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Item 3.3 Fire Station Facility Project Pay Application 14 Request for City Council Action DEPARTMENT INFORMATION ORIGINATING DEPARTMENT REQUESTOR: MEETING DATE: Public Safety Interim Fire Chief Scott February 23, 2026 PRESENTER(s) REVIEWED BY: ITEM #: Consent Kraus-Anderson City Administrator/Finance Director Flaherty 3.3 – 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 #14 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 #14 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 thirteen individual work scope requests included within Pay Application #14 for a total of $678,146.30: Voss Plumbing & Heating of Paynesville, Inc. $41,161.12 Quality Cleaning, Inc. $5,011.25 Spartan Steel Erectors, Inc. $7,600.00 BCI Construction, Inc. $82,943.24 Roof Tech, Inc. $55,921.75 Northern Glass & Glazing $19,000.00 Sonus Interiors, Inc. $23,750.00 Henkemeyer Coatings, Inc. $6,650.00 Woodside Industries, Inc. $67,572.35 Brothers Fire Protection Co. $3,648.00 Masters Plumbing Heating & Cooling LLC $265,004.70 Klein Electric, Inc. $95,303.33 Belair Builders, Inc. $4,580.56 In accordance with Minnesota Statute, the City is withholding the maximum of 5% retainage of work completed, which amounts to $537,343.54 at this time. SUPPORTING DOCUMENTS ATTACHED: • Pay Application #14 POSSIBLE MOTION PLEASE WORD MOTION AS YOU WOULD LIKE IT TO APPEAR IN THE MINUTES: Motion to approve Pay Application #14 in the amount of $678,146.30 for work completed on the Fire Station project. BUDGET INFORMATION FUNDING: BUDGETED: Fund 446 – Fire Station Facility Yes AIA® DOCUMENT G736 - 2009 Project Application and Project Certificate for Payment, Construction Manager as Adviser Edition City Of Otsego New Fire Station PROJECT:City Of Otsego APPLICATION NO: 14 14499 75th St Ne New Fire Station PERIOD TO: 1/31/2026 OWNER Otsego, MN 55330 Otsego, MN PROJECT NO: 2410290 CONSTRUCTION MANAGER ARCHITECT VIA CONSTRUCTION Adam Flaherty MANAGER:Kraus-Anderson Construction Co. PROJECT APPLICATION FOR PAYMENT PROJECT CERTIFICATE FOR PAYMENT Application is made for Payment, as shown below, in connection with the Project. AIA Document G737-2009, Summary of Contractors' Applications for Payment, is attached. 1. TOTAL CONTRACT SUMS (Item A Totals)$14,018,369.00 2. TOTAL NET CHANGES BY CHANGES IN THE WORK (Item B Totals)$62,128.58 3. TOTAL CONTRACT SUM TO DATE (Item C Totals) $14,080,497.58 4. TOTAL COMPLETED & STORED TO DATE (Item F Totals)$10,746,870.69 5. RETAINAGE (Item H Totals)$537,343.54 6. LESS PREVIOUS TOTAL PAYMENTS (Item I Totals)$9,531,380.85 7. CURRENT PAYMENT DUE (Item J Totals)$678,146.30 TOTAL OF AMOUNTS CERTIFIED…………………….. $678,146.30 The undersigned Construction Manager certifies that to the best of its knowledges, information CONSTRUCTION MANAGER: Kraus-Anderson Construction Company and belief this Project Application for Payment is an accurate compilation of the Contractors' Applications for Payment, attached hereto. By: _______________________________________ Date: 02/06/26 CONSTRUCTION MANAGER: Kraus-Anderson Construction Company By:_________________________________________________________Date:02/06/26 State of: Minnesota County of: Hennepin Subscribed and sworn to before me this 6th day of February, 2026 ARCHITECT: Wold Architects & Engineers Notary Public: By: _______________________________________ Date: My Commission expires: January 31, 2029 AIA 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 Authenticity TO 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: 4A984657-F123-4E2F-881D-906942A192FD 2/10/2026 | 5:03 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.:14been completed by each Contractor. The content of those G732APPLICATION DATE:1/31/2026forms is summarized belowPERIOD FROM:1/1/2026Otsego Fire StationPERIOD TO:1/31/2026PROJECT 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 $14,666.40 $781,878.40 $726,028.40 $0.00 $726,028.40 5.00% $36,301.42 $648,565.86$41,161.12$55,850.00 93%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 $5,275.00 $0.00 $5,275.00 5.00% $263.75 $0.00$5,011.25$21,350.00 20%WS-05A Structural Steel Material Only JRK Steel, Inc $575,531.00 $0.00 $575,531.00 $548,972.00 $0.00 $548,972.00 5.00% $27,448.60 $521,523.40$0.00$26,559.00 95%WS-05B Structural Steel Erection Spartan Steel Erectors, Inc $150,000.00 $13,251.05 $163,251.05 $150,151.05 $0.00 $150,151.05 5.00% $7,507.55 $135,043.50$7,600.00$13,100.00 92%WS-06A/07F/09A Carpentry, Metal Panels, Drywall BCI Construction, Inc $1,030,000.00 $7,566.30 $1,037,566.30 $792,783.77 $0.00 $792,783.77 5.00% $39,639.19 $670,201.34$82,943.24$244,782.53 76%WS-07H Roofing Package Roof Tech, Inc $755,620.00 $15,341.51 $770,961.51 $742,016.51 $0.00 $742,016.51 5.00% $37,100.83 $648,993.93$55,921.75$28,945.00 96%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 $168,547.00 $0.00 $168,547.00 5.00% $8,427.35 $160,119.65$0.00$116,425.00 59%WS-08D/08E Four Fold Doors/Sectional Overhead Door Crawford Door Sales Company Twin Cities, Inc $458,540.00 $0.00 $458,540.00 $448,540.00 $0.00 $448,540.00 5.00% $22,427.00 $426,113.00$0.00$10,000.00 98%WS-08F Exterior Glass & Glazing Northern Glass & Glazing $358,700.00 $0.00 $358,700.00 $339,370.00 $0.00 $339,370.00 5.00% $16,968.50 $303,401.50$19,000.00$19,330.00 95%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 $27,000.00 $0.00 $27,000.00 5.00% $1,350.00 $1,900.00$23,750.00$121,000.00 18%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 $34,356.70$0.00$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 $10,000.00 $0.00 $10,000.00 5.00% $500.00 $2,850.00$6,650.00$114,210.00 8%WS-12C Manufactured Casework Woodside Industries, Inc $272,575.00 $0.00 $272,575.00 $86,988.63 $0.00 $86,988.63 5.00% $4,349.42 $15,066.86$67,572.35$185,586.37 32%WS-21A Fire Supression Brothers Fires Protection Co. DBA Brothers Fire & Security $133,600.00 $0.00 $133,600.00 $127,840.00 $0.00 $127,840.00 5.00% $6,392.00 $117,800.00$3,648.00$5,760.00 96%WS-23B Combined Mechanical Masters Plumbing Heating & Cooling, LLC $3,135,000.00 ($245.25) $3,134,754.75 $2,223,189.12 $0.00 $2,223,189.12 5.00% $111,159.46 $1,847,024.96$265,004.70$911,565.63 71%WS-26A Electrical Klein Electric, Inc $1,693,205.00 ($24,061.25) $1,669,143.75 $1,122,995.74 $0.00 $1,122,995.74 5.00% $56,149.79 $971,542.62$95,303.33$546,148.01 67%WS-31A Site Clearing & Earthwork Belair Builders, Inc. DBA Belair Sitework Services $1,429,318.00 $37,474.82 $1,466,792.82 $1,407,604.52 $0.00 $1,407,604.52 5.00% $70,380.23 $1,332,643.73$4,580.56$59,188.30 96%WS-32A Asphalt Paving Omann Contracting Companies, Inc $189,800.00 $0.00 $189,800.00 $102,395.00 $0.00 $102,395.00 5.00% $5,119.75 $97,275.25$0.00$87,405.00 54%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 $206,923.30$0.00$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 $62,128.58 $14,080,497.58 $10,746,870.69 $0.00 $10,746,870.69 5.00% $537,343.54 $9,531,380.85 $678,146.30 $3,333,626.89 76.3%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: 4A984657-F123-4E2F-881D-906942A192FD 2/6/202641,161.12WS 03-ADocusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD2/10/2026 | 5:03 PM CST Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD Construction Manager:2/6/20265,011.25WS 03-DCity of OtsegoDocusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD2/10/2026 | 5:03 PM CST Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD 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:2508-7 PERIOD TO:1.19.26 CONTRACT FOR: CONTRACT DATE: PROJECT NOS: AIA DOCUMENTG732 -2009 Distribution to: OYvNER CONSTRUCTION MANAGER ARCHITECT CONTRACTOR FIELD CONTRACTOR'S APPLICATION FOR PAYMENTApplicationismadeforpayment,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 knowledg information and beliefthe Work covered by this Application for Payment has be completed in accordance with the Contract Documents,that all amounts have been the Contractor for Work for which previous Certificates for Payment were issued payments received from the Owner,and that current payment shown herem is now by CONTRACTOR. State of: Date County of:5.RETAINAGE: a. b. 5 %of Completed Work (Column D +E on (3703) %of Stored Material (Column F on G703) 7,507.55 150,000.00 13,251.05 163,251.05 150,151.05 7,507 55 142,643.50 135,043.50 7,600.00 20,607.55 DEDUCTIONS 13,251.05 Subscribed and sworn to befqreme this |9 Notary Public: My Commission expires • day of 3-oa-& Total Retainage (Lines 5a +5b or Total in Column I ofG703) 6.TOTAL EARNED LESS RETAINAGE (Line 4 Less Line 5 Total) 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Cenificate) 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 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents,based on on-site observations and the data comprising 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 quality of the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED 7,600.00 s s (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.) ADDITIONS 13,251.05 13,251.05 CONSTRUCTION MANAGER: By:Date: ARCHITECT:(NOTE-If Multiple Prime constractors are responsible for performingportions of the Project,the Architect's Certification is not required.) By Date: AIA DOCUMENT G702 APPLICATION AND CERTIFICATION FOR PAYMENT •1992 EDITION •AIA -@1992 This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Contractor named herein.Issuance,payment and acceptance ofpayment 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 20006-5292UsersmayobtainvalidationofthisdocumentbyrequestingacompletedAIADocumentD401-Certification of Document's Authenticity from the Licensee. 2/6/2026 WS 05-B City of Otsego Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD 2/10/2026 | 5:03 PM CST KRAUS ANDERSON Architect: Owner: Project Name:Otsego Fire Station G703 APPLICATION FOR PAYMENT SCHEDULE -G703 SPARTAN STEEL ERECTORS,INC. D APPLICATION NO:2508-7 APPLICATION DATE: PERIOD TO: PROJECT NOS: BALANCE TOITEM NO. 001 002 003 004 005 006 007 008 009 010 c SCHEDULED VALUE $6,000.00 $60,000.00 $40,000.00 $9,000.00 $25,000.00 $10,000.00 $1 ,405.25 $0.00 $3,720.00 $8,125.80 $0.00 $0.00 $0.00 $0.00 $163,251.05 WORK COMPLETED FROM PREVIOUS THIS MATERIALS PRESENTLYDESCRIPTIONOFWORK Bonds Structural -erection labor Joists -erection labor Deck -erection labor Misc.Metals -erection labor Allowance -erection labor co #1 CO #3 -COR TOTAL APPLICATION STOREDAPPLICATION $6,000.00 $60,000.00 $40,000.00 $9,000.00 $12,500.00 $1 ,400.oo $1 ,405.25 $0.00 $3,720.00 $8,125.80 $0.00 $0.00 $0.00 $142,151.05 PERIOD $0.00 $0.00 $0.00 $0.00 $8,000.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $8,000.00 (NOT IN D OR $0.00 $0.00 Page 1 TOTAL COMPLETED AND STORED TO DATE (D+E+F) $6,000.00 $60,000 00 $40,000.00 $9,000.00 $20,500.00 $1 ,400.oo $1405.25 $0.00 $3,720.00 $8,125.80 $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 $150,151.05 100.00% 100.00% 100.00% 100.00% 82.00% 14.00% 100.00% #DIV/O! 100.00% 100.00% #DIV/O! #DIV/OI #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! 0.919755493 FINISH $0.00 $0.00 $0.00 $0.00 $4,500.00 $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 $0.00 $13,100.00 1/19/2026 1/31/2026 RETAINAGE (IF VARIABLE RATE) 5% $300.00 $3,000.00 $2,000.00 $450.00 $1,025.00 $70.00 $70.26 $0.00 $186.00 $406.29 $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 $7,507.55 Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD Construction Manager:2/6/202682,943.24WS 06-AWS 07-FWS 09-ADocusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD2/10/2026 | 5:03 PM CST Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD 1-26-2026 Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD PICTURES OF THE STORED MATERIAL ARE ATTACHED AND INSURANCE IS ON FILE5Construction Manager:2/6/202655,921.75WS 07-HDocusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD2/10/2026 | 5:03 PM CST 5Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 1/26/2026 Holmes Murphy &Associates 2727 Grand Prairie Parkway Waukee IA 50263 Maren Curley 612-322-6070 mcurley@holmesmurphy.com Western National Mutual Insurance Co 15377 ROOTECPC1 Roof Tech,Inc. 1775 Industrial Blvd S P.O.Box 708 Stillwater MN 55082 586290516 A X 1,000,000 X 300,000 X Contr Liab Per 10,000 X Policy Form/XCU 1,000,000 2,000,000 X CPP1004411 12/31/2025 12/31/2026 2,000,000 A 1,000,000 X X X X Comp:$2,000 X Coll:$2,000 CPP1017004 12/31/2025 12/31/2026 Hired Auto Phys Dmg ACV up to 50,000 A X X 5,000,000UMB100059812/31/2025 12/31/2026 5,000,000 X 10,000 A X N WCV1000403 12/31/2025 12/31/2026 500,000 500,000 500,000 A A Contractors Equip -Leased/Rented Property -Replacement Cost Special Form CPP1004382 CPP1004411 12/31/2025 12/31/2025 12/31/2026 12/31/2026 ACV up to $200,000 Building:$1,406,532 Contents:$100,000 Deductible:$500 Deductible:$1,000 Deductible:$1,000 Project:City of Otsego Fire Station Value of stored materials:$58,865.00 Storage Location: RPI Investments,LLC 1775 Industrial Blvd S Stillwater,MN 55082 City of Otsego c/o Kraus-Anderson Construction 501 South 8th Street Minneapolis MN 55404 Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD Construction Manager:Architect:Date:Date:2/6/202636,298.50WS 08-F358,700.000.00Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD2/10/2026 | 5:03 PM CST This change order was not written yet358,700.0019,330.00401/2026Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD 2/6/202623,750.00WS 09-CCity of OtsegoDocusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD2/10/2026 | 5:03 PM CST Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD 2/6/2026WS 09-KDocusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD2/10/2026 | 5:03 PM CST Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD 2/6/2026 67,572.35 WS 12-C Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD 2/10/2026 | 5:03 PM CST Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD APPLICATION AND CERTIFICATE FOR PAYMENT TO PROJECT: SC00126 CITY OTSEGO NEW FIRE STATION FROM: Brothers Fire & Security 9950 East Highway 10 CONTRACT FOR: Elk River, MN55330 CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet 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) 5. RETAINAGE: a. 5.00 % of Completed Work (Columns D + E) b. 5.00 % of Stored Material (Column F) Total Retainage (Line Sa+ Sb or Total in Column I) ................. . 6. TOTAL EARNED LESS RETAINAGE .......... . (Line 4 less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 8. CURRENT PAYMENT DUE .................. . 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) CHANGE O~ER SUMMARY ADDITIONS Total changes approved in previous months by Owner 0.00 Total approved this Month 0.00 TOTALS 0.00 NET CHANGES by Change Order ~0.0-0 $133,600.00 $0.00 $133,600.00 $127,840.00 $6,392.00 $0.00 $6,392.00 $121,448.00 $117,800.00 $3,648.00 $12,152.00 DEDUCTIONS 0.00 0.00 0.00 APPLICATION NO.: 5 PERIOD TO: Jan 31/26 PROJECT NOS. : oo?Jqr Distribution to: OWNER 0 ARCHITECT 0 CONTRACTOR 0 FIELD D OTHER 0 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 in now due. CONTRACTOR: Brothers Fire & Security By: ~~;?..--,. Date: \-~ State of: Minnesota County of: 'b~ Subscribed and sworn to before me this 24th daY.. of Janua~y1 1..Q2 6 i . _. \. TA,1.''vlY ..JO RC=f=RTS r •.• -:~ .•. ~ .,,.,,._~ 1'!""1 ,-" PL1hl•c • ·:·,, ,.· ~ r • ........ -Notary fubiL " ~~ My commission expires: \-'3l-m1 ARCHITECT'S CERTIFICATE FOR PAYMENT ., In accordance with the Contract Document, based on on-site observations and the data comprising this 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 quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED ............. $ ARCHITECT: By: Date: 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. I J By: Date: Construction Manager:2/6/20263,648.00WS 21-ACity of OtsegoDocusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD2/10/2026 | 5:03 PM CST CONTINUATION SHEET APPLICATION NO.: 5 PERIOD TO: Jan 31/26 APPLICATION DATE: Jan 24/26 PROJECT NO. : SC00126 A B C D I F a H I 'MOU: CQG>Ll'l'ED MATERIALS TOTAL PRESENTLY COMPLETED BALANCE RETAINAGE ITEM DESCRIPTION OF WORK SCHEDULED l'RCIC PRIVIOUS STORED AND STORED ' TO (IF VARIABLE NO. VALUE APPLICATION 'l'HIS PIRIOD (NOT IN TO DATE (G I Cl FINISH RATE) (D + I) DORE) (D+E+F) (C -G) CONTRACT 00001 PERMIT 3800.00 3800.00 0.00 0.00 3800.00 100 0.00 190.00 00002 DESIGN 9000.00 9000.00 0.00 0.00 9000.00 100 0.00 450.00 00003 MATERIAL 71277.00 71277.00 0.00 0.00 71277.00 100 0.00 3563.85 00004 LABOR 48000.00 38400.00 3840.00 0.00 42240.00 88 5760.00 2112.00 00005 BOND 1523.00 1523.00 0.00 0.00 1523.00 100 0.00 76.15 133600.00 124000.00 3840.00 0.00 127840.00 96 5760.00 6392.00 Total Contract 133600.00 124000.00 3840.00 0.00 127840.00 96 5760.00 6392.00 Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD 2/6/2026 265,004.70 WS 23-B Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD 2/10/2026 | 5:03 PM CST Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD Construction Manager:2/6/2026WS 26-ADocusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD2/10/2026 | 5:03 PM CST Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD 2/6/2026To: City of Otsego84,580.56WS 31-ADocusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD2/10/2026 | 5:03 PM CST 8Docusign Envelope ID: 4A984657-F123-4E2F-881D-906942A192FD