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_ ,„, „, ... ._ .-.---zATA Document G703' - 1992 Continuation Sheet AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT. APPLICATiON NO: containing Contractor's signed certification is attached. APPLICATION DATE: a In tabulations below.amounts arc stated to the nearest dollar. 01/05/11 Use Column I on Contract%where variable retainage for line items may apply. PERIOD TO: ol/os/11 ARCHITECTS PROJECT NO: 1 A I B C r D i E F I O H J I WORK COMPLETED I MATERIALS TOTAL 1 1 PRESENTLY COMPLETED . B RETAINAGE ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS STORED AND STORED TO (IF VARIABLE NO. VALUE APPLICATION+ THIS PERIOD (NOT IN TO DATE (G''C) PINISH RATE) 41110 (DD OR E) (D+ELF) (C-G) 1 1 PEES 4 REMITS 2,600 2,600 0 0 2,600 100 0 0 2 1 DEMOLITION MATERIAL 4.200 4,200 0 0 4,200 100 I 2 0 2 2 DE/10LIT10N LABOR 11,900 11.900 0 0 11.900 i 100 0 0 3 1 ROOF INSULATION MATPRIar, 31,100 31.100 0 it 0 31.100 I 100 0 0 3 2 ROOF INSULATION LABOR 12,000 12,000 0 0 12,000 100 0 0 4 1 ROOF NOMA= MATERIAL 19,100 19,100 0 0 19.100 100 0 0 4 2 ROOF 1ffiMBRANE LABOR 13,200 13,200 0 0 13.200 100 0 0 5,1 SHEET METAL MATERIAL 2.300 2,300 0 0 2.300 100 0 0 5'2 Siff METAL LABOR 13,600 13,600 0 0 13,600 100 0 0 6'1 CXANGY ORDER IL 2,800- 0 2.800- 0 2.800- 100 0 0 II Ill � I 1 1 I I I .a.,_oc_ -ls,c^o - a� , r ^ - CAUTION:You should sign an original MA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. MA Document G703"-1992.Copyright 0 1963.1965.1966.1967,1970.1978,19E3 and 1992 Oy The American Institute of Architects All rights reserved.WARNING:This AIAeDocument c protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution Cl this Ale Documont,or any portion of it,may result In severe civil and criminal pora:ties,and will be prosecuted to the maximum extent DO:sible under the law.Purchaser:are 0erm,lted to reproduce ter+(10)copes of!Ms document when compacted.To report copyright violations of AlA Contract Documents,e-mail The Amencan institute o1 ArC+Reels'legal COuntel,oepyrlghteail.crg.