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Item 3.4 Fire Station Facility Project Pay Application 12
Request for City Council Action DEPARTMENT INFORMATION ORIGINATING DEPARTMENT REQUESTOR: MEETING DATE: Public Safety Interim Fire Chief Scott December 8, 2025 PRESENTER(s) REVIEWED BY: ITEM #: Consent Kraus-Anderson City Administrator/Finance Director Flaherty 3.4 – Pay Application for the Fire Station STRATEGIC VISION MEETS: THE CITY OF OTSEGO: Is a strong organization that is committed to leading the community through innovative communication. Has proactively expanded infrastructure to responsibly provide core services. X Is committed to delivery of quality emergency service responsive to community needs and expectations in a cost-effective manner. Is a social community with diverse housing, service options, and employment opportunities. Is a distinctive, connected community known for its beauty and natural surroundings. AGENDA ITEM DETAILS RECOMMENDATION: City staff recommend City Council approval of Pay Application #12 for the Fire Station project. ARE YOU SEEKING APPROVAL OF A CONTRACT? IS A PUBLIC HEARING REQUIRED? No No BACKGROUND/JUSTIFICATION: The amounts requested for Pay Application #12 are consistent with the work progress to date, have been signed by each respective contractor, and reviewed and signed by the City’s Architectural and Construction Management consultants. There are twelve individual work scope requests included within Pay Application #12 for a total of $1,018,591.35: Voss Plumbing & Heating of Paynesville, Inc. $104,574.58 Spartan Steel Erectors, Inc. $10,659.00 BCI Construction, Inc. $181,536.42 Crawford Door Sales Company Twin Cities, Inc. $66,633.00 Northern Glass & Glazing $223,250.00 Multiple Concepts Interiors $34,356.70 Henkemeyer Coatins, Inc. $2,850.00 Brothers Fire Protection Co. $66,813.54 Masters Plumbing Heating & Cooling LLC $222,154.65 Klein Electric, Inc. $48,241.13 Belair Builders, Inc. $23,697.58 Voss Plumbing & Heating of Paynesville, Inc. $33,824.75 In accordance with Minnesota Statute, the City is withholding the maximum of 5% retainage of work completed, which amounts to $422,062.12 at this time. SUPPORTING DOCUMENTS ATTACHED: • Pay Application #12 POSSIBLE MOTION PLEASE WORD MOTION AS YOU WOULD LIKE IT TO APPEAR IN THE MINUTES: Motion to approve Pay Application #12 in the amount of $1,018,591.35 for work completed on the Fire Station project. BUDGET INFORMATION FUNDING: BUDGETED: Fund 446 – Fire Station Facility Yes AIA® DOCUMENT G736 - 2009Project Application and Project Certificate for Payment, Construction Manager as Adviser EditionCity Of Otsego New Fire StationPROJECT:City Of Otsego APPLICATION NO: 1214499 75th St Ne New Fire StationPERIOD TO: 11/30/2025OWNEROtsego, MN 55330 Otsego, MNPROJECT NO: 2410290CONSTRUCTION MANAGERARCHITECTVIA CONSTRUCTIONAdam FlahertyMANAGER:Kraus-Anderson Construction Co. PROJECT APPLICATION FOR PAYMENTPROJECT CERTIFICATE FOR PAYMENTApplication is made for Payment, as shown below, in connection with the Project. AIADocument G737-2009, Summary of Contractors' Applications for Payment, is attached.1. TOTAL CONTRACT SUMS (Item A Totals)$14,018,369.002. TOTAL NET CHANGES BY CHANGES IN THE WORK (Item B Totals)$51,279.933. TOTAL CONTRACT SUM TO DATE (Item C Totals) $14,069,648.934. TOTAL COMPLETED & STORED TO DATE (Item F Totals)$8,441,242.215. RETAINAGE (Item H Totals)$422,062.12 6. LESS PREVIOUS TOTAL PAYMENTS (Item I Totals)$7,000,588.747. CURRENT PAYMENT DUE (Item J Totals)$1,018,591.35 TOTAL OF AMOUNTS CERTIFIED…………………….. $1,018,591.35The undersigned Construction Manager certifies that to the best of its knowledges, information CONSTRUCTION MANAGER: Kraus-Anderson Construction Companyand belief this Project Application for Payment is an accurate compilation of the Contractors'Applications for Payment, attached hereto. By: _______________________________________ Date: 12/01/25CONSTRUCTION MANAGER: Kraus-Anderson Construction CompanyBy:_________________________________________________________Date:12/01/25State of: MinnesotaCounty of: HennepinSubscribed and sworn to before me this 1st day of December, 2025ARCHITECT: Wold Architects & EngineersNotary Public: By: _______________________________________ Date: My Commission expires: January 31, 2029AIA DOCUMENT G736 - 2009 (formerly G722/CMa - 1992). COPYRIGHT © 1981,1992 and 2009 by The American Institute of Architects.Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's AuthenticityTO OWNER:ATTENTION: DISTRIBUTION TO:In accordance with the Contract Documents, based evaluation of the Work and the data comprising this Application, the Construction Manager certified to the Owner that to the best of its knowledge, information and belief the Work has progressed as indicated; the quality of the Work is in accordance with the Contract Documents; and the Construction Manager recommends to the Owner and Architect that the Contractors be paid the AMOUNTS set forth in the attached Summary of Contractors' Applications for Payment.In accordance with the Contract Documents, based evaluation of the Work and the data comprising this Application, the Construction Manager's recommendation, the Architect certifies to the Owner, that to the best of its knowledge, information and belief the Work has progressed as indicated; the quality of the Work is in accordance with the Contract Documents; and the Contractors are entitled to payments of the AMOUNTS set for in the attached Summary of Contractors' Applications for Payment.Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA065712/2/2025 | 1:39 PM CST AIA DOCUMENT G737 - 2009Summary of Contractors' Applications for Payment, Construction Manager as Adviser EditionAIA Document G732, Application and Certificate for Payment, hasAPPLICATION NO.:12been completed by each Contractor. The content of those G732APPLICATION DATE:11/30/2025forms is summarized belowPERIOD FROM:11/1/2025Otsego Fire StationPERIOD TO:11/30/2025PROJECT NOS.:2410290A B C D E F G H IJK LSTORED TOTALMATERIALS COMPLETED ANDCURRENTBALALANCE %ORIGINAL NET CHANGES IN CONTRACT SUM WORK IN PLACE (Not in D or I) STORED TO DATE RETAINAGE RETAINAGE PREVIOUSPAYMENTFINISH COMPL.DESCRIPTION OF WORK CONTRACTOR'S NAMECONTRACT SUM THE WORK TO DATE TO DATE(D + E) %AMOUNTPAYMENTS(F - H - I)(C - F) (F / C)WS-01J Final Cleaning Prime Solutions, LLC DBA Prime Construction Solutions $35,000.00 $0.00 $35,000.00 $0.00 $0.00 $0.00 5.00% $0.00 $0.00$0.00$35,000.00 0%WS-03A Concrete & Masonry Package Voss Plumbing & Heating Of Paynesville, Inc $767,212.00 $13,584.50 $780,796.50 $606,173.00 $0.00 $606,173.00 5.00% $30,308.65 $471,289.77$104,574.58$174,623.50 78%WS-03B Precast Structural Concrete Molin Concrete Products Company $1,456,510.00 ($1,865.00) $1,454,645.00 $1,454,645.00 $0.00 $1,454,645.00 5.00% $72,732.25 $1,381,912.75$0.00$0.00 100%WS-03D Specially Finished Concrete Quality Cleaning Inc, DBA QC Companies $26,625.00 $0.00 $26,625.00 $0.00 $0.00 $0.00 5.00% $0.00 $0.00$0.00$26,625.00 0%WS-05A Structural Steel Material Only JRK Steel, Inc $575,531.00 $0.00 $575,531.00 $373,972.00 $0.00 $373,972.00 5.00% $18,698.60 $355,273.40$0.00$201,559.00 65%WS-05B Structural Steel Erection Spartan Steel Erectors, Inc $150,000.00 $1,405.25 $151,405.25 $134,025.25 $0.00 $134,025.25 5.00% $6,701.26 $116,664.99$10,659.00$17,380.00 89%WS-06A/07F/09A Carpentry, Metal Panels, Drywall BCI Construction, Inc $1,030,000.00 $7,566.30 $1,037,566.30 $573,554.03 $0.00 $573,554.03 5.00% $28,677.70 $363,339.91$181,536.42$464,012.27 55%WS-07H Roofing Package Roof Tech, Inc $755,620.00 $15,341.51 $770,961.51 $629,491.26 $0.00 $629,491.26 5.00% $31,474.57 $598,016.69$0.00$141,470.25 82%WS-07K Joint Sealants Carciofini Company $41,900.00 $0.00 $41,900.00 $0.00 $0.00 $0.00 5.00% $0.00 $0.00$0.00$41,900.00 0%WS-08A Doors, Frames, and Hardware Contract Hardware Co., Inc $284,972.00 $0.00 $284,972.00 $146,549.00 $0.00 $146,549.00 5.00% $7,327.45 $139,221.55$0.00$138,423.00 51%WS-08D/08E Four Fold Doors/Sectional Overhead Door Crawford Door Sales Company Twin Cities, Inc $458,540.00 $0.00 $458,540.00 $70,140.00 $0.00 $70,140.00 5.00% $3,507.00 $0.00$66,633.00$388,400.00 15%WS-08F Exterior Glass & Glazing Northern Glass & Glazing $358,700.00 $0.00 $358,700.00 $273,570.00 $0.00 $273,570.00 5.00% $13,678.50 $36,641.50$223,250.00$85,130.00 76%WS-09B Tile Tim's Construction Group, LLC $140,000.00 $0.00 $140,000.00 $7,900.00 $0.00 $7,900.00 5.00% $395.00 $7,505.00$0.00$132,100.00 6%WS-09C Ceiling & Acoustical Treatment Sonus Interiors, Inc $148,000.00 $0.00 $148,000.00 $2,000.00 $0.00 $2,000.00 5.00% $100.00 $1,900.00$0.00$146,000.00 1%WS-09D Flooring Resilient & Carpet M.C.I., Inc, DBA Multiple Concepts Interiors $53,764.00 $0.00 $53,764.00 $36,164.95 $0.00 $36,164.95 5.00% $1,808.25 $0.00$34,356.70$17,599.05 67%WS-09H Fluid Applied Flooring Grazzini Brothers & Company $29,700.00 $0.00 $29,700.00 $650.00 $0.00 $650.00 5.00% $32.50 $617.50$0.00$29,050.00 2%WS-09K Wall Covering & Painting Henkemeyer Coatins, Inc $124,210.00 $0.00 $124,210.00 $3,000.00 $0.00 $3,000.00 5.00% $150.00 $0.00$2,850.00$121,210.00 2%WS-12C Manufactured Casework Woodside Industries, Inc $272,575.00 $0.00 $272,575.00 $15,859.85 $0.00 $15,859.85 5.00% $792.99 $15,066.86$0.00$256,715.15 6%WS-21A Fire Supression Brothers Fires Protection Co. DBA Brothers Fire & Security $133,600.00 $0.00 $133,600.00 $107,272.30 $0.00 $107,272.30 5.00% $5,363.62 $35,095.14$66,813.54$26,327.70 80%WS-23B Combined Mechanical Masters Plumbing Heating & Cooling, LLC $3,135,000.00 $2,441.55 $3,137,441.55 $1,587,877.50 $0.00 $1,587,877.50 5.00% $79,393.88 $1,286,328.97$222,154.65$1,549,564.05 51%WS-26A Electrical Klein Electric, Inc $1,693,205.00 ($24,669.00) $1,668,536.00 $797,801.20 $0.00 $797,801.20 5.00% $39,890.06 $709,670.01$48,241.13$870,734.80 48%WS-31A Site Clearing & Earthwork Belair Builders, Inc. DBA Belair Sitework Services $1,429,318.00 $37,474.82 $1,466,792.82 $1,402,782.87 $0.00 $1,402,782.87 5.00% $70,139.14 $1,308,946.15$23,697.58$64,009.95 96%WS-32A Asphalt Paving Omann Contracting Companies, Inc $189,800.00 $0.00 $189,800.00 $0.00 $0.00 $0.00 5.00% $0.00 $0.00$0.00$189,800.00 0%WS-32B Concrete Paving Voss Plumbing & Heating Of Paynesville, Inc $340,687.00 $0.00 $340,687.00 $217,814.00 $0.00 $217,814.00 5.00% $10,890.70 $173,098.55$33,824.75$122,873.00 64%WS-32F Landscaping Grennscape Companies, Inc $387,900.00 $0.00 $387,900.00 $0.00 $0.00 $0.00 5.00% $0.00 $0.00$0.00$387,900.00 0%$14,018,369.00 $51,279.93 $14,069,648.93 $8,441,242.21 $0.00 $8,441,242.21 5.00% $422,062.12 $7,000,588.74 $1,018,591.35 $5,628,406.72 60.0%AIA DOCUMENT G737 - 2009 (formlerly G723CMa - 1992) · Copyright ©1992 and 2009 by The Amiercan Institutue of Architects.Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's AuthenticityTOTALSDocusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 12/1/2025104,574.58471,289.77104,574.58MMWS 03-ADocusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA065712/2/2025 | 1:39 PM CST Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 APPLICATION AND CERTIFICATION FOR PAYMENT,Construction Manager as Adviser Edition TO OWNER: FROM CONTRACTOR: Spartan Steel Erectors,Inc. PO Box 215 Mound,MN 55364 Contract for Bid Steel ErectionPackage: PROJECT:Otsego Fire Station VIA CONSTRUCTION MANAGER:Kraus Anderson VIA ARCHITECT: APPLICATION NO:2508-5 PERIOD TO:11.30.25 CONTRACT FOR: CONTRACT DATE: PROJECT NOS: AIA DOCUMENTG732 -2009 Distribution to: OWNER CONSTRUCTION MANAGER ARCHITECT CONTRACTOR FIELD CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment,as shown below,in connection with the Contract. Continuation Sheet,AIA Document G703,is attached. 1.ORIGINAL CONTRACT SUM 2.NET CHANGE BY CHANGE ORDERS 3.CONTRACT SUM TO DATE (Line 1 ±2) 4.TOTAL COMPLETED &STORED TO DATE (Column G on G703) 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 b the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Ovmer,and that current payment shown herein is now due. s s 6,701.26 150,000 oo 1,405.25 151,405.25 134,025.25 6,701.26 127,323.99 116,664.99 10,659 oo DEDUCTIONS 1,405.25 CONTRACTOR. By: State of: Date: County of:5.RETAINAGE: a. b. 5 %Of Completed Work (Column D +E on G703) %of Stored Material (Column F on (3703) Total Retainage (Lines Sa +5b or Total in Column I of G703) Subscribed and sworn to before me this OJ—f day of Notary Public:_-.AZ22Zu_Lä-—My Commission expires: CERTIFICATE FOR PAYMENT In accordance with the Contract Documents,based on on-site observations and the data comprismg the 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 quallty of the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment ofthe AMOUNT CERTIFIED. 6.TOTAL EARNED LESS RETAINAGE (Line 4 Less Line 5 Total) 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Cefilficate) 8.CURRENT PAYMENT DUE 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Line 3 minus Line 6) CHANGE ORDER SUMv1ARY Total changes approved in previous months by Owner Total approved this Month TOTALS NET CHANGES by Change Order AMOUNT CERTIFIED 10,659.00 s ADDITIONS 1,405.25 1,405.25 AIA DOCUMENT G702 -APPLICATION AND CERTIFICATION FOR PAYMENT 1992 EDITION AIA 01992 (Attach explanation if amount certified differsfrom the amount applied.Initial all figures on this Application and onthe Continuation Sheet that are changed to conform with the amount certified.) CONSTRUCTION MANAGER: Date. ARCHITECT:(NOTE:If Multiple Prime constractors are responsible for performing portions of the Project,the Architect's Certification IS not required.) Date: This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Contractornamed herein.Issuance,payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE,N.w.,WASHINGTON,DC 20006-5292 Users may obuin validation of this document by requesting a completed AIA Document D401 -Certification of Document's Authenticity from the Licensee. 12/1/2025 27,801.26 WS 05-B City of Otsego Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 12/2/2025 | 1:39 PM CST KRAUS ANDERSON Architect: Owner: Project Name:Otsego Fire Station 6703 APPLICATION FOR PAYMENT SCHEDULE -G703 SPARTAN STEEL ERECTORS,INC. APPLICATION NO:2508-5 APPLICATION DATE: PERIOD TO: PROJECT NOS: 1 1124/2025 1 1 /30/2025 WORK COMPLETED ITEM NO. 001 002 003 004 005 006 007 008 009 SCHEDULED VALUE $40,000.00 $9,000.00 $25,000.00 $10,000.00 $1 ,405.25 $0.00 $720.00 $0.00 $0.00 $0.00 $0.00 $0voo $155,125.25 FROM PREVIOUS APPLICATION $6,000.00 $60,000.00 $40,000.00 $9,000.00 $5,000.00 $1,400.00 $1,405.25 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $122,805.25 THIS MATERIALS PRESENTLY TOTAL COMPLETED AND STORED TO DATE (D+E+F) $6,000.00 $60,000.00 $40,000 00 $9,000.00 $12,500 00 $11400 00 $1,405.25 $0.00 $3,720.00 $0 00 $0 00 $0.00 $0 00 $0.00 $0.00 $0 00 $0.00 $0.00 $0.00 $0.00 $0 00 $0.00 $0 00 $0.00 $0.00 $0 00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0 00 $0.00 $0.00 $134,025.25 RETAINAGE (IF VARIABLEBALANCETODESCRIPTIONOFWORK Bonds Structural -erection labor Joists -erection labor Deck -erection labor Misc.Metals -erection labor Allowance -erection labor co #1 CO#2 CO #3 -COR TOTAL APPLICATION STORED PERIOD $0.00 $0.00 $0.00 $0.00 $7,500.00 $0.00 $0.00 $0.00 $3,720.00 $0.00 $0.00 $0.00 $0.00 $0.00 $11,220.00 (NOT IN D OR $0.00 $0.00 Page 1 100.00% 100.00% 100.00% 100.00% 50.00% 14.00% 100.00% #DIV/O! 100.00% #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! #DIV/O! 0.86398088 FINISH $0.00 $0.00 $0.00 $0.00 $12,500.00 $8,600.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0 00 $0 00 $0.00 $0.00 $0.00 $0 00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $21,100.00 RATE) 50/0 $300.00 $3,000.00 $2,000.00 $450.00 $625.00 $70.00 $70.26 $0.00 $186.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $6,701.26 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Construction Manager:12/1/2025181,536.42WS 06-AWS 07-FWS-09ADocusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA065712/2/2025 | 1:39 PM CST Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 PICTURES OF THE STORED MATERIAL ARE ATTACHED AND INSURANCE IS ON FILE12/1/202566,633.00WS 08-DDocusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA065712/2/2025 | 1:39 PM CST Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 10/15/2025 (651)379-7800 North Risk Partners 2010 Centre Pointe Blvd. Mendota Heights MN 55120 (651)379-7801 charlie.raeker@northriskpartners.com 00107567 Crawford Door Sales Company 1641 Oakdale Avenue P.O. Box 18143 West St. Paul MN 55118 Cincinnati Insurance Company P O Box 145496 Cincinnati OH 45250-5496 EPP 0572922 4/1/2025 4/1/2026 Business Personal Property Including Property of Others,681,408 2,500 Replacement Cost/Agreed Amount; Special form including theft City of Otsego c/o Kraus-Anderson Construction 501 S 8th St. Minneapolis, MN 55404 subsinsurance@krausanderson.com Charlie Raeker/BMGBP1 Loc# 00001/Bldg# 00001 1641 Oakdale Ave West St. Paul, MN 55118 LOAN # AUTHORIZED REPRESENTATIVE NAME AND ADDRESS ADDITIONAL INTEREST LOSS PAYEE ADDITIONAL INSUREDMORTGAGEE REMARKS (Including Special Conditions) EVIDENCE OF PROPERTY INSURANCE DATE (MM/DD/YYYY) COMPANY THIS REPLACES PRIOR EVIDENCE DATED: EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL TERMINATED IF CHECKED POLICY NUMBERLOANNUMBERINSURED CODE:SUB CODE: AGENCY CUSTOMER ID #: THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY ADDRESS: E-MAILFAX (A/C, No): (A/C, No, Ext):PHONE DEDUCTIBLEAMOUNT OF INSURANCECOVERAGE / PERILS / FORMS COVERAGE INFORMATION LOCATION/DESCRIPTION PROPERTY INFORMATION THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. The ACORD name and logo are registered marks of ACORD ACORD 27 (2009/12)©1993-2009 ACORD CORPORATION.All rights reserved. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INS027 (200912).02 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Project: Otsego Fire Station Kraus-Anderson Construction Company and the Owner are loss payee as respects materials being stored at insured's premises in the amount of $70,140. COMMENTS/REMARKS COPYRIGHT 2000, AMS SERVICES INC.OFREMARK Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Construction Manager:Date:Date:Architect:12/1/2025223,250.0036,641.50223,250.00MMWS 08-FPICTURES OF THE STORED MATERIAL ARE ATTACHED AND INSURANCE IS ON FILEDocusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA065712/2/2025 | 1:39 PM CST 30,000.0038,570.0065,000.002,500.003,500.0010,000.0090,000.004,000.00175,000.0060,000.0060,000.00Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 09/24/2025 J.A. Price Agency, Inc. 6640 Shady Oak Road, Suite 500 Eden Prairie MN 55344-6176 Jeanette Kraemer (952) 944-8790 (952) 944-0097 jeanette.kraemer@japrice.com 00004617 Northern Glass & Glazing, Inc. 165 W 88TH St Bloomington MN 55420-2804 Selective Insurance Co. of America 12572 25-26 Stored Materials 155-165 WEST 88TH STREET BLOOMINGTON MN 55420 A 2,500 S 2121461 06/01/2025 06/01/2026 BPP incl Stock 500,000 Project: Otsego Fire Station Stored Materials at 165 W 88th St, Bloomington, MN Storing - $30,000 of Aluminum Doors & Frames City of Otsego c/o Kraus-Anderson Construction Company 501 South 8th Street Minneapolis MN 55404 INSURER(S) AFFORDING COVERAGE NAIC # INSURER F : INSURER E : INSURER D : NAME:CONTACT INSURER C : INSURER B : (A/C, No):FAX E-MAILADDRESS: CUSTOMER ID: PRODUCER PRODUCER (A/C, No, Ext):PHONE INSURED INSURER A : The ACORD name and logo are registered marks of ACORD THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. LOCATION OF PREMISES / DESCRIPTION OF PROPERTY (Attach ACORD 101, Additional Remarks Schedule, if more space is required) REVISION NUMBER:CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COVERAGES $$ $BOILER & MACHINERY / EQUIPMENT BREAKDOWN $ $ $ TYPE OF POLICY CRIME POLICY NUMBER $ $ $ $ NAMED PERILS CAUSES OF LOSS TYPE OF POLICYINLAND MARINE $ RENTAL VALUE CONTENTS BUILDING DEDUCTIBLES WIND $ $ $ $ $ $ $ $ $ BLANKET BLDG & PP BLANKET PERS PROP BLANKET BUILDING EXTRA EXPENSE BUSINESS INCOME PERSONAL PROPERTY BUILDING FLOOD EARTHQUAKE SPECIAL BROAD BASIC CAUSES OF LOSS PROPERTY POLICY EXPIRATION DATE (MM/DD/YYYY) POLICY EFFECTIVE DATE (MM/DD/YYYY) INSR LTR LIMITSCOVERED PROPERTYPOLICY NUMBERTYPE OF INSURANCE $$ $ SPECIAL CONDITIONS / OTHER COVERAGES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) © 1995-2015 ACORD CORPORATION. All rights reserved. ACORD 24 (2016/03) AUTHORIZED REPRESENTATIVE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CANCELLATION CERTIFICATE OF PROPERTY INSURANCE DATE (MM/DD/YYYY) CERTIFICATE HOLDER Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 PICTURES OF THE STORED MATERIAL ARE ATTACHED AND INSURANCE IS ON FILE12/1/202534,356.70WS 09-DDocusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA065712/2/2025 | 1:39 PM CST Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 12/1/2025WS 09-KDocusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA065712/2/2025 | 1:39 PM CST Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Construction Manager:12/1/202566,813.54WS 21-ACity of OtsegoDocusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA065712/2/2025 | 1:39 PM CST Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 12/1/2025 222,154.65 1,286,328.97 1,508,483.62 WS 23-B Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 12/2/2025 | 1:39 PM CST Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Construction Manager:12/1/2025WS 26-ADocusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA065712/2/2025 | 1:39 PM CST Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER-ADVISER EDITION AIA DOCUMENT G702/CMa (Instruction on reverse side)PAGE ONE OF TWO PAGES PROJECT: City of Otsego New Fire Station APPLICATION NO.: Distribution to: 14499 57th Street NE PERIOD TO: 11/30/2025 OWNER Otsego, MN 55330 PROJECT NOS.: ARCHITECT CONTRACTOR FROM CONTRACTOR: Belair Builders, Inc. dba Belair Sitework Services CONTRACT DATE: 11/15/24 2200 Old Highway 8 NW New Brighton, MN 55112 BELAIR JOB NO.: 40590-30/50 VIA CONSTRUCTION MANAGER: Kraus-Anderson Minneapolis CONTRACT FOR: Earthwork & Site Utilities VIA ARCHITECT: Wold Architects & Engineers Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document G703, is attached. 1.ORIGINAL CONTRACT SUM 1,429,318.00$ 2.Net Change By Change Orders 37,474.82$ CONTRACTOR: 3.CONTRACT SUM TO DATE (Line 1 +/- 2)1,466,792.82$ By: __________________________________________________________ Date: __11/20/25________________ 4.TOTAL COMPLETED & STORED TO DATE 1,402,782.87$ (Column G on G703) State of: Minnesota 5.RETAINAGE:County of: Ramsey a. 5% of Completed Work 70,139.14$ Subscribed and sworn to before (Columns D + E on G703) me this 20th day of November, 2025. b. 5% of Stored Material Notary Public: (Column F on G703) My Commission expires: 1/31/2027 Total Retainage (Line 5a + 5b or Total in Column I of G703) 70,139.14$ 6.TOTAL EARNED LESS RETAINAGE 1,332,643.73$ (Line 4 less Line 5 Total) 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT 1,308,946.15$ (Line 6 from prior Certificate) 8.CURRENT PAYMENT DUE 23,697.58$ 9.BALANCE TO FINISH, INCLUDING RETAINAGE AMOUNT CERTIFIED $ (Line 3 less Line 6) 134,149.09$ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS CONSTRUCTION MANAGER: Total changes approved in By: __________________________________________________________ Date: ________________________ previous month by Owner ARCHITECT: Total approved this Month By: __________________________________________________________ Date: ________________________ TOTALS 37,474.82 - NET CHANGES by Change Order 37,474.82 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. Jennifer Lee CERTIFICATE FOR PAYMENT CONTRACTOR'S APPLICATION FOR PAYMENT 37,474.82 In accordance with the Contract Documents, based on on-site observations and the data comprising this application, the Construction Manager and Architect certify to the Owner that to the best of their 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. 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 from the Owner, and that current payment shown herein is now due. (Attach explanation if amount certified differs from the amount applied for. Initial all figures on this application and on the Continuation Sheet that changed to conform to the amount certified.) 7 12/1/2025 23,697.58 WS 31-A To: City Of Otsego Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 12/2/2025 | 1:39 PM CST CONTINUATION SHEET PAGE TWO OF TWO PAGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT,APPLICATION NO.: containing Contractor's signed Certification, is attached.APPLICATION DATE:11/20/25 In tabulations below, amounts are stated to the nearest dollar.PERIOD TO:11/30/25 Use Column I on Contracts where variable retainage for line items may apply.CUSTOMER PROJECT NO: A B C D E F H I MATERIALS TOTAL ITEM SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED BALANCE RETAINAGE NO.DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED %TO (IF VARIABLE (D + E)(NOT IN TO DATE (G / C)FINISH RATE) D OR E)(D + E + F)(C - G) EARTHWORK 500 Flag Pole Furnish & Install 3,632.00 3,632.00 3,632.00 100.00% - 181.60 600 Work Scope Allowance 20,000.00 2,472.80 9,266.00 11,738.80 58.69% 8,261.20 586.94 315 Equipment Moves 59,650.00 59,650.00 59,650.00 100.00% - 2,982.50 320 Erosion Control 80,406.00 77,058.00 77,058.00 95.84% 3,348.00 3,852.90 325 Site Demolition & Clearing 21,682.00 21,682.00 21,682.00 100.00% - 1,084.10 330 Site Grading 211,704.00 204,304.00 204,304.00 96.50% 7,400.00 10,215.20 350 Structure Excavation and Backfill 30,407.00 30,407.00 30,407.00 100.00% - 1,520.35 351 Building Pad Class 5 Cushion 43,275.00 43,275.00 43,275.00 100.00% - 2,163.75 352 Building Sand Subbase for Draintile at Doors & Footed Stoops 30,694.00 30,694.00 30,694.00 100.00% - 1,534.70 355 Site Finishing 359,657.00 314,656.25 314,656.25 87.49% 45,000.75 15,732.81 360 Temp. Construction Fabric - 7 rolls - - 0.00% - - 361 Temp. Construction 3-inch Rock - 1,051 ton - - 0.00% - - 362 Temp. Construction 3/4-inch to 1 1/2-inch Rock - 525 ton - - 0.00% - - UTILITIES 400 Mobilization 3,178.00 3,178.00 3,178.00 100.00% - 158.90 405 Removals 3,437.00 3,437.00 3,437.00 100.00% - 171.85 410 Sanitary Sewer 46,008.00 46,008.00 46,008.00 100.00% - 2,300.40 415 Watermain 311,733.00 311,733.00 311,733.00 100.00% - 15,586.65 420 Storm Sewer 203,551.00 203,551.00 203,551.00 100.00% - 10,177.55 425 Trench Drain (Supply Only) 304.00 304.00 304.00 100.00% - 15.20 CO 001 -Additional Tree Removal 5,380.00 5,380.00 5,380.00 100.00% - 269.00 CO 002 -Change FES with Riprap to FES with ACM 16,416.00 16,416.00 16,416.00 100.00% - 820.80 CO 003 - RFI 036 Updated Schedule - No Cost - - - - - 0.00% - - CO 004 - Extend Excavation for Watermain Connection 15,678.82 15,678.82 15,678.82 100.00% - 783.94 1,466,792.82 1,377,838.05 24,944.82 - 1,402,782.87 95.64% 64,009.95 70,139.14 AIA DOCUMENT G703 (Instructions on reverse side) WORK COMPLETED G 7 Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657 12/1/202533,824.75WS 32-BCity of OtsegoDocusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA065712/2/2025 | 1:39 PM CST Docusign Envelope ID: 8D5F4264-A420-4F1C-96E7-085C72BA0657