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AIA� Document G702� - 1992 Applicarion and Certihcate for Payment TO OWNIER: City of Pequot Lakes PROJECT: Pequot lakes Maintenance Garag APPUCATION NO: 2 Distribution to: 4638 Main Street 4635 DerkSen Road OWNER: Pequot Lakes,MN 56472 Pequote lakes,MN 56472 PERIOD TO: 5/30/2018 ARCHITECT: FROM Boser Constructton Inc. VIA CONTitACT FOR: Generai Constructlon CONTRACTOR: CONTRACTOR: 7135 Sth Ave NE ARCMITECT: Widseth Smith Nolting CONTRACT OATE: FIELD: Sauk Raptds,MN 56379 7804 Industrial Park Rd PROIECT NO: 8638 Baxter,MN 56425 CONTRACTOR'S APPUCATION FOR PAYMIEM The underslgned Conaaetor cer6fres tl�at ro Ne best oi the Contract�s Knowleage,tnformaHon and App�cation is made tor payme►�,as shoum belaw,fi conrtection with the Cantract beitef the Wark cov�ed by fhb Applic�tlon for Payment has been completed in axordance wtth the AIA DoCumeM G703T�'.Cantir►uation Sheet is attached. Contract Doaments,that a0 amamb have been pald by the Contrector for Wwk Mr which prevtaus 1.ORlGINAL CONTRACT SUM $ 894.000.00 ��Payment w�e issued ar�d peyments rectived farm the Oumer.and that current ___._.._._.._..__.._._._.._..............._......_._..._._... payment ahawn heretn is rrow due. 2.NET CHANGES IN THE WORK $ - 3.CONTRACT SUM TO DATE(L1NE 1+2) '��'~W� �•�.�� $ 894,000.00 CONTRACTOR: 4.TOTAL COMPLETED AND STORED TO DATE(Column G on G703J � $ 79,857.00 By: Date: �al.�$ S.RETAINAGE �� State of:� �k a. 5%o�Completed Worlc(Column D+E on G703) S 3,982.85 County of:��,.,. � �%of Srored Material(CoJumn F on G703) g _ Subscribed and swom to before w L. Total Retainage(Lirtes 5a+5b,or Tofal In Column!on GT03) $ 3,982.85 me th fs ZI� � ay o �� ,;. 8.TOTAL EARNED LE8S RETAINA(iE �� y� S 75,674.15 Notary Public•� ,�,_� (Lrne 4 mirtus lbre 5 TWaQ _....._..._....._...__...._...._..�...._ ..._._..____ My Comm t s�i`6"n e x p� ��•�1/W611 W i l�H l tl�l �'.�•;. 7..LESS PREVIOUS CERTIFICATE FOR PAYMENT g 13,568.85 ARCHRECTS CERTIFlCATE FOR PAYMENT (Lir►e 8/rom prior Certificate) M......�......_._..�. In acoordance rdth the Cantrad Documenls.based on on-stte observetlons and tha dahd comDrisl►nJ a.CURRENT PAYMENT DUE 3 62,105.30 �'�appttcatlan,the Archttgci cer�es ro�e O►mer tl�et ro me bes�oi tlro archReas knawlsdge. 9.BALANCE TO FINISH,INCLUDU�IG RETAINAGE -�.��m�� 1f0R1�0"��wak has progressed as mmcated,are qual�y or the work is m a000rdance with fhe Contract Oocumenb.and the Caio�ectm Is entltled ro payment oi the AMOUNT (Line 3 minus Line 6) $ 818,325.85 CERTfFIED. Ad1WNT CERiIF1ED............................................ 5 - $62,105.30 (Mtach sxptana6�H e�rro�mt certlAed dffleB trom the amounl appded.Irtidat an figures on 9�Is CHANGE ORDER SUMMARY ADDITIONS DEDUCTIQNS AppAcetlon and on the Contlnuatlon Sheet that ere changed to cflniorm with the amount c�tlfled.) Total chartges a roved'm previous months by Owner $ - $ - ARCHITE� /�n Total approved this month $ - $ - er: A �� Date: 5/24/2018 TOTALS a - S - Thfs cerfAAcate is not neg te.The AMOUNT CERTIFIED is peyable oniy to tha Contraclor named herehi.Issuence,peyment and acxeptartce oi payment ere without prejudice to any righffi of the NET CHANGES Ch e Order $ _ ��►��o��der this Canraa AIA Docurt�eM G702�"-199L Copyri6ht m 1953,19b3,1965,1971,1983 and 1942 by The Ameripn Instttute of ArchKects.All►fahts reserved.WARNING:THIS AIA`�Oacument is protected by U.S.Copyn�ht Law and International Treaties.Unauthorized reproduRion of distribution of this AIA°Oocument,or any portion of IL may result in severe civil and criminal penalties,and wdl be prosecuted to the maxfmum eutent possible underthelaw.