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77060900v2 <br /> <br /> <br /> <br /> B-6 <br /> <br />Contractor’s Requisition Certificate <br />Application for Payment No.________ <br />TO: Allianz Life Insurance Company of North America (“Funding Lender”) <br /> <br />R4 Servicer LLC (“Controlling Person”) <br />FROM: Eagle Building Company, LLC (“Contractor”) <br />RE: Construction of Lica Apartments (the “Project Facilities”) by Little Canada Phase II <br />Limited Partnership (“Borrower”). <br /> <br />We are the general contractor for the Project Facilities and, to induce the Controlling Person to <br />approve disbursements of Bond proceeds and other amounts by the Funding Lender to assist in funding <br />construction of the Improvements and knowing that the Funding Lender and the Controlling Person will <br />rely on this certificate in doing so, we hereby certify as follows: <br />1. In reference to our contract dated [__________ ___, 2023], with Borrower for construction of the <br />Improvements, and the Plans and Specifications therefor, no amendments, modifications or <br />changes have been made with respect to our contract or the Plans and Specifications except such <br />as have had your prior written approval. There are no pending change orders except as follows: <br />2. Our Application for Payment No. _____________, dated ______________, 20__, which we <br />understand is to be included as an item in the Borrower’s requisition to you, is in full compliance <br />with the terms of our contract with Borrower, and, upon the payment of same, we will have no <br />other or additional claim (including claims for so-called “extras”) against Borrower on account of <br />our contract or otherwise for and through the period of time ending upon the date of our Application <br />for Payment, for all labor and materials furnished by us through and including the date of our <br />Application for Payment except as follows: <br />a. Retainage not exceeding __% of the value of labor and materials incorporated into <br />the Project Facilities and covered by applications submitted by us on account of the <br />construction of the Improvements for which payment is to be made to us after substantial <br />completion of our contract, as provided therein (the amount of said retainage), as of the <br />end of the period covered by our Application for Payment dated ______________, 202__, <br />is $_____________; and <br />b. [specify other claims, if any] <br />3. The Borrower is not in default of any of the Borrower’s obligations to us as of the date hereof <br />except as follows: [none] <br />4. We have paid in full all our obligations to subcontractors, workmen, suppliers and materialmen for <br />and with respect to all labor and materials supplied through and including the date of our last <br />Application for Payment, except for an amount equal to __% thereof, which we are holding in <br />accordance with the terms of such obligations and our contract, and all our subcontractors have <br />paid their subcontractors, workmen and materialmen in full for and with respect to all labor and <br />materials supplied through and including the date of our last Application for Payment.