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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 />Peterson Companies, Inc <br />APPLICATION NO.: 3 <br />APPLICATION DATE: 04/29/20 <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 />Survey and Layout <br />$4,310.00 <br />$4,310.00 <br />$4,310.00 <br />100.00% <br />$215.51 <br />2 <br />Athletic Equipment - Labor <br />$27,489.00 <br />$6,872.25 <br />$1,374.45 <br />$8,246.70 <br />30.00% <br />$19,242.30 <br />$412.34 <br />3 <br />Athletic Equipment - Materials <br />$68,608.00 <br />$17,152.00 <br />$51,456.00 <br />$68,608.00 <br />100.00% <br />$3,430.40 <br />4 <br />Scoreboard - Labor <br />$11,420.00 <br />$5,710.00 <br />$5,710.00 <br />50.00% <br />$5,710.00 <br />$285.50 <br />5 <br />Scoreboard - Materials <br />$22,128.00 <br />$22,128.00 <br />$22,128.00 <br />100.00% <br />$1,106.40 <br />1 <br />Athletic Equipment (CO #1) <br />$29,154.00 <br />$7,943.25 <br />$14,892.50 <br />$22,835.75 <br />78.33% <br />$6,318.25 <br />$1,141.79 <br />1 <br />Athletic Equipment (CO #2) <br />$7,150.00 <br />- <br />$7,150.00 <br />- <br />1 <br />Athletic Equipment (CO #3) <br />$3,315.91 <br />$1,657.96 <br />$1,657.95 <br />$3,315.91 <br />100.00% <br />$165.80 <br />PAYMENT TOTALS <br />$173,574.91 <br />$65,773.46 <br />$69,380.90 <br />$135,154.36 <br />77.86% <br />$38,420.55 <br />$6,757.74 <br />Page 1 of 1 <br />