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DocuSign Envelope ID: 18BCC2EB-5C45-4AO3-BBDA-FOAFAF992DFC <br />CONTINUATION 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 />CROSSTOWN MASONRY, INCORPORATED <br />APPLICATION NO.: 9 <br />APPLICATION DATE: 04/22/20 <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 />Concrete/Masonry (CO #1) <br />$697.00 <br />$697.00 <br />$697.00 <br />100.00% <br />$34.85 <br />1 <br />Concrete/Masonry (CO #2) <br />$33,996.00 <br />$33,996.00 <br />$33,996.00 <br />100.00% <br />$1,699.80 <br />1 <br />Concrete/Masonry (CO #3) <br />($3,778.00) <br />($3,778.00) <br />($3,778.00) <br />100.00% <br />($188.90) <br />1 <br />Concrete/Masonry (CO #4) <br />$689.00 <br />$689.00 <br />$689.00 <br />100.00% <br />$34.45 <br />1 <br />Concrete/Masonry (CO #5) <br />($15,209.00) <br />($15,209.00) <br />($15,209.00) <br />100.00% <br />($760.45) <br />1 <br />Concrete/Masonry (CO #6) <br />$2,930.00 <br />$2,930.00 <br />$2,930.00 <br />100.00% <br />$146.50 <br />1 <br />Concrete/Masonry (CO #7) <br />($8,500.00) <br />($8,500.00) <br />($8,500.00) <br />100.00% <br />($425.00) <br />1 <br />Concrete/Masonry (CO #6) <br />$11,039.00 <br />$11,039.00 <br />$11,039.00 <br />100.00% <br />$551.95 <br />PAYMENT TOTALS <br />$2,956,864.00 <br />$2,703,013.00 <br />$36,000.00 <br />$2,739,013.00 <br />92.63% <br />$217,851.00 <br />$136,950.65 <br />Page 2 of 2 <br />