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CONTIN
<br />ION SHEET
<br />AIA DOCUNT G703
<br />AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT,
<br />containing Contractor's signed Certification, is attached.
<br />In tabulations below, amounts are stated to the nearest dollar.
<br />Use Column I on Contracts where variable retainage for line items may apply.
<br />APPLICATION NO.: 00007
<br />APPLICATION DATE:
<br />PERIOD TO: 7/30/2004
<br />ARCHITECT'S PROJECT NO.: 23 -5290
<br />A
<br />B
<br />C
<br />D E
<br />F
<br />G
<br />11
<br />I
<br />ITEM
<br />WORK COMPLETED
<br />MATERIALS
<br />TOTAL .
<br />BALANCE
<br />RETAINAGE
<br />PRESENTLY
<br />NO.
<br />DESCRIPTION OF WORK
<br />SCHEDULED
<br />VALUE
<br />FROM PREVIOUS
<br />APPLICATION
<br />THIS PERIOD
<br />STORED
<br />COMPLETED
<br />AND STORED
<br />%
<br />TO
<br />FINISH
<br />(IF VARIABLE)
<br />RATE
<br />(D + E)
<br />(NOT IN
<br />D OR E)
<br />TO DATE
<br />(D+E +F)
<br />(G -C)
<br />(C - G)
<br />0000000001
<br />Mobilization
<br />$4,895.00
<br />$4,895.00
<br />$0.00
<br />$0.00
<br />$4,895.00
<br />100.000
<br />$0.00
<br />$0.00
<br />$4,895.00 PER Is
<br />1.000
<br />1.000
<br />0
<br />0
<br />1.000
<br />0
<br />0
<br />0000000002
<br />Submersible Pumps
<br />$26,464.00
<br />$26,464.00
<br />$0.00
<br />$0.00
<br />$26,464.00
<br />100.000
<br />$0.00
<br />$0.00
<br />$13,232.00 PER ea
<br />2.000
<br />2.000
<br />0
<br />0
<br />2.000
<br />0
<br />0
<br />0000000003
<br />Control Panel
<br />$14,190.00
<br />$14,190.00
<br />$0.00
<br />$0.00
<br />$14,190.00
<br />100.000
<br />$0.00
<br />$0.00
<br />$14,190.00 PER Is
<br />1.000
<br />1.000
<br />0
<br />0
<br />1.000
<br />0
<br />0
<br />0000000004
<br />Lift Station cover, Hardware & drop pipe
<br />$2,266.00
<br />$2,266.00
<br />$0.00
<br />$0.Q0
<br />$2,266.00
<br />•100.000
<br />$0.00
<br />$0.00
<br />$2,266.00 PER Is
<br />1.000
<br />1.000
<br />0
<br />0
<br />1.000
<br />0
<br />0
<br />0000000005
<br />10" DIP, CL 52 Station piping, valves & fitting
<br />$16,904.00
<br />$16,904.00
<br />$0.00
<br />$0.00
<br />$16,904.00
<br />100.000
<br />$0.00
<br />$0.00
<br />-
<br />$16,904.00 PER Is
<br />1.000
<br />1.000
<br />0
<br />0
<br />1.000
<br />0
<br />0
<br />00 ; )0006
<br />Painting
<br />$2,530.00
<br />$2,530.00
<br />$0.00
<br />$0.00
<br />$2,530.00
<br />100.000
<br />$0.00
<br />$0.00
<br />cn
<br />4=.
<br />$2,530.00 PER Is
<br />1.000
<br />1.000
<br />0
<br />0
<br />1.000
<br />0
<br />0
<br />00 )0007
<br />Select granular borrow (Iv)
<br />$0.00
<br />$0.00
<br />$0.00
<br />$0.00
<br />• $0.00
<br />0
<br />$0.00
<br />$0.00
<br />$22.00 PER cy
<br />0
<br />0
<br />0
<br />0
<br />0
<br />0
<br />0
<br />0000000008
<br />Agg base, CL 6
<br />$2,243.01
<br />$2,243.01
<br />$0.00
<br />$0.00
<br />$2,243.01
<br />100.000
<br />$0.00
<br />$0.00
<br />$33.00 PER tn
<br />67.970
<br />67.970
<br />0
<br />0
<br />67.970
<br />0
<br />0
<br />0000000009
<br />2" -2350 LV, Mix #4, wear course
<br />$3,646.50
<br />$3,646.50
<br />$0.00
<br />$0.00
<br />$3,646.50
<br />100.000
<br />$0.00
<br />$0.00
<br />$165.00 PER tn
<br />22.100
<br />22.100
<br />0
<br />0
<br />22.100
<br />0
<br />0
<br />0000000010
<br />2" -2350 LV, Mix #3 non wear course
<br />$1,863.90
<br />81,863.90
<br />$0.00
<br />$0.00
<br />$1,863.90
<br />100.000
<br />$0.00
<br />$0.00
<br />$114.00 PER tn
<br />16.350
<br />16.350
<br />0
<br />0
<br />16.350
<br />0
<br />0
<br />0000000011
<br />Bituminous material for tack coat
<br />$0.00
<br />$0.00
<br />$0.00
<br />$0.00
<br />$0.00
<br />0
<br />$0.00
<br />$0.00
<br />$3.00 PER gl
<br />0
<br />0
<br />0.
<br />0
<br />0
<br />0
<br />0
<br />CO1
<br />Change Order 1
<br />$4,831.00
<br />$4,831.00
<br />$0.00
<br />$0.00
<br />$4,831.00
<br />100.000
<br />$0.00
<br />.$0.00
<br />$79,833.41
<br />$79,833.41
<br />$0.00
<br />$0.00
<br />$79,833.41
<br />100.00%
<br />$0.00
<br />$0.00
<br />AIA DOCUMENT G703• APPLICATION AND CERTIFICATE FOR PAYMENT • 1992 EDITION • AIA® • 01992 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK
<br />t/� AVENUE, N.W., WASHINGTON, D.C. 20006 -5292 • WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution.
<br />�y�e
<br />This document has been reproduced electronically with the permission of The American Institute of Architects under License 97003 to Primavera Systems. Inc. Reproduction of this document without prolectapedfic information is not permitted. Contact The American Institute of Architects
<br />to verify the current version of this document and deense status."
<br />G703 -1992
<br />
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