|
> *
<br />- V f; v;
<br />..>j'tvni:!p:iypTiioM mmr AlA DOCUMENT G703 (Insiructions on reverse side)PACr 2 oi 2 I'ACrs
<br />Al^ Documcnr 0707.. APPLICATION AND CERTIFICATE FOR PAYMENT,
<br />conr.iming Conir.ictor't signed Certification, is attached.
<br />In i:ibul;iiion.'. below, amounts are stated to the nearest dollar.
<br />Use Column I on Contracts where variable rcuinage for line items may apply.
<br />APPLICATION NO:
<br />APPLICATION DATE;
<br />PERIOD TO:
<br />ARCHITECT S PROJECT NO:
<br />1
<br />7/21/05
<br />7/20/05
<br />000139-04146-0
<br />A B c D E F c H 1
<br />ITKM
<br />NO.DESCRIPTION OF WORK SCHEDULED
<br />VALUE
<br />WORK COMPLETED MATERIALS
<br />PRESENTLY
<br />STORED
<br />(NOT IN
<br />D OR E)
<br />TOTAL
<br />COMPLETED
<br />AND STORED
<br />TO DATE
<br />(D fF. ♦ F)
<br />It
<br />(C + C)
<br />QAUNCE
<br />TO
<br />FINISH
<br />(C . C)
<br />RETAINAGF.
<br />(IF VARIAULEJ
<br />RATE)FROM PREVIOUS
<br />APPLICATION
<br />(D ♦ E)
<br />THIS PERIOD
<br />i.Mobilization 4,000.00 0.00 4,000.00 0.00 4,000.00 lOOZ 0.00 200.00
<br />2.Structural Repairs 31.576.00 0.00 31,576.00 0.00 31,576.00 lOOX 0.00 1,578.00
<br />3.Surface Repairs 9,375.00 0.00 7,500.00 0.00 7,500.00 80X 1,875.00 375.00
<br />4.Containment 45,000.00 0.00 45,000.00 0.00 45,000.00 lOOX 0.00 2,250.00
<br />5.Blast Prime Int.25,260.00 0.00 25,260.00 0.00 25,260.00 lOOZ 0.00 1,263.00
<br />6.2nd Coat Int.7,500.00 0.00 0.00 0.00 0.00 OX 7,500.00 0.00
<br />7.Finish Coat INt.7,500.00 0.00 0.00 0.00 0.00 ox 7,500.00 0.00
<br />8.Blast Prime Ext 29,500.00 0.00 23,600.00 0.00 23,600.00 SOX 5,900.00 1,180.00
<br />9.2nd Coat INt 10,000.00 0.00 0.00 0.00 0.00 ox 10,000.00 0.00
<br />10.Finish Coat Int.10,000.00 0.00 0.00 0.00 0.00 ox 10,000.00 0.00
<br />11.Fence 10,780.00 0.00 5,390.00 0.00 5,390.00 ox 5,390.00 269.50
<br />12.Cathodic Protection 12,740.00 0.00 0.00 0.00 0.00 ox 12,740.00 0.00
<br />13.Logos 4,000.00 0.00
<br />0.00 0.00 0.00 ox 4,000.00 0.00
<br />14.Change Order Retch 2,500.00 0.00 2,500.00 0.00 2,500.00 lOOX 0.00 125.00
<br />209,731.00 0.00 144,826.00 0.00 144,826.00 Variei 64,905.00 7,241.30
<br />4 r Ml, uoouumt cma • cohtinimtion .smekt kj« coi • mi edition • aia * • ©wi • the A merican wsTiTure op AJioiiTtcn. I’is nesp \ork
<br />f.t'^ I AVENUE, n w. smashincton . oc i<wnb.Situ • WMItmO: IMeansed photoeopyEAQ vtobM Uik oopaiiahl kaw aid oB udijaat Cia la bjal ;irac;auUan.bf/VO-JUO-J
<br />W
<br />i
|