0.00 _ 0.00 1 0.00 0.00% 0.00 0.00 Lion John Weicht Pads 1A Final Cleaning 82,346.55 81,315.0 1,031.55 l 0.00 82,346.55 100.00°h 0.00 i 2,084.54 1 B Survey 25,568.00 25,568.00 0.00 0.00 25,568.00 100.00% 0.00 639.20 2A Building Demolition 166,199 51 166,199 51 0.00 0.00 _ 166,199.51 ; 100.00% 0.001 4,154.99 2B Selective Demolition 236,477.211 236,477.21 0.00 0.001 236,477.21 100.00% 0.00 5,911.93 3C Concrete Floor Finishes 135,699 62 135,699.62 0.00 , 0.00 135,699.62 100 00% 0.00 3,392.49 4A Masonry Systems 2,982,936 83 2,982,936 83 0.00 0.00. 2,982,936.83 100.00% 0.00 74,573.42 5A Structural Material 1,342,525.131 1,342,525.13 0.00 0.00 1,342,525.13 100.00% i 0.00 33,080.06 5B Structural Labor 457,855.001 457,855 00 0.00 0.00 457,855.00 100.00%' 0.00E 11,455.52 6A Carpentry 1,658,472.53 1,656,489.71' 1,982 82 D.00 1,658,472.53 , 100.00% 0.001 41,554.44 7A Waterproofing &WB 40,342.00 40,342.00' 0 00 l 0.00 40,342.00 100.00% = 0.00E 1,008.55 7B Roofing Systems 1,067,619 73 1,067,619,731 0.00 0.001 1,067,619.73 j 100.00% 0.00 26,690.49 7C Metal Wall Panel 186172611 186,172.61 0.00 0.00 186,172.61 100.00%1 0.00 4,654.31 8A Aluminum Entrances/Storefronts 642:926.46 642,926.46' 0.00 = 0.00= 642,926.46 100.00% 0.00 16,073.16 88 Overhead Coiling and Sectional 53,610.00 = 63,610.0010.00 _ 0.00 i 53,610.00 100.00% 0.00 _ 1,340.25 Doors 9A Gypsum Board 349,769.37' 349,769.37 0.00' 0.1001 349,769.37 ". 100.00% ; 0.00 8,744.23 98 Tiling 175,149.901 175,14990= 0.00l 0.00 175,149.90 100.00% 0.00 4,378.75 9C Acoustical Ceilings 147,905 95 147,905.95 0.00 0.001 147,905.95 100.00% 0,00 3,697.65 9D Flooring 132,262501 132,262.503 0.00 0.00 132,262.50 100.00% 0.00 3,306.56 9E Painting 444,499:00 444,499.00' 0.00 0.00 444,499.00 100.00% 0.00' 11,256.97 10A Signage 10,807 14' 10,807 14 0.00 0.00 10,807.14 100.00% 0.00 l 270.18 11A Athletic Equipment 175,176.84. 175,176 84 0.00 0.00 175,176.84 100.00% 0.001 4,379.43 1113 Concessions 101,991.83 101,991.83 0.00 1 0.00. 101,991.83 100.00%'5 0.00 ( 2,549.80 12A Roller Shades 28,659.10. 28,659.10 0.00 j 0.00 28,659.10 100.00% ; 0.00 I 716.48 13B Ice Rink Systems 2,162742.00 j 2,162,742 00 0.00 ' 0.00 2,162,742.00 100.00% 0.001 54,068.55 13C Leg Truss System 125:797.001 125,797.00 0.00 0.00' 125,797.00 100.00% : 0.001 3,144.92 14A Elevators 71,700.00 71,700 00 0.00 0.00 71,700.00 100.00% 0.00 1,792,50 21A Fire Protection 282,544.00 282,544 00 0.00 0.00 282,544.00 100.00%' 0.00 �� 7,073.61 22A Plumbing Systems 1.324,981.22 1,323,097.00 1,884 22 0.001 1,324,981.22 _ 100.00% E 0.00' 33,171.63 23A HVAC 1,875,065 33' 1,875,065.33' 0.00- 0.00 1,875,065.33 100.00% 0.00 46,876.63 26A Electrical Systems 1,876,978.67 1 1.876,978 67 0.00 0.00 `. 1,876,978.671 100.00% 0.00 _ 46,998.67 31A Multipurpose Earthwork 714,137.30 i 714,137.30 0.00 0.00 714,137.30 100.00% 0.00 17,922.26 CONTINUATION SHEET Page 3of3 Application and Certification for Payment, containing Application No.: 1B Contractor's signed cerification is attached. Application Date: 11130120 In tabulations below, amounts are stated to the nearest dollar. To: 11130120 Use Column I on Contracts where variable retainage for line items may apply. Architects Project No.: Invoice # : 9520003318 Contract : 19520.0033 Elk River Multi -Purpose Facility and Lion John Weicht Park A B C D E F G H E_ Item Description of Work Scheduled Work Completed Materials Total % Balance 1 Retainage No. value From Previous This Period Presently Completed (G I C) To Finish Applicatlon In Place Stored and Storedj (C•G) (D+E) To Date Hot in D or El D+E+ 318 Lions Earthwork 508,490 67 506,490.67 0.00 0.00 506,490.67 100.00%' 0.00. 12,654.14 32A 1 Asphalt Paving 294,509.001 294,509.00 0.00 0.001 294,509.00 100.00% 0.00 ; 7,388.22 326 Concrete/Sidewalk/Curb/Gutter 389,142.50 389,142.50; 0.00 i 0.00 389,142.50 _ 100.00% 0.001 9,839.28 32C Multipurpose Landscaping 27,000.00 27,000 W 0.00 0.00 27,000.00 100.00%1 0.00 675.00 32D' Lions Landscaping 96,460.00 94,480.001 1,980.00 0.00 96,460.00 100.00%' 000 2461.00 32E Chain Link Fence 150,325 79 ( 150,325.79 0.00 0.00 150,325.79 100.00% 0.00' 3:758.15 33A Utilities 635,496 55 635,496 55 0.00 = 0.00 635,496.551 100.00% 0.00' 15,B87.41 3B.1 Precast Concrete 1,182,922.00 1,182,922 0W 0.00 0.00 1,182,922.00 _ 100.00%, 0.00. 29,573.05 38.2 Precast Concrete 930,000.00 930,000 00 0.00 0.00 930,000.00 ' 100.00% 0.00 23,250.00 3B.3 Precast Raker/Plank/Stadia 1,048,025.00 1,048,025.001 0.00 0.00 1,048,025.00 100 00% = 0.001 26,200.62 01-00 General Conditions/Requirements 1,263,722.63 1 1,260,306.92 3,086 92 0.00 1,263.393.84 99.97% 328.791 0.00 90-50 General Liability Insurance 268,451.52 268,451.52' ° 0.00 0.001 268,451.52 1 100.00% 0.00 0.00 90-60 Construction Contingency 73,554 87 1 0 00 � 0.00 0.00 0.00 = 0.00% 73,654.87 0.00 90-80 Builders Risk Insurance 65,184 58 65,184 58 0.00 0.00; 65,184.58 100.00% 0.00 0.00 1 99-99 Contractors Fee 489,303.961 3 489,303.96t 0.00 - 0.00 489,303.961 100.00% 3� I 0.00, t 12,293.76 Grand Totals 26,501,607.40 1 26,417,658.23 9,965.51 ( 0.00 26,427,623,74 99.72% 73,983 66 620,942.60 DocuSign Envelope ID: BCE22727-B3F4.40B7-AA4D.8AA95B6ABD07 INVOICE Firom: RJM Construction, LLC &Wake., 9520003318 830 Boone Ave North- 11/30/20 Golden Valley, MN 56427 Daetlaee 1213O 20 962-837-SM To: City of Elk Riney Attn: Justin Fernrite 13085 Orono Parkway elk River, MN 55330 Coofrad : 1952o,-om Ek'R rer MtdtiPutpw Facility and Lich 9ole'r Wsicht Park Final Cleaning MATERIAL PURCHASES SparldeWash Inv# 1,031.55 Total MATERIAL PURCHASES 1,031.55 Final Cleaning Sub -Total: 1,031.55 Carpentry SUBCONTRACTS Kendall Doors 8 Hardware, Inc Hallow Metal Doors 8 Frames Inv# 19520-003311 808.22 Total SUBCONTRACTS 808.22 LABOR Carpenters Regular Earnings 6.00 HRS @ 83.90 503AO Carpenters Regular Earnings 8.00 HRS @ 83.90 671.20 Total LABOR 1,174.80 Carpentry Sub -Total: 1,982.82 Plumbing Systems SUBCONTRACTS Weidner Plumbing 8 Heating Co. Plumbing Inv* 19520-003316 1,884.22 Total SUBCONTRACTS 1,884.22 ................ Plumbing Systems Sub -Total: 1,884.22 Lions Landscaping SUBCONTRACTS Greenscape Companies, Inc Lions Landscaping Inv# 19520-00333 1,980.00 Total SUBCONTRACTS 1,980.00 Lions Landscaping Sub -Total: 1,980.00 General ConditionslRequirements MATERIAL PURCHASES SparldeWash Inv# -1,031.55 Corey Gaffer Photography 02038 1.059.27 Total MATERIAL PURCHASES 27.72 LABOR Carpenters Regular Earnings -6.00 HRS @ 83.90 -503.40 Superintendent Regular Earnings 14.00 HRS @ 109.90 1,538.60 Project Administrator Regular Earnings 2.00 HRS @ 56.40 112.80 Project Engineer Regular Earnings 10.00 HRS @ 80.40 804.00 Project Executive Regular Earnings 8.00 HRS @ 138.40 1,107.20 Total LABOR 3,059.20 General ConditionslRequinements Sub -Total: 3,086.99 DocuSign Envelope ID: BCE22727-B3F440B7-AA4D•8AA95B6A8D07 INVOICE ,. .. Summary 1A Final Cleaning 1,031.56 Retainage 9,965.51 @ 5.00% (51.58) 6A Carpentry 1,982.82 Retainage 9,965.51 @ 5.00% (99.14) 22A Plumbing Systems 1,884.22 Retainage 9,965.51 @ 5.00% (94.21) 32D Lions Landscaping 1.980.00 Retainage 9,965.51 @ 5.00% (99.00) 01-00 General Conditions/Requirements 3,086.92 Retainage 9,965.51 @ 0.00% 0.00 90-50 General Liability Insurance Retainage 9,965.51 @ 0.00% 0.00 90-80 Builders Risk Insurance Retainage 9,965.51 @ 0.00% 0.00 99-09 Contractors Fee Retainage 9,965.51 @ 5.00% 0.00 CURRENT DUE: 9,621.58 DocuSign Envelope ID: BCE22727-B3F4-40B7-AA4D-8AA95B6A8D07 APPLICATION FOR PAYMENT To: RJM Construction, LLC. Project: Elk River Multi -Purpose Facility and Lion Application No.: 11 830 Boone Avenue North John Weicht Park Golden Valley, MN 55427 Period To: 11/30120 From: Kendall Doors $ Hardware, Inc. Application Date: 11/30/20 1312 Northland Drive Project No.: 19520-0033 Suite 100 Contract Date: 11l13/19 Mendota Heights, MN 55120 Contract For: 195200033-081105 - Hollow Metal Doors & Commitment: 195200033-081105 Frames 1. ORIGINAL CONTRACT AMOUNT 2. NET CHANGE BY CHANGE ORDERS 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE (Column G) 5. RETAINAGE - of Completed Work (Columns 0 + E) - of Stored Materials (Columns F) Total Retalnage (Line So + Line 5b OR Sum of Column 1) 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PRIOR CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) $92,614.00 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by the Application for Payment has been completed In accordance with the $202,997.35 Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments reoe'wed from the Owner, and that current $295,611.35 payment shown herein is now due. $295,611.35 CONTRACTOR: By: Jason Self Date: 12/02/20 $0.00 State Of: County Of: Subscribed and swom to before me this day of Notary Public: My commission expires: ARCHITECTS CERTIFICATE FOR PAYMENT $295,611.35 In accordance with the Contract Documents, based on the on -site observations and the data _ compromising this application, the Architect certifies to the owner that to the best of the Architects knowledge, information and belief the Work under the Archltecfa Contract has progressed as indicated, the quality of Work is In accordance with the Contract Documents, and the Contractor is $294,803.13 entitled to payment of the AMOUNT CERTIFIED. $808.22 $0.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months $203,511.63 $1,322.50 Total approved this month $808.22 $0.00 TOTALS $204,319.85 $1,322.50 NET CHANGES by Change Orders $202,997.35 AMOUNT CERTIFIED $808.22 (Attach explanation if amount certified differs from the amount applied for. Initial all figures on the Application for Payment and on the Continuation shoat that are changes to conform to the amount certified.) ARCHITECT: By: Date: The 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. Page 1 of 1 mcsg,nEnvelope ID: eE23z7eR-4OB7AA4D-BAA■Kk27 ONTINUAT|ON SHEET APPLICATION D CERTIFICATION FO RPAYMENT, APPLICATION NO.: 11 containing Contractor's signedCertification is attached. APPLICATION DATE: ,mmo mtabulations below, amounts are stated bthe nearest dollar. PERIOD TO: wag Kendall Doors & Hardware, Inc. PROJECT NO.: ,eza& � � A ° , © ° ) ] .. \ [ ° ; , , \-- ---�. woK��D \ .....� .� ..� ... , � MATERIALS TOTAL � � � ,I .,! . �T. AA. G (IF DESCRIPTION OF WORK sH�u� i\mPREVIOUS PRESENTLY c��rD # e��E�ARMAkE�T.�EVALUE aRL�to p 7@ RmogoED >o w aosoSr 9+q FINISH Do E yr�q . }| . .� . `ill Metal #4.079 a kao7@@1 \ 2} p9.00 100.00%1 2 . 2 Finish Hardware $essay Aasa a' ke�oo 1g@%1 - 1 Hollow �taDoom &�_s A11Uz Aqe�| \ AE9.32 ,ge%E - ! (CO ®) \ : j �Hollow MetalDoors&Fra _s; m3�■eDO $■a@a E $A3®. ,ge# \ (CO # E 1 Hollow Metal Doors &Frames } $17.013.0 § $7.01.00 2 . $17.013.001 1g■, (CO ff 1 j , �Hollow Metal Do_&Fra _.�2524.117 �254zaq 100.00%1 \ (CO #4 \ , jHollow Metal Doors &� _s $272 a $27a2 G1 j A7■2 a ,A@ � . (CO #5) 1 Hollow MetalDoors &Frames mAe $360.3� ,68.30 ,ma#1 (CO� ` \ - � ! � � - 1 Hollow Metal Doors &Frames ■o,s■/ ■o@9.e4 j »o@sa/ ,Does! \ (CO #) | 1 }Hollow m« Doors &Frames A777 a1 $e777.3/ \ j $ems a 100.00s1 \ \ ; (CO #8) ! ; 1 }� Metal Doom&� m, ■��1 ■49.511 j j ■54�51 1g@% \ : � _! ! Hollow Metal Do_&� _s �; �91 $Az■\ $14�@/ ,ge% E � - (Comm , i :ill Metal Doors &Frames k&eg■ $22 Road »2,660.e 100.00§ (CO m1 } \ ill Metal Doors &Frames $5,oae.97 1 ■R5.97 Io5■ p 1g@s ! (COmo Mm , / �Hollow Metal Doors & Frames 1 Ass:\ ��ss,/ � § ksss:/ 100a%� .| (CO Dom , 1 Hollow Metal Doors &Frames ,@47.4a #ra, \ j ■■4�49 ,ge% j �@o m« j 1 Hollow Metal Doors &Frames 4350.00)1 f,& gp / AgQo ,g■% � (CO 5 \ j 1� �■ m_&�_s A72e)1 @@■72p - A2G\,g2%. j . - ( : DocuSlgn Envelope ID: BCE22727-B3F4-4OB7-AA4D-8AA95B6ABDO7 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 11 containing Contractor's signed Certification Is attached. APPLICATION DATE: 11/30/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 11/30/20 Kendell Doors & Hardware, Inc. PROJECT NO.: 1952MO33 A B C I D E F — - G — H WORK COMPLETED MATERIALS TOTAL 1 ITEM DESCRIPTION OF WORK _ SCHEDULED ;FROM PREVIOUS PRESENTLY COMPLETED °h BALANCE TO RETAINAGE (IF ] NUM VALUE STORED NOT IN gppLICATION (D THIS PERIOD j ( AND STORED TO (G + C 3 ) FINISH (C - G) ;VARIABLE RATE ) € + E) ? D OR E) DATE 3 I Hallow Metal Doors S Frames $959.07 $959.07 1� - $959.07 100.00% - (CO #16) 1 Hollow Metal Doors & Frames g $1,200.00 $1,200.00 E $1,200.00 100.00% - - (CO #17) E i 1 Hollow Metal Doors & Frames $950.00 E $950.00 E - $950.00 ; 100.00%! (CO #18) 1 Hollow Metal Doors & Frames $808.22 € $808.22 - - $808.22I 100.00%' -j (CO #19) 1 Hollow Metal Doors & Frames I $808.22 1 - $808.22 - $808.221 100.00% -, €(CO #20) 3 PAYMENT TOTALS = $295,611.351 $294,803.13 1 $808.22 $295,611.35' 100.00%= - Page 2 of 2 DocuSign Envelope ID: BCE22727-B3F4-4OB7-AA4D-SAA95B6A8DO7 APPLICATION FOR PAYMENT To: RJM Construction, LLC. Project: Elk River Multi -Purpose Facility and Lion Application No.: 16 830 Boone Avenue North John Weicht Park Period To: 11130/20 Golden Valley, MN 55427 From: WEIDNER MECHANICAL Application Date: 11/30/20 29 WILSON AVENUE NE Project No.: 19520-0033 PO BOX 1087 ST CLOUD, MN 56304 Contract Date: 08/23/19 Contract For: 195200033-220105 - Plumbing Commitment: 195200033-220105 1. ORIGINAL CONTRACT AMOUNT 2. NET CHANGE BY CHANGE ORDERS 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE (Column G) 5. RETAINAGE - of Completed Work (Columns D + E) - of Stored Materials (Columns F) Total Retainage (Line 5a + Line 5b OR Sum of Column 1) 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PRIOR CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) $1,206,000.00 $118,981.22 $1,324,961.22 $1,324,981.22 The undersigned Contractor certifies that to the best of the Contractors knowledge, information and belief the Work covered by the Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were Issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: By: Karen Schenk Date: 12/02/20 State Of. County Of: Subscribed and sworn to before me this day of Notary Public: My commission expires: $0.00 ARCHITECTS CERTIFICATE FOR PAYMENT $1,324,981.22 In accordance with the Contract Documents, based an the on -site observations and the data compromising this application, the Architect certilles to the owner that to the best of the Architects knowledge, Information and belief the Work under the ArchitedVa Contract has progressed as Indicated, the quality of Work is In accordance with the Contract Documents, and the Contractor is $1,323,097.00 entitled to payment of the AMOUNT CERTIFIED. $1,884.22 $0.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months $122,280.00 $5,183.00 Total approved this month $1,884.22 $0.00 TOTALS NET CHANGES by Change Orders $124,164.22 1 $5,183.00 $118,981.22 AMOUNT CERTIFIED $1,884.22 (Attach explanation if amount cerliffied differs from the amount applied for. Initial all figures on the Application for Payment and on the Continuation sheet that are changes to conform to the amount certified.) ARCHITECT: By: Date: The 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. Page 1 of 1 DocuSign Envelope ID: BCE22727-B3F4-40B7-AA4D-8AA95B6A8D07 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 16 containing Contractor's signed Certification is attached. APPLICATION DATE: 11130120 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 11/30/20 WEIDNER MECHANICAL PROJECT NO.: 19520-0033 A B C - - - - - ---------- D E - F G H WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RE' rAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN AND STORED TO = (G + C) FINISH (C - G) VARIABLE RATE) + E) 0 OR E) DATE 1 10.105 Bond $10,333.00 $10,333.00 $10,333001 100.00%1 .2 10.1109AIlowance i $7,500.001 $7.500.00 $7,500.001 100.00%1 3 10.115 Pipe &Fittings $23568900 $235,689.00 $235,689.00 100.00%- .4 10.119 Drains & Carriers $47,196.00 $47,196.00 $47,196.00 100.00% 1 15 10.123 Pumps & Tanks $5,400.00 $5,400.00 I $5.400.00 100.00% 16 10.127 Water Heaters $82,739.00 $82,739,00 $82,739.00 100.00%9 17 10.137 Plumbing Fixtures & i $79,004.00 $79,004.00 $79,004.00 100.00%1 1 Trim 10.139 Misc Plumbing 100.00%1 8 $42,488.00 $42,488.00. $42,488.00 9 11.185 Labor - Plumbl ng $560,753.002 $560,753.001 $560,753.00 100.00%1 10 130.300 Digging/Backfill $37,034.00 $37,034.00' $37,034.001 100.00% 11 130.325 Rentals $13,000.001 $13,000.00 $13,00.00 100.00% 112 130.360 Pipe Covering $84.864.00. I $84,864.00 $84,664.001 i 100.00% 1 Plumbing (CO #1) $7,430.001 $7,430.00. $7,430.00 100.00% I Plumbing (CO #2) ($2,203.00) ($2,203.00)l tt ($2,203,00) 100.00%. Plumbing (CO #3) ($2,980.00)1 ($2,980.00) ($2,980.00) 1100.00%, 1 Plumbing (CO #4) $2,506.00 $2.506.00 $2,506.00 100.00% 1 3Plumbing (CO #5) $10,815.00 $10,815.00 $10,815.00 100.00%1 I Plumbing (CO #6) $1,338.00 $1,338.00 $1,330.00 100.00%2 1 Plumbing (CO #7) $15,209.00 $15,209.00 $15,209.00 100.00%1 1 Plumbing (CO #8) $2,645.00. $2,645.001 $2,645.00 100.00% 1 Plumbing (CO #9) $10,615.00 i $10,615.00 $10,615.00 100.00% 1 Plumbing (CO #10) $25, 562.001 $25,562.00 $25,562.0 0 1 00. 00% 1 Plumbing (CO #6) $2,041.001 $2,041.00 $2,041.00 100.00%1 I Plumbing (CO # 11) $26,547.001 $26,547.00 $26,547.00 100.00% I Plumbing (CO #112) $1,943.00. $1,943.00 $1,943.00 100.00%' 1 Plumbing (CO #13) $6,842.00 $6,842001 $6,842.00 100.00% I Plumbing (CO #14) $771.00 $771.00 $771.00 100.00% 1 Plumbing (CO #15) $1,020.009 $1,020.001 3 $1,020.002 100.00% Page 1 of 2 DocuSign Envelope ID: BCE22727-B3F4-40B7-AA4D-BAA950BA8D07 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 16 containing Contractor's signed Certification is attached. In tabulations below, amounts are stated to the nearest dollar. APPLICATION DATE: 11/30/20 PERIOD TO: 11/30/20 WEIDNER MECHANICAL PROJECT NO.: 19520-0033 A B C _ _ D F E F G H i I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO i RETAINAGE (IF NUM VALUE s APPLICATION (D THIS PERIOD STORED IN AND STORED TO (G = C) i FINISH (C - G) VARIABLE RATE) +E) i R(NEOT ATE [ i _. 1 Plumbing (CO #16) $6,996.00 i $6,996.001 - - $6,996.00 100.00% - - 1 Plumbing (CO #17) ? $1,884.22 ` $1,884.22 _ $1.884.22 100.00% i PAYMENT TOTALS $1,324,981.22 ` $1,323,097.00 $1,884.22 - $1,324,981.22 i 100.00%1 Page 2 of 2 DocuSign Envelope ID: BCE22727-B3F440B7-AA4D-8AA95B6A8D07 APPLICATION FOR PAYMENT To: RJM Construction, LLC. Project: Elk River Multi -Purpose Facility and Lion Application No.: 3 830 Boone Avenue North John Weicht Park Golden Valley, MN 55427 Period To: 11/30/20 From: Greenscape Companies, INC Application Date: 11/30/20 11684 219th ave Project No.: 19520-0033 Elk River Elk River, MN 55330 Contract Date: 07/23119 Contract For: 195200033-329010 - Lions Landscaping Commitment: 195200033-329010 1. ORIGINAL CONTRACT AMOUNT 2. NET CHANGE BY CHANGE ORDERS 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE (Column G) 5. RETAINAGE - of Completed Work (Columns D + E) - of Stored Materials (Columns F) Total Retainage (Line 5a +Line 5b OR Sum of Column 1) 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PRIOR CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) $96,500.00 ($5,040.00) $91,460.00 $91,460.00 $0.00 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by ihs Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were Issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: By: Luke Melquist Date: 12102/20 State Of: County Of: Subscribed and sworn to before me this day of Notary Public: My commission expires: ARCHITECTS CERTIFICATE FOR PAYMENT $91,460.00 In accordance with fire Contract Documents, based on the on -site observations and the data compromising this application, the Architect certifies to the owner that to the best of the Architects knowledge, information and belief the Work under the Architect's Contract has progressed as indicated, the quality of Work is in accordance with the Contract Documents, and the Contractor is $89,480.00 entitled to payment of the AMOUNT CERTIFIED, $1,980.00 $0.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months $180.00 $7,200.00 Total approved this month $1,980.00 $0.00 TOTALS $2,160.00 $7,200.00 NET CHANGES by Change Orders ($5,040.00) AMOUNTCERTIFIED $1,980.00 (Attach explanation if amount certified differs from the amount applied for. Initial all figures on the Application for Payment and on the Continuation sheet that are changes to conform to the amount certified.) ARCHITECT: By: Date: The 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. Page 1 of 1 DocuSign Envelope ID: BCE22727-B3F4-40B7-AA41168AA95B6A8D07 CONTINUATION SHEET APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO.: 3 containing Contractor's signed Certification is attached. APPLICATION DATE* 11/30/20 In tabulations below, amounts are stated to the nearest dollar, PERIOD TO: 11/30/20 Greenscape Companies, INC PROJECT NO.: 19520-0033 A B. C D E F G H I WORK COMPLETED j'MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % BALANCE TO RETAINAGE (IF NUM VALUE APPLICATION (D THIS PERIOD STORED (NOT IN ' AND STORED TO (G + C) FINISH (C - G) VARIABLE RATE) j + E) D OR E) DATE - 1 3 Planting of trees and shrubs [ $23,000.00 - $23,000.00 6 $23,000 00 100.00% 1 2 (Irrigation i $47,000.00 $47,000.00 $47,000.00 100.00°,6 - - (3 :Seed $26,500.00 $26,500.00 � - $26,500.00 r o 100.00 % -� -� -� 6 ( -� 7 110 13 14 15 � 1 Lions Landscaping (CO #1) $160.00 $180.00 $180.00 100.00% ( T 1 ( Lions Landscaping (CO #2) ($2,200.00 ($2,200.00 ) - _ ($2,200.00 ) � 100.00%= 12 Multipurpose Landscaping ($5,000.00) 1 ($5,000.00) , - - ( ($5,000.00) 1 100.00% (CO #3) 1 Lions Landscaping (CO #4) $1,980.00 = $1,980.001 $1,980.001 100.00% - PA01.1-1 IMTALS $91,460.001 E $89,480.00� $1,960.00i $91,460.001, 10000% -3 Page 1 of 1 3� CONSTRUCTION To City of Elk River Owner. Attn: Justin Femrite 13065 Orono Parkway Elk River, MN 55330 CONTRACTOR'S APPLICATION FOR PAYMENT t — Please Remit Payment to: RJM Construction, LLC 830 Boone Ave North Golden Valley, MN 55427 APPLICATION AND CERTIFICATE FOR PAYMENT ENT Project:19520-0033 Elk River Multi -Purpose Facility and Liar John Weicht Park Architect: Application is made for psymerd, as shown below, in connection with the Contract. Continuation Sheet is attached. 1. Odginal Contract Sum .................. . ...... . 2.Net Change By Change Order .................... 3. Contract Sum To Date .......................... 4. Total Completed and Stored To Date .............. . 5. Retainage: a. 0.00% of Completed Work $0•00 b. 0.00% of Stored Material $0.00 Total Retainage ............................ 6. Total Earned Less Retainage ..................... . 7. Less Previous Certificates For Payments ............ $25,934,028.00 $567,579.40 $26,501,607.40 $26,427,623.74 $0.00 $26,427,623.74 $25,806,680.94 8. Current Payment Due ........................... $620,942.80 9. Balance To Finish, Plus Retainage ................. $73,983.66 Invoice 0: 9520003319 Distribution to: Application No.: 19 Owner Application Date: 11130/2020 Architect 0 Contractor Period From: To: 11/30/2020 The undersigned Contractor certifies that to the beat 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. RJM Construction LLC Stale of. A0County of. �c Subscribed a me this day of _ _ Notary Pubiin. My Commissioexpires: `" JUSTIN r" KING In accordance with the Contract Documents, based on on -site observations � � co01 Pubfic.Mfnnesot, comprising the above application, the Architect certifies to the Ownerthat n to mka►on .ran 3t, 20; 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. ARCHITECTS CERTIFICATE FOR PAYMENT AMOUNT CERTIFIED $ 620,942.80 (Attach e*Wndw if amount certified differs from the amount applied. inf ia/ all figures on this Applkatfon and on the ConMustfon Sheet that are changed to conform with the amount certified.) BRCHITECT;;q�.,. Data - Y This 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 Page 2of3 Application and Certification for Payment, containing Application No.: 19 Contractor's signed certification is attached. Application Date: 11/30120 In tabulations below, amounts are stated to the nearest dollar. To: 11/30120 Use Column I on Contracts where variable retainage for line items may apply. Architect's Project No.: Invoice 9 : 9520003319 Contract : 19520.0033 Elk River Mufti -Purpose Facility and Lion John Welcht Park A B C 0 E F G H Item Description of Work Scheduled _ Work Completed Materials Total % Balance Retalnage No. Value From Previous This Period Presently Completed (G 1 C) To Finish Application In Place Stored and Stored (C-G) (D+E) To Date 1 Elk River Multi -Purpose facility and 0.00 0.00 0 00 0.00; 0.00 0.00% 0.00 0.00 Lion John Weicht Park , 1A Final Cleaning 82,346.551 82,346.55; 0.00 0.00' 82,346.55 100.0011/1 F 0.00 0.00 1 B Survey 25,568.00 25,568.00 = 0.00 0.00- 25,568.00 100.00% ; 0.00 0.00 2A Building Demolition 166,199.51 186,199.51 0.00 0.00 166,199.51 100.000/1 0.00, 0.00 2B Selective Demolition 236,477 21 236,477.21 l 0.00 0.00 236,477.21 = 100.00% 0.00' 0.00 3C Concrete Floor Finishes 135,699.62 135,699.62, 0.00 0.00' 135,699.62 100.00% o.001 0.00 4A Masonry Systems 2,982,936.83 1 2,982,936.83 0.00 0.00 2,982,936.83 100.00% 0.00 0.00 5A Structural Material 1,342,525.13 , 1,342,525.13 0.00 0.00 1,342,525.13 j 100.00% 1 0.00 0.00 513 Structural Labor 457,855 00 457,855.00 0.00 0.00 457,855.00 100.00% ' 0.00 I 0.00 6A Carpentry 1,658,472 531 1,658 472 53 0.00 0.00 1,658.472.53 100.00% 1 0.001 0.00 7A 'Waterproofing &WB 40,342.001 40,342.00 0.00 0.00 40,342.00 1 100.00% 0.00 € 0.00 7B Roofing Systems 1,067 619.731 1,067 619 73_ 0.00 0.001 1,067,619.73 z 100.00%-0.00 j 0.00 7C Metal Wall Panel 186:172.61 1 186,172.61( 0.00 0.001 186,172.61 100.00% = 0.00 0.00 8A Aluminum Entrances/Storefronts 642,926.46 642,926.46 0.00 1 0.001 642,926.46 100.00%- 0.00 € 0.00 8B Overhead Coiling and Sectional 53,610.00 1 53,610,00 0.00 0.001 53,610.00 100.00% 0.00 { 0.00 Doors 9A Gypsum Board 349,769 37 349,769.37 0.00 0.001 349,769.37 100.00% ; 0.00 0.00 9B Tiling 175,149.90 175,149.90` 0.00 0.00 175,149.90 100.00%] 0.00 a 0.00 9C Acoustical Ceilings 147,905 95 147,905 951 0.00 0.00 147,905.95 100.00%1 0.00 0.00 9D Flooring 132,262.50 132,262.50 0.00 = 0.00 132,262.50 100.00% 0.00 0.00 9E Painting 444,499.00" 444,499,00 0.00 0.001 444,499.00 = 100.00%. 0.001 0.00 10A Signage 10,807 14' 10,807.14 0.00 0.00' 10807.14 100.00%' 0.00 0.00 11A Athletic Equipment 175,176.134 175176.84 0.00 0.001 175:176.84_ 100.00% 0.00, 0.00 11B Concessions 101,991.8311 101:991 831 0.00 0.00 101,991.83 100.00%' 0.001 0.00 12A Roller Shades 28,659.10 1 28,659.10 0.00 0.001 2B,659.10 100.00%- 0.00 0.00 13B Ice Rink Systems 2,162,742.00 2,162,742.00 0.00 0.001 2,162,742.00 100 00% ( 0.00 1 0.00 13C Leg Truss System 125797.001 125,797.001 0.00 0.00 ` 125,797.00 1 100.00% 1 0.00 0.00 14A Elevators 71:700.00 71,700.001 0.00E 0100-1 71,700.00 I 100 00% 1 0.00+ 0.00 21A Fire Protection 282,544.00 282,544.00. 0.00 0.00 282,544.00 1 100.00% 1 0.00 0.00 22A Plumbing Systems 1,324,981.22 132498122` 0.00 1 0.00 1,324,981,22 100,00% 0.00 0.00 23A HVAC: 1,875,065.33= 1:875:065:33 0.00 0.00 1,875,065.33 100.00% 1 0.00 0.00 26A Electrical Systems 1,876,978.67 1,876,978.67 0.00 0.001 1,876,978.67 1 100.00%! 0,001 0.00 31A I Multipurpose Earthwork 714,13730 714,137.30 0.00 0.00 714,137.30 100.00%- _ 0.00 j 0.00 CONTINUATION SHEET Page 3 of 3 Application and Certification for Payment, containing Application No.: 19 Contractor's signed certification is attached. Application Date: 111300 In tabulations below, amounts are stated to the nearest dollar, To: 11/30120 Use Column I on Contracts where variable retainage for line items may apply. Architect's Project No.: Invoice 0: 9520003319 Contract: 19520-0033 Elk River Multi -Purpose Facility and Lion John Welcht Fork A 8 C 0 E F 0 --,L-H Item Description of Work Scheduled Work Completed Materials Total % Balance Retainage No. Value From Previous This Period Presently Completed (G I C) To Finish Application In Place Stored and Stored (C-G) (D+E) To Date Not In D or E) E+F) 31B Lions Earthwork 508,490.67;' 508,490.67 0.00 i 0.00 j 508,490.67 100000/, 0.00 0.00 32A Asphalt Paving 294,509.00 294,509.001 0.00 0.00 1 294,509.00 10000Z � 0.00 0.00 328 Concrete/Sidewalk/Curb/Gutter 389142.503 389,142.50 0.001 0.00 i 389,142.501 100.00% i 0.00 0.00 32C Multipurpose Landscaping 27:00000 27,000.00. 0.00' mol 27,000.001 100.00% 0.00 0.00 32D Lions Landscaping 96,460.00 96,460.00 0.00 0.001 96,460.001 100.00%1 0.00 i 0.00 32E Chain Link Fence 150,325.79 1 150,325.79 0.00 0.001 150,325.79 100.00% 0.00 0.00 33A Utilities 635,496.55 635,496.55- 0.00 0.001 635,496.55 = 100.00% 0.00' 0100 3B.1 Precast Concrete 1, 182,922.00 1,182,922.00'- 0.00 0.001 1,182,922.00 100,00% 0.00 0.00 313.2 Precast Concrete 930,000.00 930,000.001 0.00 0.00� 930,000.00 100.00% 0.00 0.00 3B.3 Precast Raker/Plank/Stadia 1,048,025.00 1,048,025.001 0.00 0.00 11,048,025.00 100.00%1 am 0.00 01-00 General Conditions/Requirements 1,263,722.63 1,263 393 84 0.00 0.00 1,263,393.84 99.97%' 328.79 0.00 90-50 General Liability Insurance 268,451.521 268,451.52 i 0.00 0.00 = 268,451.52 100.00% i 0.00 1 0.00 E 90-60 Construction Contingency 73,654.871 0.00 i 0.00 a 0.00 0.00 = 0.00%, 73,654.87' 0.00 90-80 Builders Risk Insurance 65,184.58 65,184.561 0.00 0.001 65,184.5 8, 100.00% 0.001 0.00 1 99-99 Contractors Fee 489,303.96 489,303.961 0.00 0.001 489303.96 100.00%1 0.001 0.00 1 Grand Totals 126,501,607A0 26,427,623.74 0.00 0.00 26,427,623.74 99.72% 73,953.66 0.00 1ig ..r.Document G702° —1992 Application and Certificate for Payment TO OWNER: City of Elk River 13065 Orono Parkway NW Elk River, MN 55330 FROM Terra Construction CONTRACTOR: 21025 Commerce Blvd Ste 1000 Rogers MN 55374 Code: 421-4-2190-4520 Signature: �I, PROJECT: 20-700 Elk River Public Safety Building Expansion and Fire Station No. 3 VIA BKV Group ARCHITECT: 222 N 2nd St, #101 MInneapolis, MN 55401 CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. AIA Document G703", Continuation Sheet, is attached. 1.ORIGINAL CONTRACT SUM................................................................................ $6,290,219.00 2. NET CHANGE BY CHANGE ORDERS................................................................. $0.00 3. CONTRACT SUM TO DATE (Line 1 f 2)............................................................ S6,290,219.00 4. TOTAL COMPLETED & STORED TO DATE (Column G on G703) ................. $411,987.47 5. RETAINAGE: a. 5.00 % of Completed Work (Column D T E on G703) $20,599.37 b. 0 % of Stored Material (Column F on G703) S0.00 Total Retainage (Lines 5a + 5b or Total in Column I of G703) ................. $20,599.37 6. TOTAL EARNED LESS RETAINAGE................................................................... $391,388.10 (Line 4 Less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT ............................................ $56,954.81 (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE.......................................................................... $334,433,29 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) $5,898,830,90 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner $0.00 $0,00 Total approved this Month S0.00 $0,00 TOTALS S0.00 $0.00 NET CHANGES by Change Order 1 $0.00 APPLICATION NO: 20-700-002 Distribution to: PERIOD TO: November 30, 2020 OWNER: CONTRACT FOR: General Constriction ARCHITECT: CONTRACT DATE: October 19, 2020 PROJECT NOS: / 20-700 / CONTRACTOR: 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 f om ie wrier, and that current payment shown herein is now due. CONTRACTOR: / q By:Date: State of: Minne to County of: Hennepin Subscribed and sworn to before me this qwy of t Notary Public: = eresa L. Jensen I My Commission ex es: January 31, 2026 v►— TERESA L JENSEN Will ftble, State of Minneadla 1(8 January 31, 2026 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...................................................................................... S334,433.29 (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.) ARCHITECT:{��gx'�w.•. Date: 12/10/2020 Y 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 G70V— 1992. Copyright © 1953, 1963, 1965, 1971, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. The ".Almencan 1, stitute o° Architects," `AIA," the- AIA Logo, `C702," and `:A ontract Documents are reYistred trademarks and ay not be , sed v;st ut pern issien. This document was produced by AIA software at 11:22:10 CT on 12f09/2020 under Order No.6421824392 which expires on 04/24/2021, is not for resale, is licensed for one-time use only, and may only be used in accordance with the AIA Contract DocumentsO Terms of Service. To report copyright violations, e-mail copyright@aia.org. User Notes: (369ADA4B) Terra Prq ect Number 20.700 Terra Elk River Public Safety Building Expansion Ml _0.5TrI.'--0. City of Elk River CONTINUATION SHEET AIA DOCUMENT G 703 AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing APPLICATION NO: 2 Contractor's signed certification is attached. APPLICATION DATE: 10/14/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 11/30/20 A-F A.1 B C CA G2 G3 D E F G H I SUBCONTRACTOR ITEM BID DESCRIPTION OF WORK SCHEDULED CHANGE BUDGET REVISED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE VENDOR NO. PACK VALUE ORDERS REVISION/ SCHEDULED PRESENTLY COMPLETED (G=C) TO FINISH FROM PREVIOUS THIS PERIOD EMPLOYEE NO. CONTINGENCY VALUE APPLICATION STORED AND STORED (C -G) COST TRANSFER (D+E) (NOT IN TO DATE CODE DOR E) (D+E+F) Preconstruction 01-0002 Preconstruction $ 10,000.00 $ 10,000.00 $ 10,000.00 $ - $ 10,000.00 100.00% $ - $ 500.00 Bonds 01-0110 Bonds & Insurance $ 79,528.00 $ 79,528.00 $ 47,886.00 $ 4,789.00 $ 52,675.00 66.23% $ 26,853.00 $ 2,633.75 Permits 01-0120 Building Permit/SAC/WAC/SWPPP $ 127,156.00 $ 127,156.00 $ - $ 400.00 $ 400.00 0.31% $ 126,756.00 $ 20.00 CM General Requirements CM General Requirements $ 789,795.50 $ 789,795.50 $ 1,198.77 $ 89,535.04 $ 90,733.81 11.49% $ 699,061.69 $ 4,536.69 CM Contingency 01-0150 CM Contingency $ 238,379.00 $ 238,379.00 $ - $ - $ - 0.00% $ 238,379.00 $ - CM Fee CM Fee $ 92,372.00 $ 92,372.00 $ 867.66 $ 5,954.00 $ 6,821.66 7.38% $ 85,550.34 $ 341.08 Envirobate 02-2070 2A Selective Demolition $ 132,619.00 $ - $ 132,619.00 $ - $ - 0.00% $ 132,619.00 $ - Ebert 03-3300 3A General Conditions $ 22,866.00 $ - $ - $ 22,866.00 $ - $ 5,800.00 $ 5,800.00 25.37% $ 17,066.00 $ 290.00 Ebert 03-3300 3A Bonds & Insurance $ 6,200.00 $ - $ - $ 6,200.00 $ - $ 6,200.00 $ 6,200.00 100.00% $ - $ 310.00 Ebert 03-3300 3A Rebar & Accessories Material $ 50,400.00 $ - $ - $ 50,400.00 $ - $ 50,400.00 $ 50,400.00 100.00% $ - $ 2,520.00 Ebert 03-3300 3A Area A Found Labor $ 35,550.00 $ - $ - $ 35,550.00 $ - $ - 0.00% $ 35,550.00 $ - Ebert 03-3300 3A Area A Found Material $ 31,521.00 $ - $ - $ 31,521.00 $ - $ - 0.00% $ 31,521.00 $ - Ebert 03-3300 3A Area A SOG Labor $ 27,900.00 $ - $ - $ 27,900.00 $ - $ - 0.00% $ 27,900.00 $ - Ebert 03-3300 3A Area A SOG Material $ 40,577.00 $ - $ - $ 40,577.00 $ - $ - 0.00% $ 40,577.00 $ - Ebert 03-3300 3A Area A Top Slabs Labor $ 4,800.00 $ - $ - $ 4,800.00 $ - $ - 0.00% $ 4,800.00 $ - Ebert 03-3300 3A Area A Top Slabs Material $ 3,814.00 $ - $ - $ 3,814.00 $ - $ - 0.00% $ 3,814.00 $ - Ebert 03-3300 3A Area C Found Labor $ 33,900.00 $ - $ - $ 33,900.00 $ - $ 33,900.00 $ 33,900.00 100.00% $ - $ 1,695.00 Ebert 03-3300 3A Area C Found Material $ 26,241.00 $ - $ - $ 26,241.00 $ - $ 26,241.00 $ 26,241.00 100.00% $ - $ 1,312.05 Ebert 03-3300 3A Area C SOG Labor $ 41,400.00 $ - $ - $ 41,400.00 $ - $ - 0.00% $ 41,400.00 $ - Ebert 03-3300 3A Area C SOG Material $ 71,919.00 $ - $ - $ 71,919.00 $ - $ - 0.00% $ 71,919.00 $ - Ebert 03-3300 3A Exterior Concrete Labor $ 8,700.00 $ - $ - $ 8,700.00 $ - $ - 0.00% $ 8,700.00 $ - Ebert 03-3300 3A Exterior Concrete Material $ 7,412.00 $ - $ - $ 7,412.00 $ - $ - 0.00% $ 7,412.00 $ - Ebert 03-3300 32D General Conditions $ 5,200.00 $ - $ - $ 5,200.00 $ - $ - 0.00% $ 5,200.00 $ - Ebert 03-3300 32D Bond & Insurance $ 1,181.00 $ - $ - $ 1,181.00 $ - $ 1,181.00 $ 1,181.00 100.00% $ - $ 59.05 Ebert 03-3300 32D Rebar & Accessories $ 2,885.00 $ - $ - $ 2,885.00 $ - $ 2,885.00 $ 2,885.00 100.00% $ - $ 144.25 Ebert 03-3300 32D Curb &Gutter $ 38,784.00 $ - $ - $ 38,784.00 $ - $ - 0.00% $ 38,784.00 $ - Ebert 03-3300 32D Site Concrete Labor $ 13,100.00 $ - $ - $ 13,100.00 $ - $ - 0.00% $ 13,100.00 $ - Ebert 03-3300 32D Site Concrete Material $ 10,219.00 $ - $ - $ 10,219.00 $ - $ - 0.00% $ 10,219.00 $ - Ebert 03-3300 32D Existing Walk Rep Labor $ 4,800.00 $ - $ - $ 4,800.00 $ - $ - 0.00% $ 4,800.00 $ - Ebert 03-3300 32D Existing Walk Rep Material $ 2,531.00 $ - $ - $ 2,531.00 $ - $ - 0.00% $ 2,531.00 $ - Huffcut 03-3400 3B Precast $ 278,526.00 $ - $ - $ 278,526.00 $ - $ - 0.00% $ 278,526.00 $ - Concrete Treatments 03-3350 3C Polished Concrete $ 12,360.00 $ - $ - $ 12,360.00 $ - $ - 0.00% $ 12,360.00 $ - B&D Associates 04-4200 4A FD-Addition/Remodel 034500 L Labor $ 3,000.00 $ - $ - $ 3,000.00 $ - $ - 0.00% $ 3,000.00 $ - B&D Associates 04-4200 4A FD-Addition/Remodel 034500 M Material $ 4,020.00 $ - $ - $ 4,020.00 $ - $ - 0.00% $ 4,020.00 $ - B&D Associates 04-4200 4A FD-Addition/Remodel 042000 L Labor $ 179,900.00 $ - $ - $ 179,900.00 $ - $ - 0.00% $ 179,900.00 $ - B&D Associates 04-4200 4A FD-Addition/Remodel 042000 M Material $ 107,800.00 $ - $ - $ 107,800.00 $ - $ - 0.00% $ 107,800.00 $ - B&D Associates 04-4200 4A ED- Addition/Re model 034500 L Labor $ - $ - $ - $ - $ - $ - #DIV/01 $ - $ - B&D Associates 04-4200 4A ED- Addition/Re model 034500 M Material $ - $ - $ - $ - $ - $ - #DIV/01 $ - $ - B&D Associates 04-4200 4A ED- Addition/Re model 042000 L Labor $ 41,000.00 $ - $ - $ 41,000.00 $ - $ - 0.00% $ 41:000.00 $ - B&D Associates 04-4200 4A ED- Addition/Re mode 1042000M Material $ 35,180.00 $ - $ - $ 35,180.00 $ - $ - 0.00% $ 35180.00 $ - Ben's Structural Fab 05-5120 5A Steel Supplier $ 154,950.00 $ - $ - $ 154,950.00 $ - $ - $ - 0.00% $ 154,950.00 $ - Pace 1 / 6 SPC East Sower - Terra Pay App Terra Prq ect Number 20.700 Terra Elk River Public Safety Building Expansion -oevrT^'-`'-T'-'=- City of Elk River CONTINUATION SHEET AIA DOCUMENT G 703 AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing APPLICATION NO: 2 Contractor's signed certification is attached. APPLICATION DATE: 10/14/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 11/30/20 A_F A.1 B C CA G2 G3 D E F G H I SUBCONTRACTOR ITEM BID DESCRIPTION OF WORK SCHEDULED CHANGE BUDGET REVISED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE VENDOR NO. PACK VALUE ORDERS REVISION/ SCHEDULED PRESENTLY COMPLETED (G=C) TO FINISH FROM PREVIOUS THIS PERIOD EMPLOYEE NO. CONTINGENCY VALUE APPLICATION STORED AND STORED (C -G) COST TRANSFER (D+E) (NOT IN TO DATE CODE DOR E) (D+E+F) Patriot Erectors 05-5121 5B PD- Structural Steel Labor $ 8,362.00 $ - $ - $ 8,362.00 $ - $ - 0.00% $ 8,362.00 $ - Patriot Erectors 05-5121 5B PD- Steel Joist Labor $ 6,500.00 $ - $ - $ 6,500.00 $ - $ - 0.00% $ 6,500.00 $ - Patriot Erectors 05-5121 5B PD- Steel Roof Deck Labor $ 7,500.00 $ - $ - $ 7,500.00 $ - $ - 0.00% $ 7,500.00 $ - Patriot Erectors 05-5121 5B PD- Metal Fab Labor $ 4,500.00 $ - $ - $ 4,500.00 $ - $ - 0.00% $ 4,500.00 $ - Patriot Erectors 05-5121 5B PD- Metal Stairs Labor $ - $ - $ - $ - $ - $ - #DIV/01 $ - $ - Patriot Erectors 05-5121 5B PD- Pipe &Tube Railings Labor $ - $ - $ - $ - $ - $ - #DIV/01 $ - $ Patriot Erectors 05-5121 5B FD- Structural Steel Labor $ 2,780.00 $ - $ - $ 2,780.00 $ - $ - $ - 0.00% $ 2,780.00 $ Patriot Erectors 05-5121 5B FD-Steel Joist Labor $ 2,000.00 $ - $ - $ 2,000.00 $ - $ - 0.00% $ 2,000.00 $ - Patriot Erectors 05-5121 5B FD-Steel Roof Deck Labor $ 4,000.00 $ - $ - $ 4,000.00 $ - $ - 0.00% $ 4,000.00 $ Patriot Erectors 05-5121 5B FD-Metal Fab Labor $ 1,750.00 $ - $ - $ 1,750.00 $ - $ - 0.00% $ 1,750.00 $ Patriot Erectors 05-5121 5B FD-Metal Stairs Labor $ 1,600.00 $ - $ - $ 1,600.00 $ - $ - $ - 0.00% $ 1,600.00 $ Patriot Erectors 05-5121 5B FD- Pipe&Tube Railings Labor $ 1,500.00 $ - $ - $ 1,500.00 $ - $ - $ - 0.00% $ 1,500.00 $ - Patriot Erectors 05-5121 5B Bond $ 658.00 $ - $ - $ 658.00 $ - $ - 0.00% $ 658.00 $ - Century Construction 06-6100 6A Area A FD Addition Envelop $ 11,000.00 $ - $ - $ 11,000.00 $ - $ 3,000.00 $ 3,000.00 27.27% $ 8,000.00 $ 150.00 Century Construction 06-6100 6A Area A FD Addition Interior $ 10,200.00 $ - $ - $ 10,200.00 $ - $ - $ - 0.00% $ 10,200.00 $ - Century Construction 06-6100 6A Area A FD Renovation $ 17,000.00 $ - $ - $ 17,000.00 $ - $ - $ - 0.00% $ 17,000.00 $ Century Construction 06-6100 6A Area C PD Addition Envelope $ 18,000.00 $ - $ - $ 18,000.00 $ - $ - $ - 0.00% $ 18,000.00 $ Century Construction 06-6100 6A Area C PD Addition Interior $ 3,000.00 $ - $ - $ 3,000.00 $ - $ - $ - 0.00% $ 3,000.00 $ - Century Construction 06-6100 6A Area C PD Renovation $ 10,300.00 $ - $ - $ 10,300.00 $ - $ - $ - 0.00% $ 10,300.00 $ - Century Construction 06-6100 6A Area B PD Phase 1 $ 15,000.00 $ - $ - $ 15,000.00 $ - $ - $ - 0.00% $ 15,000.00 $ - Century Construction 06-6100 6A Area B PD Phase 2 $ 14,000.00 $ - $ - $ 14,000.00 $ - $ - $ - 0.00% $ 14,000.00 $ - Century Construction 06-6100 6A Alternate #1 - LL Area B $ 2,000.00 $ - $ - $ 2,000.00 $ - $ - $ - 0.00% $ 2,000.00 $ - Century Construction 06-6100 6A Performance and Payment Bond $ 4,500.00 $ - $ - $ 4,500.00 $ - $ 4,500.00 $ 4,500.00 100.00% $ - $ 225.00 Century Construction 06-6100 6A Allowance $ 10,000.00 $ - $ - $ 10,000.00 $ - $ - $ - 0.00% $ 10,000.00 $ - Century Construction 06-6100 6A Area A Materials $ 12,500.00 $ - $ - $ 12,500.00 $ - $ 3,000.00 $ 3,000.00 24.00% $ 9,500.00 $ 150.00 Century Construction 06-6100 6A Area B Materials $ 14,000.00 $ - $ - $ 14,000.00 $ - $ - $ - 0.00% $ 14,000.00 $ - Century Construction 06-6100 6A Area C Materials $ 12,500.00 $ - $ - $ 12,500.00 $ - $ - $ - 0.00% $ 12,500.00 $ - Casework(TED) 06-6200 6B Casework $ 83,750.00 $ - $ - $ 83,750.00 $ - $ - $ - 0.00% $ 83,750.00 $ - Structural Applicators 07-7210 7C Fluid Applied Air Barriers $ 14,696.00 $ - $ - $ 14,696.00 $ - $ - $ - 0.00% $ 14,696.00 $ - John A Dalsin 07-7510 7A Roofing $ 236,246.00 $ - $ - $ 236,246.00 $ - $ - $ - 0.00% $ 236,246.00 $ - Lake Area Roofing 07-7412 7B Metal Wall Panels $ 17,881.00 $ - $ - $ 17,881.00 $ - $ - 0.00% $ 17,881.00 $ - Waumadee Creek 07-7900 7D Sealants $ 39,684.00 $ - $ - $ 39,684.00 $ - $ - $ - 0.00% $ 39,684.00 $ - Mid -Central Door 08-8200 8A Doors and Frames $ 86,245.00 $ - $ - $ 86,245.00 $ - $ - $ - 0.00% $ 86,245.00 $ - Crawford Doors 08-8361 8B OH Doors $ 124,800.00 $ - $ - $ 124,800.00 $ - $ - $ - 0.00% $ 124,800.00 $ - Heartland Glass 08-8800 8C Aluminum, Glass and Glazing $ 67,934.00 $ - $ - $ 67,934.00 $ - $ - $ - 0.00% $ 67,934.00 $ - Quality Drywall 09-9250 9A Mobilization $ 5,000.00 $ - $ - $ 5,000.00 $ - $ - $ - 0.00% $ 5,000.00 $ - Pace 2 / 6 SPC East Sower - Terra Pay App Terra Prq ect Number 20.700 Terra Elk River Public Safety Building Expansion Ml _0rJ5Tnt.`'-T 0. City of Elk River CONTINUATION SHEET AIA DOCUMENT G 703 AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing APPLICATION NO: 2 Contractor's signed certification is attached. APPLICATION DATE: 10/14/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 11/30/20 A_F A.1 B C CA G2 G3 D E F G H I SUBCONTRACTOR ITEM BID DESCRIPTION OF WORK SCHEDULED CHANGE BUDGET REVISED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE VENDOR NO. PACK VALUE ORDERS REVISION/ SCHEDULED PRESENTLY COMPLETED (G=C) TO FINISH FROM PREVIOUS THIS PERIOD EMPLOYEE NO. CONTINGENCY VALUE APPLICATION STORED AND STORED (C -G) COST TRANSFER (D+E) (NOT IN TO DATE CODE DOR E) (D+E+F) Quality Drywall 09-9250 9A Metal Framing Labor $ 45,000.00 $ - $ - $ 45,000.00 $ - $ - $ - 0.00% $ 45,000.00 $ Quality Drywall 09-9250 9A Metal Framing Material $ 12,000.00 $ - $ - $ 12,000.00 $ - $ - $ - 0.00% $ 12,000.00 $ Quality Drywall 09-9250 9A Drywall Labor $ 60,000.00 $ - $ - $ 60,000.00 $ - $ - $ - 0.00% $ 60,000.00 $ Quality Drywall 09-9250 9A Drywall Material $ 20,000.00 $ - $ - $ 20,000.00 $ - $ - $ - 0.00% $ 20,000.00 $ Quality Drywall 09-9250 9A Taping Labor $ 20,000.00 $ - $ - $ 20,000.00 $ - $ - $ - 0.00% $ 20,000.00 $ Quality Drywall 09-9250 9A Taping Material $ 4,000.00 $ - $ - $ 4,000.00 $ - $ - $ - 0.00% $ 4,000.00 $ Quality Drywall 09-9250 9A EIFS Labor $ 15,000.00 $ - $ - $ 15,000.00 $ - $ - $ - 0.00% $ 15,000.00 $ Quality Drywall 09-9250 9A EIFS Material $ 8,000.00 $ - $ - $ 8,000.00 $ - $ - $ - 0.00% $ 8,000.00 $ Quality Drywall 09-9250 9A Allowance $ 7,000.00 $ - $ - $ 7,000.00 $ - $ - $ - 0.00% $ 7,000.00 $ - Mid -State Tile 09-9300 9B Tile Labor $ 19,311.00 $ - $ - $ 19,311.00 $ - $ - $ - 0.00% $ 19,311.00 $ - Mid -State Tile 09-9300 9B Tile Materials $ 17,693.00 $ - $ - $ 17,693.00 $ - $ - $ - 0.00% $ 17,693.00 $ - Mid -State Tile 09-9300 9B Bond $ 800.00 $ - $ - $ 800.00 $ - $ - $ - 0.00% $ 800.00 $ - Mid -State Tile 09-9300 9B Area B- Upper(212, 220, 221) Labor $ 8,307.00 $ - $ - $ 8,307.00 $ - $ - $ - 0.00% $ 8,307.00 $ - Mid -State Tile 09-9300 9B Area B- Lower (150) Material $ 300.00 $ - $ - $ 300.00 $ - $ - $ - 0.00% $ 300.00 $ - Twin City Acoustics 09-9510 9C ACT $ 34,700.00 $ - $ - $ 34,700.00 $ - $ - $ - 0.00% $ 34,700.00 $ - Carpet& Resilient(TED) 09-9680 9D Flooring $ 52,125.00 $ - $ - $ 52,125.00 $ - $ - $ - 0.00% $ 52,125.00 $ - Surface Pro's 09-9671 9E Resinous Flooring $ 98,912.50 $ - $ - $ 98,912.50 $ - $ - $ - 0.00% $ 98,912.50 $ - Virnig Painting 09-9900 9F Painting $ 107,444.00 $ - $ - $ 107,444.00 $ - $ - $ - 0.00% $ 107,444.00 $ - Precise Heating 15-1500 22A Performance Bond HVAC $ 5,596.00 $ - $ - $ 5,596.00 $ - $ 5,596.00 $ 5,596.00 100.00% $ - $ 279.80 Precise Heating 15-1500 22A Performance Bond Plumbing $ 2,143.00 $ - $ - $ 2,143.00 $ - $ 2,143.00 $ 2,143.00 100.00% $ - $ 107.15 Precise Heating 15-1500 22A PD HVAC Material $ 317,077.00 $ - $ - $ 317,077.00 $ - $ - $ - 0.00% $ 317,077.00 $ - Precise Heating 15-1500 22A PD HVAC Labor $ 103,400.00 $ - $ - $ 103,400.00 $ - $ - $ - 0.00% $ 103,400.00 $ - Precise Heating 15-1500 22A FD HVAC Material $ 240,627.00 $ - $ - $ 240,627.00 $ - $ - $ - 0.00% $ 240,627.00 $ - Precise Heating 15-1500 22A FD HVAC Labor $ 79,400.00 $ - $ - $ 79,400.00 $ - $ 15,261.00 $ 15,261.00 19.22% $ 64,139.00 $ 763.05 Precise Heating 15-1500 22A PD Plumbing Material $ 83,618.00 $ - $ - $ 83,618.00 $ - $ - $ - 0.00% $ 83,618.00 $ - Precise Heating 15-1500 22A PD Plumbing Labor $ 47,650.00 $ - $ - $ 47,650.00 $ - $ - $ - 0.00% $ 47,650.00 $ - Precise Heating 15-1500 22A FD Plumbing Material $ 93,549.00 $ - $ - $ 93,549.00 $ - $ - $ - 0.00% $ 93,549.00 $ - Precise Heating 15-1500 22A FD Plumbing Labor $ 58,780.00 $ - $ - $ 58,780.00 $ - $ - $ - 0.00% $ 58,780.00 $ - Precise Heating 15-1500 22A ADD Alt#3 RTU Replacement Material $ 100,200.00 $ - $ - $ 100,200.00 $ - $ - $ - 0.00% $ 100,200.00 $ - Precise Heating 15-1500 22A ADD Alt#3 RTU Replacement Labor $ 2,800.00 $ - $ - $ 2,800.00 $ - $ - $ - 0.00% $ 2,800.00 $ - Summit Fire 15-1533 21A Police Labor $ 22,500.00 $ - $ - $ 22,500.00 $ - $ - $ - 0.00% $ 22,500.00 $ - Summit Fire 15-1533 21A Police Material $ 12,100.00 $ - $ - $ 12,100.00 $ - $ - $ - 0.00% $ 12,100.00 $ - Summit Fire 15-1533 21A Fire Labor $ 11,500.00 $ - $ - $ 11,500.00 $ - $ 11,500.00 $ 11,500.00 100.00% $ - $ 575.00 Summit Fire 15-1533 21A Fire Material $ 6,200.00 $ - $ - $ 6,200.00 $ - $ - $ - 0.00% $ 6,200.00 $ - Klein Electric 16-1600 26A Mobilization $ 17,328.00 $ - $ - $ 17,328.00 $ - $ 1,733.00 $ 1,733.00 10.00% $ 15,595.00 $ 86.65 Klein Electric 16-1600 26A Permit/Bond $ 4,500.00 $ - $ - $ 4,500.00 $ - $ 4,500.00 $ 4,500.00 100.00% $ - $ 225.00 Klein Electric 16-1600 26A Exterior Temp Services/Job Trailer Temp Power $ 1,500.00 $ - $ - $ 1,500.00 $ - $ 1,500.00 $ 1,500.00 100.00% $ - $ 75.00 Klein Electric 16-1600 26A Switchgear/Panels/Border States Electric $ 4,737.00 $ - $ - $ 4,737.00 $ - $ - $ - 0.00% $ 4:737.00 $ - Klein Electric 16-1600 26A Light Fixtures/Controls/Werener Electric Co. $ 109,114.00 $ - $ - $ 109,114.00 $ - $ - $ - 0.00% $ 109114.00 $ - Page 3 / 6 SPC East Sower - Terra Pay App Terra Prq ect Number 20.700 Terra Elk River Public Safety Building Expansion Ml _oevrTnt.`'-T 0. City of Elk River CONTINUATION SHEET AIA DOCUMENT G 703 AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing APPLICATION NO: 2 Contractor's signed certification is attached. APPLICATION DATE: 10/14/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 11/30/20 A_F A.1 B C CA G2 G3 D E F G H I SUBCONTRACTOR ITEM BID DESCRIPTION OF WORK SCHEDULED CHANGE BUDGET REVISED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE VENDOR NO. PACK VALUE ORDERS REVISION/ SCHEDULED PRESENTLY COMPLETED (G=C) TO FINISH FROM PREVIOUS THIS PERIOD EMPLOYEE NO. CONTINGENCY VALUE APPLICATION STORED AND STORED (C -G) COST TRANSFER (D+E) (NOT IN TO DATE CODE DOR E) (D+E+F) Klein Electric 16-1600 26A Div 28/Fire Alarm/Twenty4Seven $ 22,667.00 $ - $ - $ 22,667.00 $ - $ - $ - 0.00% $ 22,667.00 $ - KleinElectric 16-1600 26A FD- Demolition $ 2,197.00 $ - $ - $ 2,197.00 $ - $ 439.00 $ 439.00 19.98% $ 1,758.00 $ 21.95 Klein Electric 16-1600 26A FD- Temporary Power/Lights $ 1,146.00 $ - $ - $ 1,146.00 $ - $ - $ - 0.00% $ 1,146.00 $ - KleinElectric 16-1600 26A FD- Site Underground Material $ 1,060.00 $ - $ - $ 1,060.00 $ - $ - $ - 0.00% $ 1,060.00 $ Klein Electric 16-1600 26A FD- Site Underground Labor $ 2,980.00 $ - $ - $ 2,980.00 $ - $ - $ - 0.00% $ 2,980.00 $ - Klein Electric 16-1600 26A FD-Site Pole Base Material $ 922.00 $ - $ - $ 922.00 $ - $ - $ - 0.00% $ 922.00 $ - Klein Electric 16-1600 26A FD-Site Pole Base Labor $ 817.00 $ - $ - $ 817.00 $ - $ - $ - 0.00% $ 817.00 $ - Klein Electric 16-1600 26A FD-Site Set Parking Lot Poles $ 473.00 $ - $ - $ 473.00 $ - $ - $ - 0.00% $ 473.00 $ Klein Electric 16-1600 26A FD-Switchgear/Panels Install Labor $ 1,886.00 $ - $ - $ 1,886.00 $ - $ - $ - 0.00% $ 1,886.00 $ Klein Electric 16-1600 26A FD-Switchgear/Panels Install Material $ 1,127.00 $ - $ - $ 1,127.00 $ - $ - $ - 0.00% $ 1,127.00 $ - Klein Electric 16-1600 26A FD- Light Fixture Install Labor $ 13,351.00 $ - $ - $ 13,351.00 $ - $ - $ - 0.00% $ 13,351.00 $ - Klein Electric 16-1600 26A FD- Light Fixture Install Material $ 4,298.00 $ - $ - $ 4,298.00 $ - $ - $ - 0.00% $ 4,298.00 $ - Klein Electric 16-1600 26A FD- Light Fixture Controll Install Labor $ 2,875.00 $ - $ - $ 2,875.00 $ - $ - $ - 0.00% $ 2,875.00 $ - Klein Electric 16-1600 26A FD- Light Fixture Controll Install Material $ 1,012.00 $ - $ - $ 1,012.00 $ - $ - $ - 0.00% $ 1,012.00 $ Klein Electric 16-1600 26A FD-Precast Rough-In's Labor $ 4,107.00 $ - $ - $ 4,107.00 $ - $ - $ - 0.00% $ 4,107.00 $ Klein Electric 16-1600 26A FD-Precast Rough-In's Material $ 1,350.00 $ - $ - $ 1,350.00 $ - $ - $ - 0.00% $ 1,350.00 $ Klein Electric 16-1600 26A FD-Power/Devices/Receptcales Labor $ 16,038.00 $ - $ - $ 16,038.00 $ - $ - $ - 0.00% $ 16,038.00 $ Klein Electric 16-1600 26A FD-Power/Devices/Receptcales Material $ 9,485.00 $ - $ - $ 9,485.00 $ - $ - $ - 0.00% $ 9,485.00 $ Klein Electric 16-1600 26A FD-Unit Heaters Labor $ 1,256.00 $ - $ - $ 1,256.00 $ - $ - $ - 0.00% $ 1,256.00 $ Klein Electric 16-1600 26A FD-Unit Heaters Material $ 429.00 $ - $ - $ 429.00 $ - $ - $ - 0.00% $ 429.00 $ Klein Electric 16-1600 26A FD-Exhaust Fans Labor $ 950.00 $ - $ - $ 950.00 $ - $ - $ - 0.00% $ 950.00 $ Klein Electric 16-1600 26A FD-Exhaust Fans Material $ 463.00 $ - $ - $ 463.00 $ - $ - $ - 0.00% $ 463.00 $ Klein Electric 16-1600 26A FD-VAV's Labor $ 816.00 $ - $ - $ 816.00 $ - $ - $ - 0.00% $ 816.00 $ Klein Electric 16-1600 26A FD-VAV's Material $ 291.00 $ - $ - $ 291.00 $ - $ - $ - 0.00% $ 291.00 $ Klein Electric 16-1600 26A FD-Boilers Labor $ 339.00 $ - $ - $ 339.00 $ - $ - $ - 0.00% $ 339.00 $ Klein Electric 16-1600 26A FD-Boilers Material $ 196.00 $ - $ - $ 196.00 $ - $ - $ - 0.00% $ 196.00 $ Klein Electric 16-1600 26A FD-Pumps Labor $ 2,096.00 $ - $ - $ 2,096.00 $ - $ - $ - 0.00% $ 2,096.00 $ Klein Electric 16-1600 26A FD-Pumps Material $ 754.00 $ - $ - $ 754.00 $ - $ - $ - 0.00% $ 754.00 $ Klein Electric 16-1600 26A FD-MAU Labor $ 797.00 $ - $ - $ 797.00 $ - $ - $ - 0.00% $ 797.00 $ Klein Electric 16-1600 26A FD-MAU Material $ 219.00 $ - $ - $ 219.00 $ - $ - $ - 0.00% $ 219.00 $ Klein Electric 16-1600 26A FD-CU Labor $ 1,074.00 $ - $ - $ 1,074.00 $ - $ - $ - 0.00% $ 1,074.00 $ Klein Electric 16-1600 26A FD-CU Material $ 764.00 $ - $ - $ 764.00 $ - $ - $ - 0.00% $ 764.00 $ Klein Electric 16-1600 26A FD-AHU Labor $ 618.00 $ - $ - $ 618.00 $ - $ - $ - 0.00% $ 618.00 $ Klein Electric 16-1600 26A FD-AHU Material $ 174.00 $ - $ - $ 174.00 $ - $ - $ - 0.00% $ 174.00 $ Klein Electric 16-1600 26A FD-Steam Generator Labor $ 1,108.00 $ - $ - $ 1,108.00 $ - $ - $ - 0.00% $ 1,108.00 $ Klein Electric 16-1600 26A FD-Steam Generator Material $ 669.00 $ - $ - $ 669.00 $ - $ - $ - 0.00% $ 669.00 $ Klein Electric 16-1600 26A FD- Pressure Washers Labor $ 688.00 $ - $ - $ 688.00 $ - $ - $ - 0.00% $ 688.00 $ Klein Electric 16-1600 26A FD- Pressure Washers Material $ 244.00 $ - $ - $ 244.00 $ - $ - $ - 0.00% $ 244.00 $ - Klein Electric 16-1600 26A FD-Audio Visual Rough-In's Labor $ 1,237.00 $ - $ - $ 1,237.00 $ - $ - $ - 0.00% $ 1,237.00 $ - Klein Electric 16-1600 26A FD-Audio Visual Rough-In's Material $ 640.00 $ - $ - $ 640.00 $ - $ - $ - 0.00% $ 640.00 $ - Klein Electric 16-1600 26A FD-Security Rough In's Labor $ 1,900.00 $ - $ - $ 1,900.00 $ - $ - $ - 0.00% $ 1,900.00 $ - Klein Electric 16-1600 26A FD-Security Rough In's Material $ 664.00 $ - $ - $ 664.00 $ - $ - $ - 0.00% $ 664,00 $ - Klein Electric 16-1600 26A FD- Fire Alarm Rough In's Labor $ 1,003.00 $ - $ - $ 1,003.00 $ - $ - $ - 0.00% $ 1,003.00 $ Klein Electric 16-1600 26A FD- Fire Alarm Rough In's Material $ 205.00 $ - $ - $ 205.00 $ - $ - $ - 0.00% $ 205.00 $ Klein Electric 16-1600 26A FD-DATA Rough-In's Labor $ 988.00 $ - $ - $ 988.00 $ - $ - $ - 0.00% $ 988.00 $ Klein Electric 16-1600 26A FD-DATA Rough-In's Material $ 377.00 $ - $ - $ 377.00 $ - $ - $ - 0.00% $ 377.00 $ - Klein Electric 16-1600 26A ED- Demolition $ 3,916.00 $ - $ - $ 3,916.00 $ - $ - $ - 0.00% $ 3,916.00 $ - Page 4 / 6 SPC East Sower - Terra Pay App Terra Prq ect Number 20.700 Terra Elk River Public Safety Building Expansion Ml _oevrTnt.`'-T 0. City of Elk River CONTINUATION SHEET AIA DOCUMENT G 703 AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing APPLICATION NO: 2 Contractor's signed certification is attached. APPLICATION DATE: 10/14/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 11/30/20 A_F A.1 B C CA G2 G3 D E F G H I SUBCONTRACTOR ITEM BID DESCRIPTION OF WORK SCHEDULED CHANGE BUDGET REVISED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE VENDOR NO. PACK VALUE ORDERS REVISION/ SCHEDULED PRESENTLY COMPLETED (G=C) TO FINISH FROM PREVIOUS THIS PERIOD EMPLOYEE NO. CONTINGENCY VALUE APPLICATION STORED AND STORED (C -G) COST TRANSFER (D+E) (NOT IN TO DATE CODE DOR E) (D+E+F) Klein Electric 16-1600 26A PD- Temporary Power/Lights $ 2,053.00 $ - $ - $ 2,053.00 $ - $ - $ - 0.00% $ 2,053.00 $ Klein Electric 16-1600 26A ED- Site Underground Labor $ 4,718.00 $ - $ - $ 4,718.00 $ - $ - $ - 0.00% $ 4,718.00 $ Klein Electric 16-1600 26A ED- Site Underground Material $ 1,743.00 $ - $ - $ 1,743.00 $ - $ - $ - 0.00% $ 1,743.00 $ - Klein Electric 16-1600 26A ED- Site Pole Base Labor $ 2,177.00 $ - $ - $ 2,177.00 $ - $ - $ - 0.00% $ 2,177.00 $ - Klein Electric 16-1600 26A PD - Site Pole Base Material $ 2,464.00 $ - $ - $ 2,464.00 $ - $ - $ - 0.00% $ 2,464.00 $ - Klein Electric 16-1600 26A PD - Site Set Parking Lot Poles $ 1,261.00 $ - $ - $ 1,261.00 $ - $ - $ - 0.00% $ 1,261.00 $ Klein Electric 16-1600 26A PD- Switchgear/Panels Install Material $ 1,514.00 $ - $ - $ 1,514.00 $ - $ - $ - 0.00% $ 1,514.00 $ Klein Electric 16-1600 26A ED- Switchgear/Panels Install Labor $ 2,330.00 $ - $ - $ 2,330.00 $ - $ - $ - 0.00% $ 2,330.00 $ - Klein Electric 16-1600 26A PD- Light Fixture Install Material $ 5,897.00 $ - $ - $ 5,897.00 $ - $ - $ - 0.00% $ 5,897.00 $ - Klein Electric 16-1600 26A PD- Light Fixture Install Labor $ 18,365.00 $ - $ - $ 18,365.00 $ - $ - $ - 0.00% $ 18,365.00 $ - Klein Electric 16-1600 26A PD- Light Fixture Control Install Material $ 2,664.00 $ - $ - $ 2,664.00 $ - $ - $ - 0.00% $ 2,664.00 $ - Klein Electric 16-1600 26A PD- Light Fixture Control Install Labor $ 6,322.00 $ - $ - $ 6,322.00 $ - $ - $ - 0.00% $ 6,322.00 $ - Klein Electric 16-1600 26A PD- Precast Rough-In's Material $ 584.00 $ - $ - $ 584.00 $ - $ - $ - 0.00% $ 584.00 $ - Klein Electric 16-1600 26A PD- Precast Rough-In's Labor $ 4,135.00 $ - $ - $ 4,135.00 $ - $ - $ - 0.00% $ 4,135.00 $ - Klein Electric 16-1600 26A PD- Power/Devices/Receptacles Material $ 8,409.00 $ - $ - $ 8,409.00 $ - $ - $ - 0.00% $ 8,409.00 $ - Klein Electric 16-1600 26A PD- Power/Devices/Receptacles Labor $ 17,640.00 $ - $ - $ 17,640.00 $ - $ - $ - 0.00% $ 17,640.00 $ - Klein Electric 16-1600 26A PD- Unit Heaters Material $ 200.00 $ - $ - $ 200.00 $ - $ - $ - 0.00% $ 200.00 $ - Klein Electric 16-1600 26A PD- Unit Heaters Labor $ 477.00 $ - $ - $ 477.00 $ - $ - $ - 0.00% $ 477.00 $ - Klein Electric 16-1600 26A PD- Exhaust Fans Material $ 482.00 $ - $ - $ 482.00 $ - $ - $ - 0.00% $ 482.00 $ - Klein Electric 16-1600 26A PD- Exhaust Fans Labor $ 1,132.00 $ - $ - $ 1,132.00 $ - $ - $ - 0.00% $ 1,132.00 $ - Klein Electric 16-1600 26A PD- Boilers Material $ 196.00 $ - $ - $ 196.00 $ - $ - $ - 0.00% $ 196.00 $ - Klein Electric 16-1600 26A PD- Boilers Labor $ 339.00 $ - $ - $ 339.00 $ - $ - $ - 0.00% $ 339.00 $ - Klein Electric 16-1600 26A PD- Pumps Material $ 883.00 $ - $ - $ 883.00 $ - $ - $ - 0.00% $ 883.00 $ - Klein Electric 16-1600 26A PD- Pumps Labor $ 2,583.00 $ - $ - $ 2,583.00 $ - $ - $ - 0.00% $ 2,583.00 $ - Klein Electric 16-1600 26A PD- MAU Material $ 219.00 $ - $ - $ 219.00 $ - $ - $ - 0.00% $ 219.00 $ - Klein Electric 16-1600 26A PD- MAU Labor $ 979.00 $ - $ - $ 979.00 $ - $ - $ - 0.00% $ 979.00 $ - Klein Electric 16-1600 26A PD- RTU-1 Material $ 492.00 $ - $ - $ 492.00 $ - $ - $ - 0.00% $ 492.00 $ - Klein Electric 16-1600 26A PD- RTU-1 Labor $ 530.00 $ - $ - $ 530.00 $ - $ - $ - 0.00% $ 530.00 $ - Klein Electric 16-1600 26A ED- Audio Visual Rough-In's Material $ 1,146.00 $ - $ - $ 1,146.00 $ - $ - $ - 0.00% $ 1,146.00 $ - Klein Electric 16-1600 26A ED- Audio Visual Rough-In's Labor $ 2,197.00 $ - $ - $ 2,197.00 $ - $ - $ - 0.00% $ 2,197.00 $ Klein Electric 16-1600 26A PD- Security Rough-In's Material $ 1,184.00 $ - $ - $ 1,184.00 $ - $ - $ - 0.00% $ 1,184.00 $ Klein Electric 16-1600 26A PD- Security Rough-In's Labor $ 3,376.00 $ - $ - $ 3,376.00 $ - $ - $ - 0.00% $ 3,376.00 $ - Klein Electric 16-1600 26A PD- Fire Alarm Rough-In's Material $ 368.00 $ - $ - $ 368.00 $ - $ - $ - 0.00% $ 368.00 $ - Klein Electric 16-1600 26A PD- Fire Alarm Rough-In's Labor $ 1,786.00 $ - $ - $ 1,786.00 $ - $ - $ - 0.00% $ 1,786.00 $ - Klein Electric 16-1600 26A PD- DATA Rough-In's Material $ 678.00 $ - $ - $ 678.00 $ - $ - $ - 0.00% $ 678.00 $ - Klein Electric 16-1600 26A PD- DATA Rough-In's Labor $ 1,752.00 $ - $ - $ 1,752.00 $ - $ - $ - 0.00% $ 1,752.00 $ - New Look 31-1000 31A Mobilization $ 27,400.00 $ - $ - $ 27,400.00 $ - $ 13,700.00 $ 13,700.00 50.00% $ 13,700.00 $ 685.00 New Look 31-1000 31A Locates, Permits, Surveys $ 17,380.00 $ - $ - $ 17,380.00 $ - $ 8,690.00 $ 8,690.00 50.00% $ 8,690.00 $ 434.50 New Look 31-1000 31A Erosion Control $ 4,840.00 $ - $ - $ 4,840.00 $ - $ 4,840.00 $ 4,840.00 100.00% $ - $ 242.00 New Look 31-1000 31A EC Materials $ 4,000.00 $ - $ - $ 4,000.00 $ - $ 4,000.00 $ 4,000.00 100.00% $ - $ 200.00 New Look 31-1000 31A Removals $ 15,750.00 $ - $ - $ 15,750.00 $ - $ 7,875.00 $ 7,875.00 50.00% $ 7,875.00 $ 393.75 New Look 31-1000 31A Temp Agg Base $ 6,350.00 $ - $ - $ 6,350.00 $ - $ 1,588.00 $ 1,588.00 25.01% $ 4,762.00 $ 79.40 New Look 31-1000 31A Grading $ 15,980.00 $ - $ - $ 15,980.00 $ - $ - $ - 0.00% $ 15:980.00 $ - New Look 31-1000 31A Sand Import $ 2,332.00 $ - $ - $ 2,332.00 $ - $ - $ - 0.00% $ 2,332.00 $ - New Look 31-1000 31A Soil Correction $ 17,885.00 $ - $ - $ 17,885.00 $ - $ 17,885.00 $ 17,885.00 100.00% $ - $ 894.25 New Look 31-1000 31A Structure Exc $ 39,240.00 $ - $ - $ 39,240.00 $ - $ - $ - 0.00% $ 39,240.00 $ - Page 5 / 6 SPC East Sower - Terra Pay App Terra Terra Prq ect Number 20.700 Ml Elk River Public Safety Building Expansion _0.5Tnt.`'--0. City of Elk River CONTINUATION SHEET AIA DOCUMENT G 703 AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing APPLICATION NO: 2 Contractor's signed certification is attached. APPLICATION DATE: 10/14/20 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 11/30/20 A-F A.1 B C CA G2 G3 D E F G H I SUBCONTRACTOR ITEM BID DESCRIPTION OF WORK SCHEDULED CHANGE BUDGET REVISED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE VENDOR NO. PACK VALUE ORDERS REVISION/ SCHEDULED PRESENTLY COMPLETED (G=C) TO FINISH FROM PREVIOUS THIS PERIOD EMPLOYEE NO. CONTINGENCY VALUE APPLICATION STORED AND STORED (C -G) COST TRANSFER (D+E) (NOT IN TO DATE CODE DOR E) (D+E+F) New Look 31-1000 31A Topsoil $ 14,300.00 $ - $ - $ 14,300.00 $ - $ - $ - 0.00% $ 14,300.00 $ New Look 31-1000 31A Fine Grading $ 11,943.00 $ - $ - $ 11,943.00 $ - $ - $ - 0.00% $ 11,943.00 $ - Fencing(TED) 32-4000 32A Fencing $ 120,375.00 $ - $ - $ 120,375.00 $ - $ - $ - 0.00% $ 120,375.00 $ - Autumn Ridge 32-3291 32B Landscaping $ 42,980.00 $ - $ - $ 42,980.00 $ - $ - $ - 0.00% $ 42,980.00 $ - Bituminous Roadways 32-1216 32C Asphalt $ 144,740.00 $ - $ - $ 144,740.00 $ - $ - $ - 0.00% $ 144,740.00 $ - St. Paul Utilities 31-3123 33A Water Main Labor $ 20,000.00 $ - $ - $ 20,000.00 $ - $ 6,500.00 $ 6,500.00 32.50% $ 13,500.00 $ 325.00 St. Paul Utilities 31-3123 33A Water Main Material $ 10,000.00 $ - $ - $ 10,000.00 $ - $ - $ - 0.00% $ 10,000.00 $ - St. Paul Utilities 31-3123 33A Storm Sewer Labor $ 42,000.00 $ - $ - $ 42,000.00 $ - $ 6,500.00 $ 6,500.00 15.48% $ 0.00 $ 325.00 St. Paul Utilities 31-3123 33A Storm Sewer Material $ 12,000.00 $ - $ - $ 12,000.00 $ - $ - $ - 0.00% $ 12:35,50000.00 $ - GRANDTOTALS $ 6,290,219,00 $ - $ - $ 6,290,219,00 $ 59,952,43 $ 352,035,04 $ - $ 411,987,47 6.55% $ 5,878,231,53 $ 20,599,37 Pace 6 / 6 SPC East Sower - Terra Pay App Terra General Contractors, LLC 21025 Commerce Blvd., Ste 1000 Rogers, MIN 55374 Phone 763-463-0220 City of Elk River 13065 Orono Parkway Elk River, IVIN 55330 Construction Services - November 2020 INVOICE Invoice Date Customer ID Invoice ID 11-30-2020 1 1-CIT013 20-700-20201130 Due Date Draw ID Job Number 12-30-2020 2 20-700 Job Location: Elk River Public Safety 352,035.04 Amount Billed $352,035.04 Retainage Held 17,601.75 Total Amount Due $334,433.29