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__ Unstfu ctions on reverse side)application NO: ThroePERIOD TO: 8-31-92ARCHITECT'S PROJECT NO: 1124.04CONTRACT DATE:wet ONI OfOhtribvtion to:□ owner□ ARCHITECT□ CONTRACTOR□□SUM.................................... 342,500.00..................................$ ( 13.870.75)^TE (Line 1 ±2)........................j 328.629.2SrOKED TO DAH....................S ,14 9.000 nnWork $ 14.682.00 703)sriai $ 218.00 <br />■ 5b or <br />C703) <br />ainage <br />tal) <br />:ates for <br />14,900.00 <br />134,100.00 <br />n prior Certificate)...............$ 110.799.00 m <br />.......................................... J-- 23.301.00 <br />iSREUINAGE ....................j 194.S29.2S <br />L <br />J. WATRUD I <br />f certitied diffen from the amount applied for.) <br />Date:—----------------------------------------------------------------------------------------------------------------------------------- - ■ <br />abte^The AMOUNT CERTIFIED is payable only to Ihe <br />f w acceptance of payment are wdhouT <br />■ >wner or Contractor under this Contract <br />r.702-1*>ai <br />I ' »ORONO Clii H/vLL/i>... . i. I'uot.IC WokKS Bu i SCONTINUATION SHEET /\IA DOCLJMLNT G703 (Instructions on reverse side) I’ACt PACESAIA Document C7()>, APPIICATION AND CERTIFICATE EOR PAYMENT, conlaininji Contrudor's signerl Certificalion is attached.In tabulations below, amounts are stated to the nearest dollar.Use Column I on Contracts where variable retaina(;e for line items may apply.TIMNO.BmSCKIl’TION Of WOKK1. <br />2. <br />Foundation - Rebar C.B. - above grade Cone, floors ixt. Veneer Site <br />PUBLIC WORKS <br />City Hall/Police Station <br />Veneer <br />CSCHLnUILI)VAIIJE61,800.0065,800.0033.800.0053.400.00 30,429.25 <br />83,400.00 <br />328,629.25 <br />rWORK COMPIfTinROM I’KtVIOUS APPI ICATION (D I £)60,600.0059,510.00-0-3,000.00-0- <br />-0- <br />123,110.00 <br />THIS PI RIOT)1,200.002,500.00-0-5,010.00-0- <br />15,000.00 <br />APPI ICATION NUMBER APPLICATION DATE PERIOD TO ARCHITECT'S PROJECT NO Three8-01-92 to 8-31-92 8-31-92 <br />3,710.00 <br />FMAURIAIS PKIbLNIlY STORtI) (NOT IN I) OR 1)C. <br />1,680.00 <br />2,180.00 <br />TOTALCOMPI [TED AND SIOKLD TO (TATE (D E E I F)61,800.0062,510.00-0-8,010.00-0- <br />16,680.00 <br />149,000.00 <br />BALANCE TO FiNiSII (C-G)-0-3,290.0033.800.0045.390.00 30,429.25 <br />66,720.00 <br />179,629.25 <br />IRETAINAGE6,180.006,251.00-0-801.00-0- <br />1,668.00 <br />14,900.00 <br />’ ALA DOCUMINI G703 • AIMIKAIION SN|) ( IKtllK All M)K fAVMINI • MAY V«H IDDION • AIA* • t> l‘J«) <br />' nil AAURltArj INSTIUJll Of ARCMiriaS, 1715 NIW YORK AVINUL, N \V„ VS'ASHIN(,ION, D C. iOOOt.G703-I983