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HomeMy WebLinkAboutContract 2160 R * tAIA Document G704TM - 2000 Certificate of Substantial Completion PROJECT: (Name and address) PROJECT NUMBER: 0806 OWNER Public Safety Center CONTRACT FOR: Geothermal Heat Exchanger City of Columbia Heights ARCHITECT IX CONTRACT DATE: December 8, 2008 CONTRACTOR TO OWNER: (Name and address) TO CONTRACTOR: (Name and address) FIELD ❑ City of Columbia Heights GTI Inc 590 40th Avenue N.E. 1817 180th Avenue OTHER ❑ Columbia Heights, MN 55421 -3878 Canby, MN 56220 Project or portion of the Project designated for partial occupancy or use shall include: The Work performed under this Contract has been reviewed and found, to the Architect's best knowledge, information and belief, to be substantially complete. Substantial Completion is the stage in the progress of the Work when the Work or designated portion is sufficiently complete in accordance with the Contract Documents so that the Owner can occupy or utilize the Work for its intended use. The date of Substantial Completion of the Project or portion designated above is the date of issuance established by this Certificate, which is also the date of commencement of applicable warranties required by the Contract Documents, except as stated below: Warranty Date of Commencement ARCHITECT BY (Signature) DATE OF ISSUANCE A list of items to be completed or corrected is attached hereto. The failure to include any items on such list does not alter the responsibility of the Contractor to complete all Work in accordance with the Contract Documents. Unless otherwise agreed to in writing, the date of commencement of warranties for items on the attached list will be the date of issuance of the final Certificate of Payment or the date of final payment. Cost estimate of Work that is incomplete or defective: $ 0 The Contractor will complete or correct the Work on the list of items attached hereto within ( ) days from the above date of Sub ntial Co • . = ion. ,\ GTI, Inc _ >i Z� ' i U CONTRACTOR ture) DATE The Owner accepts the Work or designated portion as substantially complete and will assume full possession at (time) on (date). /, / £ % l f� / F j Pf ' './% OWNER BY (Signature) DATE / The responsibilities of the Owner and Contractor for security, maintenance, heat, utilities, damage to the Work and insurance shall be as follows: (NOTE: Owner's and Contractor's legal and insurance counsel should determine and review insurance requirements and coverage.) AIA Document G704" — 2000. Copyright © 1963, 1978, 1992 and 2000 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was created on 05/10/2010 14:30:38 under the terms of AIA Documents- on- DemandTM order no. 2005175346 , and is not for resale. This document is licensed by the American Institute of Architects for one -time use only, and may not be reproduced prior to its completion. • MOM 1AIi Document G706TM -1994 Contractor's Affidavit of Payment of Debts and Claims PROJECT: (Name and address) ARCHITECT'S PROJECT NUMBER: 0806 OWNER EXI Public Safety Center City of Columbia Heights CONTRACT FOR: Geothermal Heat Exchanger ARCHITECT CONTRACTOR IN TO OWNER: (Name and address) CONTRACT DATED: December 8, 2008 SURETY ❑ City of Columbia Heights 590 40th Avenue N.E. OTHER ❑ Columbia Heights, MN 55421 -3878 STATE OF: Minnesota COUNTY OF: Anoka The undersigned hereby certifies that, except as listed below, payment has been made in full and all obligations have otherwise been satisfied for all materials and equipment furnished, for all work, labor, and services performed, and for all known indebtedness and claims against the Contractor for damages arising in any manner in connection with the performance of the Contract referenced above for which the Owner or Owner's property might in any way be held responsible or encumbered. EXCEPTIONS: SUPPORTING DOCUMENTS ATTACHED HERETO: CONTRACTOR: (Name and address) 1. Consent of Surety to Final Payment. Whenever GTI, Inc Surety is involved, Consent of Surety is required. 1817 180th Avenue AIA Document G707TM, Consent of Surety, may be Canby, MN 56220 used for this purpose. Indicate Attachment ❑ Yes N No BY The following supporting documents should be attached (Si:•re of authorize: representative) hereto if required by the Owner: Glen Citrowske, President 1. Contractor's Release or Waiver of Liens, conditional (Printed name and title) upon receipt of final payment. 2. Separate Releases or Waivers of Liens from Subscribed and sworn to before me Subcontractors and material and equipment suppliers, on this date: 'Ma-et , c9 U / to the extent required by the Owner, accompanied by a list thereofPublic: Notary . y 3. Contractor's Affidavit of Release of Liens My Commission E : (AIA Document G706ATM). SHERRY LKERN NOTARY PUBLIC. MINNESOTA CMA M WMa an. x1.2015 AIA Document G706TM —1994. Copyright © 1970 and 1994 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA' Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was created on 05/10/2010 14:30:38 under the terms of AIA Documents -on- Demand TM order no, 2005175346 , and is not for resale. This document is licensed by the American Institute of Architects for one -time use only, and may not be reproduced prior to its completion. ....�_ Document G706ATM -1994 Contractor's Affidavit of Release of Liens PROJECT: (Name and address) ARCHITECT'S PROJECT NUMBER: 0806 OWNER Public Safety Center City of Columbia Heights CONTRACT FOR: Geothermal Heat Exchanger ARCHITECT CONTRACTOR El TO OWNER: Name and address) CONTRACT DATED: December 8, 2008 SURETY ❑ City of Columbia Heights 590 40th Avenue N.E. OTHER ❑ Columbia Heights, MN 554213878 STATE OF: Minnesota COUNTY OF: Anoka The undersigned hereby certifies that to the best of the undersigned's knowledge, information and belief, except as listed below, the Releases or Waivers of Lien attached hereto include the Contractor, all Subcontractors, all suppliers of materials and equipment, and all performers of Work, labor or services who have or may have liens or encumbrances or the right to assert liens or encumbrances against any property of the Owner arising in any manner out of the performance of the Contract referenced above. EXCEPTIONS: SUPPORTING DOCUMENTS ATTACHED HERETO: CONTRACTOR: (Name and address) 1. Contractor's Release or Waiver of Liens, conditional GTI, Inc upon receipt of final payment. 1817 180th Avenue Canby, 1 62:0 2. Separate Releases or Waivers of Liens from BY: Subcontractors and material and equipment suppliers, to the extent required by the Owner, (Signature of authors - presentative) accompanied by a list thereof. Glen Citrowske, President (Printed name and title) Subscribed and sworn to before me on this date: 'Matt, tt d 7, f SHERRY L KERN Notary Public: e . ,e4A NOTARY PUBLIC - MINNESOTA IM COMMIININ Expire. Jn. 31,2015 My Commission Expires: / . /- /5 AIA Document G706AT'" —1994. Copyright © 1970 and 1994 by The American Institute of Architects. All rights reserved. WARNING: This AIA` Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA" Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was created on 05/10/2010 14:30:38 under the terms of AIA Documents- on- DemandTM order no. 2005175346 , and is not for resale. This document is licensed by the American Institute of Architects for one -time use only, and may not be reproduced prior to its completion. May 14, 2010 City of Columbia Heights 590 40 Avenue N.E. Columbia Heights, MN 55421 FINAL PAY APPLICATION REQUEST FOR RETAINAGE RE: Columbia Heights Public Safety Center GTI, Geothermal Systems, Inc is requesting payment of the final payment that has been held as retainage for work completed on the Columbia Heights Public Safety Center. Attached you will find other documentation request for this final payment: AIA Document G -704 Certificate of Substantial Completion AIA Document G706 Contractors Affidavit of Payment of Debts and Claims AIA Document G706A Contractor's Affidavit of Release of Leans Final Lien Waiver Please advise GTI if any further documentation is required to complete the final payment for the Columbia Heights Public Safety Center. Res . ib 11y Sub •• itted Glen Citrowske President III � O■ is" A vf Witness, Witness Print Form CONTRACTOR'S FINAL RELEASE AND WAIVER OF LIEN Project/ Owner Contractor Project:Columbia Heights Public Safety Name: GTI Inc Center Address: 590 40th Avenue N.E. Address: 1817 180th Avenue Columbia Heights MN 55421 Canby MN 56220 City State Zip Code City State Zip Code Contractor Licence: Owner: City of Columbia Heights Contract Date: 12 / 8 /2008 TO ALL WHOM IT MAY CONCERN: For good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the undersigned Contractor hereby waives, discharges, and releases any and all liens, claims, and rights to liens against the above - mentioned project, and any and all other property owned by or the title to which is in the name of the above - referenced Owner and against any and all funds of the Owner appropriated or available for the construction of said project, and any and all warrants drawn upon or issued against any such funds or monies, which the undersigned Contractor may have or may hereafter acquire or possess as a result of the furnishing of labor, materials, and /or equipment, and the performance of Work by the Contractor on or in connection with said project, whether under and pursuant to the above - mentioned contract between the Contractor and the Owner pertaining to said project or otherwise, and which said liens, claims or rights of lien may arise and exist. The undersigned further hereby acknowledges that the sum of Fourteen thousand seven hundred fifty dollars Dollars ($14,750.00 ) constitutes the entire unpaid balance due the undersigned in connection with said project whether under said contract or otherwise and that the payment of said sum to the Contractor will constitute payment in full and will fully satisfy any and all liens, claims, and demands which the Contractor may have or assert against the Owner in connection with said contract or project. Dated this Z1 day of M67 20 ) 6f-T ) Witness to Signature: / , Contra . • r /I►! /. 4 ` -.lei( ILL Title: '4 ft Page 1 of 1 Page 1 of 1 MINNESOTA• REVENUE 1 Minnesota Revenue Home 1 Contact Us 1 Help 1 Contractor's Withholding Affidavit Confirmation GEOTHERMAL SYSTEMS LLC ID 8244625 GTI LLC Please keep this information for your records. To print or save this page, use your browser's print or save function. Do not use your browser's back button. Submit a copy of this page to the project owner to receive your final payment. Confirmation number 316850 Thu May 27 10:34:48 CDT 2010 Project owner CITY OF COLUMBIA HEIGHTS Project number 0806 Project begin date December 2008 Project end date June 2009 Project location COLUMBIA HEIGHTS PUBLIC SAFETY CENTER Subcontractors No subcontractors listed. Submit Another : Logout Minnesota Department of Revenue Site privacy & security Use of information https:// www. mndor .state.mn.us /wc /action/process 5/27/2010