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<br /> �" Chan es er Pro�ect Manager:
<br /> =:� _ 9 P J
<br /> _ Document G703 1992 Jason Rentmeester
<br /> Continuation Sheet
<br /> AIA Document G702T"x-1992,Application and Certificate for Payment,or G732T"�-2009, APPLICATION N0: �� �
<br /> Application and Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE: 11/21/2014
<br /> containing Contractor's signed certification is att�ched.
<br /> In tabulations below,amounts are in US dollars. PERIOD T0: 11/30/2014
<br /> Use Colwnn I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT N0:
<br /> A B C D E F G H I
<br /> WORK COMPLETED
<br /> MATERIALS TOTAL BALANCE TO
<br /> ITEM SCHEDULED PRESENTLY COMPLETED AND % RETAINAGE
<br /> DESCRIPTION OF WORK FROM PREVIOUS FINISH
<br /> NO. VALUE STORED STORED TO DA1'E (G-C) (If var�able rate)
<br /> APPLICATION THIS PERIOD �yot in D or E) (D+E+F) (C-G)
<br /> (D+E)
<br /> 01 Bond $ 2,855.00 $ 2,855.00 $ - $2,855.00 00% $0.00 $142.75
<br /> 02 Architectural Woodwork $ 58,860.00 $ - $ C��' S�,�� $
<br /> 03 Joint Sealers $ 3,240.00 $ - $ - $0.00 0% $3,240.00 $0.00
<br /> 04 Doors, Frames, Hardware $ 29,300.00 $ $`1'.�`�- $7,325.00 25% $21,975.00 $366.25
<br /> 05 Sectional overhead doors $ 3,325.00 $ - $ - $0.00 0% $3,325.00 $0.00
<br /> 06 Louvers $ 3,595.00 $ - $ - $0.00 0% $3,595.00 $0.00
<br /> 07 Toilet Compartments $ 1,740.00 $ - $ - $0.00 0% $1,740.00 $0.00
<br /> 08 ToiletAccessories $ 3,000.00 $ - $ 2,100.00 $2,100.00 70% $900.00 $105.00
<br /> 09 Fire Extinguishers $ 720.00 $ - $ - $0.00 0% $720.00 $0.00
<br /> 10 Entrance Mats $ 2,160.00 $ - $ - $0.00 0% $2,160.00 $0.00
<br /> 11 Selective Demo Gen. Con. $ 8,480.00 $ 8,480.00 $ - $8,480.00 00% $0.00 $424.00
<br /> 12 Selective Demo- Labor $ 31,670.00 $ 31,670.00 $ - $31,670.00 00% $0.00 $1,583.50
<br /> 13 Allowance $ 3,000.00 $ - $ 1,311.00 $1,311.00 44% $1,689.00 $65.55
<br /> 14 Carpentry -Gen. Con. $ 9,145.00 $ $ Z-z�"2-5 $2,286.25 25% $6,858.75 $114.31
<br /> 15 Rough Carpentry L&M $ 19,585.00 $ $� �,���jS $18,605.75 95% $979.25 $930.29
<br /> 16 Finish Carpentry $ 8,650.00 $ - $ - $0.00 0% $8,650.00 $0.00
<br /> 17 Doors - Labor $ 4,905.00 $ - $ - $0.00 0% $4,905.00 $0.00
<br /> 18 Louvers- Labor $ 620.00 $ - $ - $0.00 0% $620.00 $0.00
<br /> 19 Specialties- Labor $ 3,400.00 $ - $ - $0.00 0% $3,400.00 $0.00
<br /> 20 Change Order 1A $ (654.00) $ , $�5�y,,X��' -$654.00 00°/a $0.00 -$32.70
<br /> 21 Change Order 1B $ (149.00) $ . $� ��1�1.�p� -$149.00 00% $0.00 -$7.45
<br /> GRANDTOTAL $197,447.00 $ '�-�'3.��-- v� 3�. �Z'" Z3 .�(� 37 �b �2 �-� ' �iO��•�
<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 G703T""-1992.Copyright OO 1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of ArcMitects.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 it,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 ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal
<br /> counsel,copyright@aia.org. 10727pp0DeA
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