09.03B Maintenance Facility Project - Boser Construction Payment Certificate #6

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AIA� Document G702� - 1992 Application and Certificate for Payment TO OWNER: City of Pequot Lakes PROJECT: Pequot takes Maintenance Garag APPUCATION NO: 6 Distribution to: 4638 Main Street 4635 Derksen Road G 2�,/�($ OWNER: Pequot Lakes,MN 56472 Pequote Lakes,MN 56472 PERIOD TO: ARCHITECT: FROM Boser Construction Inc. VIA CONTRACT FOR: General Construction CONTRACTOR: CONTRACTOR: 7135 5th Ave NE ARCHITECT: Widseth Smith Nolting �ONTRAR DATE: FiEID: Sauk Rapids,MN 56379 7804 Industrial Park Rd PROJECT NO: 8638 Baxter,MN 56425 CONTRACTOR'S APPUCATION FOR PAYMENT The undersigned Contractor certlfies Ihat�me best oi me Contractars Knowledge,iniortnatlon and Application is made for payment.as shorm below.in connection with the Contract beAei fhe Wak covered by this Appticatbn for Payment has been canplated in aaardance with ihe AIA Document G703TM',Continuatron Sheet,is attached. �^��"��"�have been paid Dy!he Contracta fa W«k 6a which previaus 1.ORIGINAL CONTRACT SUM S 894,000.00 ��P��t were issued and payments reoeived(orm the Owner,and tliat curtent ............................................................................................. payment shawn herehi is now due. 2.NET CHAN(3ES IN THE WORK 3 - .....................................................................___..._............. 3.CONTRACT SUM TO DATE(LINE 1+p) � 894,000.00 CONTRACTOR: .........._......................................_........�_...._ ....._............ •Z`!�- 4.TOTAL COMPLETED AND STORED TO DATE(Column G on G703) (�"�$�'�('�,.'�� 3 -b99.E9��0 By: Date: 5.RETAINAGE State of:�� a 5%�Completed Work(Cdumn D+E on G703) � �4,58435r 3'��`�3°1•b� County of:�-�,,,�. b �of Stored Nlaterial(Column F on G703) S _ Subscribed and sworn to before �� M�� Total Retainage(Lines 5a+56,or Total in Column!on G703) �{�,�� S -�4.98�:5� me this 2`ti � ��_� ................._......................�'r'�a............... .:.,:' „��io�t E�Nes hl��1,2� B.TOTAL EARNED LESS RETAINAGE �,��$7"3,53 S -1364.Z06.35_ Notary Publi ( 9 ..........................._.............................. Y ., Line 4 minus Lirre 5 Toia M Com ' n ex ' es: 7..LESS PREYIOUS CERTIFICATE FOR PAYMENT S 495,689.75 ARCHRECTS CERTIFICATE FOR Y ..........................................._....._............. (Line 6 from pria CeRihcete) In accordance wtlh M�e Contract Documenfs,based on on-site abservaUons and the date comprising 8.CURRENT PAYMENT DUE <�cl*��,.;1 b�_,�g,$}g;.{� �+�s applica�on,the Architect aer�fies ro the Owner thet ro Me best of the Arct�itecls knawledge. ........._......._.._.............................................• - mforma6on and bepel the Wafc has progressed as indicated,the qualily o1 tlie Wark is in aocordance 9.BALANCE TO FlNISH,INCLUDING RETAINAGE wipi g�e ConUaa popiments,�d the Canhactar is eotiUed ta payment of the AMOUNT (L1ne 31Rinus Lrne 6) 3 —�2�49Sa5''2�7,�LLjO(.�d �RTIFIEd �& t4R.1L'S - AMOUNT CERTIFIED....................•-•--.._................ 5369:6t6'd0" (Atfach e�laiation'rf anount certified d'iflers hom the amount appMed.IniHal aM Rgures an this CHANGE ORDER SUMMARY AOOITIONS DEDUCTIONS AppRcadon and m the Contlnuadon Sheet that are changed to cantorm with the amount certilied.) Total changes approved in previous months by Owner 3 - S - I Total approved lhis month $ - S - By- � Da�e:Q �,.fi g TOTALS $ - S - TMs cerbficate is not egotiaDle.The AMOUNT CERTIFIED is payable anly to the Co cta named herein.Issuance,payment and acceptance of payn►ent are without�ejudlee to a�ry rlghts o(tl�e NET CHANGES b Cha Ord� S - �� AIA Document G702"'-1992.Copyfight O 1953,1963,1965,1971,1983 and 1992 by The American InstRute of Architeds.All rights reserved.WARNING:7H15 AIA°'Dxument is protected by U.S.Copyright Law and Intemational Treaties.Unauthorized reprodudion of distribution of this AIA'Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible underthelaw.