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AIA Document G703 - 1992 <br />Continuation Sheet <br />AIA Document G702, APPLICATION AND CERTIFICATION 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: 001 <br />APPLICATION DATE: <br />PERIOD TO: <br />ARCHITECTS PROJECT NO: <br />A <br />B <br />C <br />D <br />E <br />F <br />G <br />H`.Y <br />I <br />ITEM <br />NO. <br />DESCRIPTION OF WORK <br />SCHEDULED <br />VALUE <br />WORK COMPLETED <br />MATERIALS <br />PRESENTLY <br />STORED (NOT <br />IN D OR E) <br />TOTAL <br />COMPLETED <br />AND STORED <br />TO DATE <br />(D+E+F) <br />% <br />(G — C) <br />BALANCE TO <br />FINISH <br />(C - G)_,_ <br />______ <br />RETAINAGE <br />(IF VARIABLE <br />RATE)_, <br />_ ___ ___ _ <br />FROM <br />PREVIOUS <br />APPLICATION <br />(D + E) <br />THIS PERIOD <br />GRAND TOTAL <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />0.00 % <br />$ 0.00 <br />s::-- $° 0.00. <br />AIA Document G703a` - 1992. Copyright ® 1992 by The American Institute of Architects. A11 rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International <br />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 <br />extent possible under the law. This draft was produced by AIA software at 10:55:46 on 03/02/2005 under Order No.1000142432 1 which expires on 10/20/2005, and is not for resale. <br />User Notes: <br />(2692137931) <br />1 <br />