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Item 3.3 Fire Station Facility Project Pay Application 19 Request for City Council Action DEPARTMENT INFORMATION ORIGINATING DEPARTMENT REQUESTOR: MEETING DATE: Fire Fire Chief McCoy July 27, 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 #19 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 #19 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 (13) individual work scope requests included within Pay Application #19 for a total of $167,813.70: Prime Solutions, LLC $9,500.00 Voss Plumbing & Heating $8,185.11 Quality Cleaning, Inc. $4,408.00 Spartan Steel Erectors, Inc. $4,690.62 BCI Construction, Inc. $14,280.21 Roof Tech, Inc. $3,287.00 Sonus Interiors, Inc. $2,955.45 Multiple Concepts Interiors $3,311.01 Woodside Industries, Inc. $13,901.70 Brothers Fire & Security $6,680.00 Masters Plumbing Heating & Cooling, LLC $11,638.64 Klein Electric, Inc. $79,631.75 Greenscape Companies, Inc. $5,344.21 In accordance with Minnesota Statute, the City is withholding the maximum of 5% retainage of work completed, which amounts to $681,478.15 at this time. SUPPORTING DOCUMENTS ATTACHED: • Pay Application #19 POSSIBLE MOTION PLEASE WORD MOTION AS YOU WOULD LIKE IT TO APPEAR IN THE MINUTES: Motion to approve Pay Application #19 in the amount of $167,813.70 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: 1914499 75th St Ne New Fire StationPERIOD TO: 6/30/2026OWNEROtsego, 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)$219,945.633. TOTAL CONTRACT SUM TO DATE (Item C Totals) $14,238,314.634. TOTAL COMPLETED & STORED TO DATE (Item F Totals)$14,097,475.695. RETAINAGE (Item H Totals)$681,478.15 6. LESS PREVIOUS TOTAL PAYMENTS (Item I Totals)$13,248,183.847. CURRENT PAYMENT DUE (Item J Totals)$167,813.70 TOTAL OF AMOUNTS CERTIFIED…………………….. $167,813.70The 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: 07/10/26CONSTRUCTION MANAGER: Kraus-Anderson Construction CompanyBy:_________________________________________________________Date:07/10/26State of: MinnesotaCounty of: HennepinSubscribed and sworn to before me this 10th day of July, 2026ARCHITECT: 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: 9FB2DB36-48BA-8A55-80ED-93E27A691B087/15/2026 | 8:31 AM CDT AIA DOCUMENT G737 - 2009Summary of Contractors' Applications for Payment, Construction Manager as Adviser EditionAIA Document G732, Application and Certificate for Payment, hasAPPLICATION NO.:19been completed by each Contractor. The content of those G732APPLICATION DATE:6/30/2026forms is summarized belowPERIOD FROM:6/1/2026Otsego Fire StationPERIOD TO:6/30/2026PROJECT 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 $35,000.00 $0.00 $35,000.00 5.00% $1,750.00 $23,750.00$9,500.00$0.00 100%WS-03A Concrete & Masonry Package Voss Plumbing & Heating Of Paynesville, Inc $767,212.00 $21,378.12 $788,590.12 $786,740.12 $0.00 $786,740.12 5.00% $39,337.01 $739,218.00$8,185.11$1,850.00 100%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 $4,640.00 $31,265.00 $31,265.00 $0.00 $31,265.00 5.00% $1,563.25 $25,293.75$4,408.00$0.00 100%WS-05A Structural Steel Material Only JRK Steel, Inc $575,531.00 ($5,439.00) $570,092.00 $560,842.00 $0.00 $560,842.00 5.00% $28,042.10 $532,799.90$0.00$9,250.00 98%WS-05B Structural Steel Erection Spartan Steel Erectors, Inc $150,000.00 $18,188.55 $168,188.55 $168,188.55 $0.00 $168,188.55 5.00% $8,409.43 $155,088.50$4,690.62$0.00 100%WS-06A/07F/09A Carpentry, Metal Panels, Drywall BCI Construction, Inc $1,030,000.00 $33,347.69 $1,063,347.69 $1,063,347.69 $0.00 $1,063,347.69 5.00% $53,167.41 $995,900.07$14,280.21$0.00 100%WS-07H Roofing Package Roof Tech, Inc $755,620.00 $33,308.05 $788,928.05 $788,928.05 $0.00 $788,928.05 5.00% $39,446.41 $746,194.64$3,287.00$0.00 100%WS-07K Joint Sealants Carciofini Company $41,900.00 $0.00 $41,900.00 $38,495.00 $0.00 $38,495.00 5.00% $1,924.75 $36,570.25$0.00$3,405.00 92%WS-08A Doors, Frames, and Hardware Contract Hardware Co., Inc $284,972.00 $17,714.00 $302,686.00 $295,401.00 $0.00 $295,401.00 5.00% $14,770.05 $280,630.95$0.00$7,285.00 98%WS-08D/08E Four Fold Doors/Sectional Overhead Door Crawford Door Sales Company Twin Cities, Inc $458,540.00 $0.00 $458,540.00 $458,540.00 $0.00 $458,540.00 5.00% $22,927.00 $435,613.00$0.00$0.00 100%WS-08F Exterior Glass & Glazing Northern Glass & Glazing $358,700.00 $9,814.04 $368,514.04 $368,514.04 $0.00 $368,514.04 5.00% $18,425.70 $350,088.34$0.00$0.00 100%WS-09B Tile Tim's Construction Group, LLC $140,000.00 $1,613.00 $141,613.00 $141,613.00 $0.00 $141,613.00 5.00% $7,080.65 $134,532.35$0.00$0.00 100%WS-09C Ceiling & Acoustical Treatment Sonus Interiors, Inc $148,000.00 $5,264.00 $153,264.00 $153,264.00 $0.00 $153,264.00 5.00% $7,663.20 $142,645.35$2,955.45$0.00 100%WS-09D Flooring Resilient & Carpet M.C.I., Inc, DBA Multiple Concepts Interiors $53,764.00 $2,515.32 $56,279.32 $56,279.32 $0.00 $56,279.32 0.00% $0.00 $52,968.31$3,311.01$0.00 100%WS-09H Fluid Applied Flooring Grazzini Brothers & Company $29,700.00 $0.00 $29,700.00 $29,700.00 $0.00 $29,700.00 5.00% $1,485.00 $28,215.00$0.00$0.00 100%WS-09K Wall Covering & Painting Henkemeyer Coatins, Inc $124,210.00 $18,010.00 $142,220.00 $132,220.00 $0.00 $132,220.00 5.00% $6,611.00 $125,609.00$0.00$10,000.00 93%WS-12C Manufactured Casework Woodside Industries, Inc $272,575.00 $5,459.25 $278,034.25 $278,034.25 $0.00 $278,034.25 0.00% $0.00 $264,132.55$13,901.70$0.00 100%WS-21A Fire Supression Brothers Fires Protection Co. DBA Brothers Fire & Security $133,600.00 $0.00 $133,600.00 $133,600.00 $0.00 $133,600.00 0.00% $0.00 $126,920.00$6,680.00$0.00 100%WS-23B Combined Mechanical Masters Plumbing Heating & Cooling, LLC $3,135,000.00 $8,747.02 $3,143,747.02 $3,131,666.10 $0.00 $3,131,666.10 5.00% $156,583.31 $2,963,444.15$11,638.64$12,080.92 100%WS-26A Electrical Klein Electric, Inc $1,693,205.00 ($17,907.72) $1,675,297.28 $1,670,734.26 $0.00 $1,670,734.26 5.00% $83,536.72 $1,507,565.79$79,631.75$4,563.02 100%WS-31A Site Clearing & Earthwork Belair Builders, Inc. DBA Belair Sitework Services $1,429,318.00 $37,474.82 $1,466,792.82 $1,466,792.82 $0.00 $1,466,792.82 5.00% $73,339.64 $1,393,453.18$0.00$0.00 100%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 $335,687.00 $0.00 $335,687.00 5.00% $16,784.35 $318,902.65$0.00$5,000.00 99%WS-32F Landscaping Grennscape Companies, Inc $387,900.00 $27,683.49 $415,583.49 $415,583.49 $0.00 $415,583.49 5.00% $20,779.17 $389,460.11$5,344.21$0.00 100%$14,018,369.00 $219,945.63 $14,238,314.63 $14,097,475.69 $0.00 $14,097,475.69 5.00% $681,478.15 $13,248,183.84 $167,813.70 $140,838.94 99.0%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: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 WS 01-JDocusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 9,500.007/10/2026Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B087/15/2026 | 8:31 AM CDT Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 7/10/20268,185.11WS 03-ADocusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B087/15/2026 | 8:31 AM CDT Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 7/10/2026WS 03-DCity of Otsego4,408.004,408.00MMDocusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B087/15/2026 | 8:31 AM CDT Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 APPLICATION AND CERTIFICATION FOR PAYMENT,Construction Manager as Adviser Edition TO 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:2508-9 PERIOD TO:6.23.26 CONTRACT FOR: CONTRACT DATE: PROJECT NOS: AIA DOCUMENTG732 -2009 Distribution to: ON\NER CONSTRUCTION MANAGER ARCHITECT CONTRACTOR FIELD CONTRACTORS 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 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 C)vmer-and that current payment shown herein is now due. -E CONTRACTOR: By State of:.n Date: 5.RETAINAGE: a. b. C ounty of: 5 %of Completed Work (Colum D +E on G703) %of Stored Material (Column F on G 703) s s 8_409.43 Total Retainage (Lines 5a +5b or Total in Column I of G703) s s s s s s 150,000.00 18,188.55 168,188.55 168,188.55 8,409.43 159,779 e 155,088 so 4,690.62 8,409.43 UCTI 18.18855 Subscribed and sworn to before me this day of—EÆ Notary public: My Commission expires: 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. 6.TOTAL EARNED LESS RETAINAGE (Line 4 Less Line 5 Total) 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8.CURRENT PAYMENT DUE 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Line 3 minus Line 6) CHANGE ORDER Total changes approved in previous months by Ovvmer Total approved this Month TOTALS NET CHANGES by Change Order AMOUNT CERTIFIED 4_690.62 s s 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.) ITIO 13,251.05 4,937.50 18,188.55 CONSTRUCTION MANAGER: By:Date: ARCHITECT:(NOTE:If Multiple Prime constractors are responsible for performing portions of the Project,the Architect's Certification is not required.) By:Date: AIA DOCUMENT G702 APPLICATION AND CERTIFICATION FOR PAYMENT 1992 EDITION •AIA •01992 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 (hmer or Contractor under this Contract. THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE_.N.w.,WASHINGTON,DC 20006-5292 Users may obtain validation of this document by requesting a completed AIA Document D401 -Certification of Document's Authenticity from the Licensee. 7/10/2026 WS 05-B City of Otsego Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 7/15/2026 | 8:31 AM CDT KRAUS ANDERSON G703 APPLICATION FOR PAYMENT SCHEDULE -G703 SPARTAN STEEL ERECTORS,INC. APPLICATION NO:2508-9 ITEM NO. 001 002 003 004 005 006 007 008 009 010 011 012 013 Architect: Owner: Project Name:Otsego Fire Station C SCHEDULEDDESCRIPTIONOFWORKVALUE Bonds $6,000.00 Structural -erection labor $60,000.00 Joists -erection labor $40,000.00 Deck -erection labor $9,000.00 Misc.Metals -erection labo $25,000.00 Allowance -erection labor $10,000.00 co #1 $1 ,405.25 co #2 $0.00 $3,720.00CO#3 -COR #30 $8,125.80 co #5 $126.50 CO#6 $2,291.00 co #7 $2,520.00 $0.00 TOTAL $168,188.55 WORK COMPLETED FROM PREVIOUS THIS MATERIALS PRESENTLY APPLICATION DATE: PERIOD TO: PROJECT NOS: BALANCE TO APPLICATION STOREDAPPLICATION $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 $163,251.05 PERIOD $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $126.50 $2,291.00 $2,520.00 $0.00 $4,937.50 (NOT IN D OR $0.00 $0.00 Page I TOTAL COMPLETED AND STORED TO DATE (D+E+F) $6,000.00 $60,000.00 $40,000.00 $9.ooo.oo $25,000.00 $10,000.00 $1 ,405.25 $0.00 $3,720.00 $8,125.80 $126 so $2,291.00 $2,520.00 $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 $168,188.55 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% #DIV/O! 100.00% 100.00% 100.00% 100.00% 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! IV/O! #DIV/O! #DIV/O! FINISH $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 so-oo $0.00 $0.00 $0.00 $0.00 so.oo $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 6/23/2026 6/30/2026 RETAINAGE (IF VARIABLE RATE) 5% $300.00 $3,000.00 $2,000.00 $1 ,250.oo $500.00 $70.26 $0.00 $186.00 $406.29 $6.33 $114.55 $126.00 $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 $8,409.43 Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 WS 06-AWS 07-FWS 09-A14,280.217/10/2026Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B087/15/2026 | 8:31 AM CDT Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 Construction Manager:7/10/20263,287.00WS 07-H9Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B087/15/2026 | 8:31 AM CDT 9Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 9Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 7/10/20262,955.45WS 09-CCity of OtsegoDocusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B087/15/2026 | 8:31 AM CDT Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 52,968.313,311.01MM7/10/20263,311.01WS 09-DDocusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B087/15/2026 | 8:31 AM CDT 0.00 523.20523.2055,756.12Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 7/10/2026 13,901.70 WS 12-C Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 7/15/2026 | 8:31 AM CDT Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 7/10/2026Construction Manager:$(17,907.72)1,675,297.2888,099.74WS 26-ADocusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B087/15/2026 | 8:31 AM CDT Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 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. .00 % of Completed Work b. (Columns D + E) 5.00 % of Stored Material (Column F) Total Retainage (Line 5a + 5b or Total in Column I) ................. . 6. TOTAL EARNED LESS RETAINAGE .......... . (Line 4 less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 8. 9. CURRENT BALANCE (Line 3 PAYMENT DUE .................. . TO FINISH, INCLUDING RETAINAGE less Line 6) CHANGE ORDER 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 $0.00 $133,600.00 $0.00 $133,600.00 $133,600.00 $0.00 $0.00 $0.00 $133,600.00 $126,920.00 $6,680.00 $0.00 DEDUCTIONS 0.00 0.00 0.00 APPLICATION NO.: 8 PERIOD TO: Jun 30/26 PROJECT NOS . : CO!.fTRACT DATE: Distribution to: OWNER D ARCHITECT 0 CONTRJI.CTOR 0 FIELD D OTHER D The undersigned Contractor certifies that to the best of the Contractor's knowledge, info:::mation and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein in now due. CONTRACTOR: Brothers Fire & Security By: ~ Date: {.p-;}-3-dftJ State of: Minnesota County of: SW0urne... Subscribed and sworn to before me this 1,J'.51.f::~,... TAMMY JO ROBERTS ,~j~<? [.{~'{1 Not~ry Public -,,_,,__~/$!Pl Minnesota ·~<~~.;,~~';:;:/7 .. ./4 ____ r_._ ·---1 ..... 'l~ ,..,,v-,"7 Notary l;'ub:l.ic: My commission expires: ARCHITECT'S CERTIFICATE 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 ~.rchitect'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 AMOU?..-T CERTIFIED . AM:>UNT 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 thls Contract. By: Date: Construction Manager:7/10/20266,680.00WS 21-ACity of OtsegoDocusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B087/15/2026 | 8:31 AM CDT CONTINUATION SHEET APPLICATION NO.: 8 APPLICATION DATE: Jun 23/26 A B ITEM DESCRIPTION OF WORK NO. CONTRACT 00001 PERMIT 00002 DESIGN 00003 MATERIAL 00004 LABOR 00005 BOND Total Contract C SCHEDULED VALUE 3800.00 9000.00 71277.00 48000.00 1523.00 133600.00 133600.00 D E WORK Cc»«>LETED FRCJ,f PREVIOUS APPLICATION THIS PERIOD (D + E) 3800.00 0.00 9000.00 0.00 71277.00 0.00 48000.00 0.00 1523.00 0.00 133600.00 0.00 133600.00 0.00 F G MATERIALS TOTAL PRESENTLY COMPLETED STORED AND STORED (NOT IN TO DATE DORE) (D+E+F) 0.00 3800.00 0.00 9000.00 0.00 71277.00 0.00 48000.00 0.00 1523.00 0.00 133600.00 0.00 133600.00 PERIOD TO: Jun 30/26 PROJECT NO.: SC00126 H I % (G / CJ 100 100 100 100 100 100 100 BALANCE TO FINISH (C -G) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 RETAINAGE (IF VARIABLE RATE) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 7/10/2026 WS 32-F Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 7/15/2026 | 8:31 AM CDT Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 7/10/202611,638.64WS 23-B2,975,082.792,963,444.15Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B087/15/2026 | 8:31 AM CDT Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08 Docusign Envelope ID: 9FB2DB36-48BA-8A55-80ED-93E27A691B08