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Item 3.3 Emergency Services Facility Pay Application 6 Request for City Council Action DEPARTMENT INFORMATION ORIGINATING DEPARTMENT REQUESTOR: MEETING DATE: Emergency Services Emergency Services Director Rausch June 23, 2025 PRESENTER(s) REVIEWED BY: ITEM #: Consent Kraus-Anderson City Administrator/Finance Director Flaherty 3.3 – Pay Application for the Emergency Services Facility 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 is recommending City Council approval of Pay Application #6 for the Fire & Emergency Services Facility project. ARE YOU SEEKING APPROVAL OF A CONTRACT? IS A PUBLIC HEARING REQUIRED? No No BACKGROUND/JUSTIFICATION: The amounts requested for Pay Application #6 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 3 individual contractors included within Pay Application #6 for a total of $218,610.79 • BCI Construction, Inc. ($25,433.99) • Masters Plumbing Heating & Cooling, LLC ($155,768.65) • Klein Electric, Inc. ($37,408.15) In accordance with Minnesota Statute, the City is withholding the maximum of 5% retainage of work completed, which amounts to $39,595.02 at this time. SUPPORTING DOCUMENTS ATTACHED: • Pay Application #6 POSSIBLE MOTION PLEASE WORD MOTION AS YOU WOULD LIKE IT TO APPEAR IN THE MINUTES: Motion to approve Pay Application #6 in the amount of $218,610.79 for work completed on the Fire & Emergency Services Facility project. BUDGET INFORMATION FUNDING: BUDGETED: Fund 446 – Fire & Emergency Services 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: 6 14499 75th St Ne New Fire Station PERIOD TO: 5/31/2025 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)$0.00 3. TOTAL CONTRACT SUM TO DATE (Item C Totals)$14,018,369.00 4. TOTAL COMPLETED & STORED TO DATE (Item F Totals)$791,900.47 5. RETAINAGE (Item H Totals)$39,595.02 6. LESS PREVIOUS TOTAL PAYMENTS (Item I Totals)$533,694.66 7. CURRENT PAYMENT DUE (Item J Totals)$218,610.79 TOTAL OF AMOUNTS CERTIFIED…………………….. $218,610.79 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: 06/12/25 CONSTRUCTION MANAGER: Kraus-Anderson Construction Company By:_________________________________________________________Date:06/12/25 State of: Minnesota County of: Hennepin Subscribed and sworn to before me this 12th day of June, 2025 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: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA 6/17/2025 | 9:04 AM CDT AIA DOCUMENT G737 - 2009 Summary of Contractors' Applications for Payment, Construction Manager as Adviser Edition AIA Document G732, Application and Certificate for Payment, has APPLICATION NO.:6 been completed by each Contractor. The content of those G732 APPLICATION DATE:5/31/2025 forms is summarized below PERIOD FROM:5/1/2025 Otsego Fire Station PERIOD TO:5/31/2025 PROJECT NOS.:2410290 A B C D E F G H I J K L STORED TOTAL MATERIALS COMPLETED AND CURRENT BALALANCE % ORIGINAL NET CHANGES IN CONTRACT SUM WORK IN PLACE (Not in D or I) STORED TO DATE RETAINAGE RETAINAGE PREVIOUS PAYMENT FINISH COMPL. DESCRIPTION OF WORK CONTRACTOR'S NAME CONTRACT SUM THE WORK TO DATE TO DATE (D + E) %AMOUNT PAYMENTS (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 $0.00 $767,212.00 $0.00 $0.00 $0.00 5.00% $0.00 $0.00 $0.00 $767,212.00 0% WS-03B Precast Structural Concrete Molin Concrete Products Company $1,456,510.00 $0.00 $1,456,510.00 $0.00 $0.00 $0.00 5.00% $0.00 $0.00 $0.00 $1,456,510.00 0% 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 $34,510.00 $0.00 $34,510.00 5.00% $1,725.50 $32,784.50 $0.00 $541,021.00 6% WS-05B Structural Steel Erection Spartan Steel Erectors, Inc $150,000.00 $0.00 $150,000.00 $6,000.00 $0.00 $6,000.00 5.00% $300.00 $5,700.00 $0.00 $144,000.00 4% WS-06A/07F/09A Carpentry, Metal Panels, Drywall BCI Construction, Inc $1,030,000.00 $0.00 $1,030,000.00 $38,616.62 $0.00 $38,616.62 5.00% $1,930.83 $11,251.80 $25,433.99 $991,383.38 4% WS-07H Roofing Package Roof Tech, Inc $755,620.00 $0.00 $755,620.00 $11,600.00 $0.00 $11,600.00 5.00% $580.00 $11,020.00 $0.00 $744,020.00 2% 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 $0.00 $0.00 $0.00 5.00% $0.00 $0.00 $0.00 $284,972.00 0% WS-08D/08E Four Fold Doors/Sectional Overhead Door Crawford Door Sales Company Twin Cities, Inc $458,540.00 $0.00 $458,540.00 $0.00 $0.00 $0.00 5.00% $0.00 $0.00 $0.00 $458,540.00 0% WS-08F Exterior Glass & Glazing Northern Glass & Glazing $358,700.00 $0.00 $358,700.00 $0.00 $0.00 $0.00 5.00% $0.00 $0.00 $0.00 $358,700.00 0% 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 $0.00 $0.00 $0.00 5.00% $0.00 $0.00 $0.00 $53,764.00 0% 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 $0.00 $0.00 $0.00 5.00% $0.00 $0.00 $0.00 $124,210.00 0% 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 $14,323.00 $0.00 $14,323.00 5.00% $716.15 $13,606.85 $0.00 $119,277.00 11% WS-23B Combined Mechanical Masters Plumbing Heating & Cooling, LLC $3,135,000.00 ($207.00) $3,134,793.00 $408,457.00 $0.00 $408,457.00 5.00% $20,422.85 $232,265.50 $155,768.65 $2,726,336.00 13% WS-26A Electrical Klein Electric, Inc $1,693,205.00 $207.00 $1,693,412.00 $219,884.00 $0.00 $219,884.00 5.00% $10,994.20 $171,481.65 $37,408.15 $1,473,528.00 13% WS-31A Site Clearing & Earthwork Belair Builders, Inc. DBA Belair Sitework Services $1,429,318.00 $0.00 $1,429,318.00 $32,100.00 $0.00 $32,100.00 5.00% $1,605.00 $30,495.00 $0.00 $1,397,218.00 2% 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 $0.00 $0.00 $0.00 5.00% $0.00 $0.00 $0.00 $340,687.00 0% 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 $0.00 $14,018,369.00 $791,900.47 $0.00 $791,900.47 5.00% $39,595.02 $533,694.66 $218,610.79 $13,226,468.53 5.6% 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 Authenticity TOTALS Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA 6/12/202525,433.99WS 06-A WS 07-F WS 09-ADocusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA6/17/2025 | 9:04 AM CDT Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA 6/12/2025 155,768.65 WS 23-B (207.00) 3,134,793.00 2,746,758.85 PICTURES OF THE STORED MATERIAL ARE ATTACHED AND INSURANCE IS ON FILE Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA 6/17/2025 | 9:04 AM CDT Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA LENDER'S LOSS PAYABLE PHONEAGENCY COMPANY(A/C, No, Ext): FAX E-MAIL (A/C, No):ADDRESS: SUB CODE: AGENCY CUSTOMER ID #: INSURED LOAN NUMBER POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE THIS REPLACES PRIOR EVIDENCE DATED: LOCATION/DESCRIPTION COVERAGE / PERILS / FORMS AMOUNT OF INSURANCE DEDUCTIBLE NAME AND ADDRESS CONTINUED UNTIL TERMINATED IF CHECKED ADDITIONAL INSURED LOSS PAYEE MORTGAGEE LOAN # PERILS INSURED BASIC BROAD SPECIAL 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. 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. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PROPERTY INFORMATION COVERAGE INFORMATION REMARKS (Including Special Conditions) CANCELLATION ADDITIONAL INTEREST ACORD 27 (2016/03)© 1993-2015 ACORD CORPORATION. All rights reserved. EVIDENCE OF PROPERTY INSURANCE DATE (MM/DD/YYYY) CODE: AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD 5/22/2025 (952) 653-1000 Middlesex Insurance CompanyChristensen Group, Inc. 9855 W 78th Street Suite 100 Eden Prairie, MN 55344-8004 (952) 653-1100 Masters Plumbing Heating & Cooling, LLC; Tilleskjor Properties LLC 3446 State Hwy 29 N Alexandria, MN 56308 Blanket Property Coverages Business Income $100,000 Blanket Building & Business Personal Property $3,809,998 1,000 Equipment Breakdown - Included 1,000 Personal Property of Others - Included 1,000 Wind/Hail Deductible 10,000 Special Conditions: RE: Otsego Fire Station project : - Stored plumbing materials value $36,500. Blanket Limit of Personal Property applies to Personal Property of Others stored by Masters Plumbing Heating & Cooling Inc at 3446 State Hwy 29N Alexandria, MN 56308. City of Otsego 13400 90th St NE Elk River, MN 55330 BZAWATZKE A0181968002 11/3/2024 11/3/2025 MASTPLU-38 X Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA 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 5/22/2025 Holmes Murphy &Associates 2727 Grand Prairie Parkway Waukee IA 50263 Mike Stasny 612-349-2432 mstasny@holmesmurphy.com Zurich American Insurance Company 16535 UHLCOMPC Hanover Insurance Company 22292UHLCompany,Inc 9065 Zachary Lane N Maple Grove,MN 55369 Vantage Risk Specialty Insurance Co StarStone Specialty Insurance Company 44776 1308340179 A X 1,000,000 X 100,000 10,000 1,000,000 2,000,000 X GLO380464106 1/1/2025 1/1/2026 2,000,000 A 1,000,000 X BAP380464206 1/1/2025 1/1/2026 C D X X 10,000,000P03XC0000074520 CSX90263982P00 1/1/2025 1/1/2025 1/1/2026 1/1/2026 10,000,000 A X N WC380464006 1/1/2025 1/1/2026 1,000,000 1,000,000 1,000,000 B BPP/Rented Pers.Prop. Installation Floater RHXD90050306 1/1/2025 1/1/2026 Business Pers.Prop. Any Location: $1,608,700 $500,000 Stored Materials at: Otsego Fire Station 14499 75th St NE Otsego,MN 55330 Additional Insured only if required by written contract with respect to General Liability,Automobile Liability and Umbrella/Excess Liability applies on a primary basis and the insurance of the additional insured shall be non-contributory:Masters Plumbing Heating &Cooling LLC and Others as required by written contract. See Attached... Masters Plumbing Heating &Cooling LLC 3446 State Hwy 29 N Alexandria,MN 56308 Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: UHLCOMPC 1 1 Holmes Murphy &Associates UHL Company,Inc 9065 Zachary Lane N Maple Grove,MN 55369 25 CERTIFICATE OF LIABILITY INSURANCE Waiver of Subrogation only if required by written contract with respect to General Liability,Automobile Liability,Workers Compensation and Umbrella/Excess Liability applies in favor of:Masters Plumbing Heating &Cooling LLC and Others as required by written contract. The following supersedes the cancellation wording:Should any of the above described policies be cancelled before the expiration date,30 Days written notice (10 Days for Non-Payment)will be delivered to the certificate holder. Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA PICTURES OF THE STORED MATERIAL ARE ATTACHED AND INSURANCE IS ON FILEConstruction Manager:6/12/202537,408.1537,408.151,484,522.20219,884.0010,994.2010,994.20208,889.80MMWS 26-ADocusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA6/17/2025 | 9:04 AM CDT Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA 4,425.00219,884.001,473,528.0010,994.20Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA LENDER'S LOSS PAYABLE PHONEAGENCY COMPANY(A/C, No, Ext): FAX E-MAIL (A/C, No):ADDRESS: SUB CODE: AGENCY CUSTOMER ID #: INSURED LOAN NUMBER POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE THIS REPLACES PRIOR EVIDENCE DATED: LOCATION/DESCRIPTION COVERAGE / PERILS / FORMS AMOUNT OF INSURANCE DEDUCTIBLE NAME AND ADDRESS CONTINUED UNTIL TERMINATED IF CHECKED ADDITIONAL INSURED LOSS PAYEE MORTGAGEE LOAN # PERILS INSURED BASIC BROAD SPECIAL 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. 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. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PROPERTY INFORMATION COVERAGE INFORMATION REMARKS (Including Special Conditions) CANCELLATION ADDITIONAL INTEREST ACORD 27 (2016/03)© 1993-2015 ACORD CORPORATION. All rights reserved. EVIDENCE OF PROPERTY INSURANCE DATE (MM/DD/YYYY) CODE: AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD 3/24/2025 (952) 653-1000 SECURA Insurance A Mutual CompanyChristensen Group, Inc. 9855 W 78th Street Suite 100 Eden Prairie, MN 55344-8004 (952) 653-1100 Klein Electric Inc. 24729 Lake Road Saint Cloud, MN 56301-9713 Loc # 0, Bldg # 0, Blanket Loc # 0, Bldg # 0 Special (Including theft)$283,610 1,000 Evidence of Insurance RSCHAEFER TC3380207 1/13/2025 1/13/2026 KLEIELE-01 Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA Docusign Envelope ID: 9FCAF5E5-68DD-4B01-812D-58BF21B766DA