Laserfiche WebLink
DocuSign Envelope ID: 18BCC2EB-5C45-4AO3-BBDA-FOAFAF992DFC <br />NTINUATION SHEET <br />APPLICATION AND CERTIFICATION FOR PAYMENT, <br />containing Contractor's signed Certification is attached. <br />In tabulations below, amounts are stated to the nearest dollar. <br />Ebert Construction <br />APPLICATION NO.: 5 <br />APPLICATION DATE: 04/24/20 <br />PERIOD TO: 04/30/20 <br />PROJECT NO.: 19520-0033 <br />A <br />B <br />C <br />D <br />E <br />F <br />G <br />H <br />I <br />WORK COMPLETED <br />MATERIALS <br />TOTAL <br />ITEM <br />DESCRIPTION OF WORK <br />SCHEDULED <br />FROM PREVIOUS <br />PRESENTLY <br />COMPLETED <br />% <br />BALANCE TO <br />RETAINAGE (IF <br />NUM <br />VALUE <br />APPLICATION (D <br />THIS PERIOD <br />STORED (NOT IN <br />AND STORED TO <br />(G + C) <br />FINISH (C - G) <br />VARIABLE RATE) <br />+ E) <br />D OR E) <br />DATE <br />1 <br />General Conditions/Bond <br />$9,888.00 <br />$4,259.00 <br />$2,662.60 <br />$6,921.60 <br />70.00% <br />$2,966.40 <br />$346.08 <br />2 <br />Selective Demolition <br />$193,912.00 <br />$8,166.00 <br />$176,050.40 <br />$184,216.40 <br />95.00% <br />$9,695.60 <br />$9,210.82 <br />3 <br />Allowance <br />$20,000.00 <br />$2,794.00 <br />$2,794.00 <br />13.97% <br />$17,206.00 <br />$139.70 <br />1 <br />Demolition (CO #1) <br />($3,866.00) <br />($3,866.00) <br />($3,866.00) <br />100.00% <br />($193.30) <br />1 <br />Demolition (CO #2) <br />$1,324.40 <br />$1,324.40 <br />$1,324.40 <br />100.00% <br />$66.22 <br />2 <br />Demolition (CO #3) <br />($9,000.00) <br />- <br />($9,000.00) <br />- <br />PAYMENT TOTALS <br />$212,258.40 <br />$12,677.40 <br />$178,713.00 <br />$191,390.40 <br />90.17% <br />$20,868.00 <br />$9,569.52 <br />Page 1 of 1 <br />