Agenda - Council - 11/27/2001 - Laserfiche WebLink

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APPLICATION FOR PAYMENT NO. 1 To: City or R~qmsey (OWNI~.R) From: Mapo-ney Contruction; [nc,. 19245 Hwy 7, Excelsior, MN 55331 (CONTRACTOR) Contract: General Con.qtnmtion Project: Minnesnta Pump Holme No. 3 OWNER's Contract No. ENGINEER's Project No. For Work accomplished through the date of: 10/31/01 1 .) Original Contract Pr/ce: 2.) Net change by Change Orders/Written Amendments (+-) 3.) Current Contract Pr/ce (1 plus 2): 4.) Total completed and stored to date: 5.) Retainage (per Ag-reement): 5% of completed work $ 1~194_55 5% of stored material: $ 761 25 Total Retainage: 6.) Total completed and stored to date less retainage (4-5) 7.) Less previous Application for Payments: 8.) DUE THIS APPLICATION (6-7) $ 405.50000 $ $ 405,500.00 $ t9.11600 $ $ "gT. 160 2O Accompanying Documentation: CONTRACTOR'S Certification: The undersigned CONTRACTOR certifies that (1) all previous progress payments received from OWNER on account of Work done under the Contract referred to above have been applied on account to discharge CONTRACTOR's legitimate obligations incurred in connection with Work covered by prior Applications for Payment numbered 1 through 1 inclusive; (2) title of ali Work, materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for Payment will pass to OWNER at time of payment free and clear of all Liens, security interests and encumbrances (expect such as are covered by a Bond acceptable to OWNER indemmfying OWNER against any such Lien, security interest or encumbrance); and (3) all Work covered by this Application for Payment is in accordance with. the Contract Documents and not defective. Dated November 1:21301 Magney Construction, Inc (Contractor) By ~..~_ ~----- ~ .,,f ~ ~Mark C. Magney, Pr~sid'ent V-/ S /7///~/A/'~./9C)~(,~ j Count¥i¥ Su~::vnbp~bl:cndSwgrn .be rem t _TL__dayof _ Ptolton & Menk Inc._ (engineer/ -103-