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ui <br />APPLICATION N( <br />H <br />LU <br />2 <br />AQ <br />N ru <br />E <br />CDN <br />O <br />LL <br />OUJ <br />U <br />Q <br />V W <br />LL Z <br />a <br />0 <br />WCC <br />Vl <br />2 <br />Q z <br />Z <br />OJ <br />V z <br />z <br />O- u 2 <br />a00 <br />N <br />O <br />m <br />00 <br />PERIOD TO: <br />5555 W 78TH ST, SUITE A <br />MINNEAPOLIS, MN 55439 <br />CONST. MANAGER <br />C <br />ao <br />- c <br />o co <br />x <br />w <br />o > <br />Q in <br />-0 O <br />V) <br />06 <br />O 3' in <br />ro <br />LL V, LO <br />Ramsey, MN 55303 <br />$330,300.00 <br />N <br />LO m <br />N O <br />4m4 N <br />4.4 <br />$296,032.77 <br />o = o <br />LO o <br />Y O <br />_o o b4 <br />C CO <br />O C 0 <br />o <br />in l7 0 w <br />4- C V1 <br />N N L O z <br />> O 0 - F- <br />ro o Oa m w <br />a o a,� .L +rNCC <br />at LO 0 5 -° m" ro in CO <br />o a CJ0 ro LnL9 Y <br />I- <br />CU < U J 0 Om a) o t, m0 c �O J <br />Ln <br />r0 Gl Q s- J U E C v N. <br />.... CC �W 41 <br />VI h W cu Q 2 O W u W O C COClj E Z J <br />- 0 O l7 to OCO Q v1 <br />C O C l7 OO`� LL.0 O w ut <br />O cc UU 0 C Z C .� J N_C -.° uro <br />Z i^ u F-OnIUOI-oI <br />a+F- cu '°E �. ¢� <br />CL <br />n�°oU < EQ 1E v <br />o m <br />00 N. <br />CO <br />64 N <br />64 <br />APPLICATION FOR PAYMENT <br />CHANGE ORDER SUMMARY <br />DEDUCTIONS <br />ADDITIONS <br />Change Orders Approved in <br />7. LESS PREVIOUS CERTIFICATES FOR <br />$276,614.13 <br />PAYMENT (Line 6 from prior Certificate) <br />8. CURRENT PAYMENT DUE <br />O yc <br />C v <br />VI <br />o E <br />:E . <br />rq o .no <br />u u <br />N- N 0_0 <br />Lc) <br />a! O. - <br />Q r6 <br />0 o m v ,N L <br />'A- <br />O co O O >) ° <br />b4 O O 4-,_C U <br />al 01 4-4 w 44 ra -p tll <br />_c v <br />a) O <br />u <br />0 0 0 0 o N o 0 0 QJ <br />0 0 0 0 0 0 N- 0 0 o r v o <br />O O O O O O N 06 0 N u> c <br />p y. O O O CD CD IS) • > -° <br />p Ln o No N coLo Ul CO rnl a) L <br />p m 0 LO O 0 N 0m d' na s 0 <br />b4 b4 a- VI- tfT b 44 b V <br />v+ to Ln LrsC '1'' u <br />( c.) CIS <br />2= c <br />LD LO LO LO vs C -O <br />���� Q °-o a) <br />0 ,- C '' <br />F--L1LOLOLO 0 = ro °� <br />L F- a) _ O <br />CU <br />c p 0 o <br />, o co <br />3 O am, a) O rp u <br />0 Q CO U E C <br />T _ tv <br />C Y' c v O v <br />4-_0 <br />Cv o >U, •ac-° .0 <br />ECZ <br />4 <br />0LE _oin <br />L rL <br />`^ v o000000000 ro a�i C <br />0 o c o 0 0 0 0 0 0 0 0 o c 0 a <br />E0000000000 0E <br />> <br />5 c o 0 0 0 0 0 0 0 0 o CI) <br />O <Zmrnmmmmmmmm Z F-- a <br />9. BALANCE TO FINISH, PLUS RETAINAGE <br />rli <br />0 <br />O <br />C <br />tL <br />rp <br />C <br />rL <br />-C <br />C <br />0 <br />0 <br />rn <br />to <br />C <br />0) <br />r6 <br />0_ <br />c <br />ry <br />0 <br />u <br />r6 <br />_c <br />co <br />Wine 3 fess Line 6) <br />SUBCONTRACTOR: <br />State of. MINNESOTA <br />Subscribed and <br />lD <br />O <br />OD <br />4i <br />0 <br />In Accordance with the Contract Documents, based on on -site observations and the <br />a, 0, -o <br />4 CO C <br />o -0 r0 <br />Y al <br />vi <br />4-,in4- <br />r0 v c <br />L 0(- a! <br />Y 0 E <br />al O <br />r1 v <br />in <br />O <br />0 r0 0 <br />al .cV <br />O>O Cu <br />Y > ° <br />v v u <br />4-' <br />t 4-,a a= <br />U N <br />4-, > <br />C.)CCU -0 O <br />E ro c < <br />C rD ' <br />< .° -6 <br />aJ N O 4 <br />- E U <br />C O C <br />0 `�- •- <br />7 c 1n <br />U 0 <br />0 <br />O N <br />a <br />CU <br />> O ' <br />° o 4- <br />o O <br />r0 vl <br />N v• <br />4- -, j i <br />ao <br />C U o-: <br />V <br />T.:Q C <br />aL <br />E Y <br />a)O Uo n <br />a v <br />r0 0) ° <br />-O o .0 <br />