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'S.-MAIN Document G703" -1992
<br />Continuation Sheet
<br />AIA Document 0702T"r-1992, Application and Certificate for Payment, or 0732T1'-2009,
<br />APPLICATION NO:
<br />Application and Certificate for Payment. Construction Manager as Adviser Edition,
<br />containing Contractor's signed certification is attached.
<br />APPLICATION DATE:
<br />In tabulations below, amounts are in US dollars.
<br />PERIOD TO:
<br />Use Column 1 on Contracts where variable retainage for line items may apply
<br />ARCHITECT'S PROJECT NO:
<br />A
<br />-_ B C _.. D-. ..._ E .—.
<br />P
<br />G
<br />WORK COMPLETED---
<br />_
<br />-
<br />MATERIALS
<br />1 TOTAL
<br />IT
<br />DESCRIPTION OF WORK
<br />FROM FROM PREVIOUS
<br />PRESENTLY
<br />COMPLETED AND .
<br />NO.
<br />VALUE APPLICATION THIS PERIOD
<br />STORED
<br />STOREDTODATE (G4,Q
<br />(D+E)
<br />(,No/Lr D or G)
<br />(D+E+F)
<br />Phd
<br />quipment
<br />oofing Materials
<br />oofing Labor
<br />Sheet Metal Materials
<br />Sheet Metal Labor
<br />Subcontractor
<br />r.00", CO
<br />3,500.00
<br />67,143.00
<br />43,644.00
<br />3,900.00
<br />6,000.00
<br />36,100.00
<br />1,250.00
<br />pals: 168,137.00
<br />2
<br />06/13/2018
<br />06/13/2018
<br />_ H I
<br />BALANCE TD RETAINAGE
<br />FINISH
<br />(C-L) pfrm•iublerare)
<br />6.000.00
<br />6,000.00
<br />160.00
<br />300.00
<br />60,968.70
<br />2,800.00
<br />6,774.30
<br />2,800.00
<br />80.00
<br />700.00
<br />140.00
<br />67,743.00
<br />100.00
<br />3,387.15
<br />43,644.00
<br />43,644.00
<br />100.001
<br />2,182.20
<br />3,900.00
<br />3,900.00
<br />100.00
<br />195.00
<br />6,000.00
<br />36,100.00
<br />36,100.00
<br />100.00
<br />1,805.00
<br />1.250.00
<br />66,968.70 !
<br />93,218.30
<br />i
<br />160,187.00
<br />95.27
<br />j 7,950.00
<br />8,009.35
<br />i
<br />I �
<br />I
<br />GRAND TOTAL
<br />CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not be obscured.
<br />AIA Document G703- - 1992. Copyright m 1963, 1965. 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING; This AIA'• Document is protected by U.S. Copyright
<br />Law and International Treaties. Unauthorized reproduction or distribution of this AIA` Document, or any portion of 11, may result in severe civil and criminal penalties. and will be prosecuted to the maximum extent
<br />possible under the law. Purchasers are permitted to reproduce len (10) copies of this document when completed. To report copyright violations of AIA Contract Documents, a -mall The American Institute of Architects' legal
<br />counsel, copyright@ala.org.�
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