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DocuSIgn Envelope ID: 27E728AB-E761-4D8D-8B46-447BC430C75D <br />;CONTINUATION SHEET <br />APPLICATION AND CERTIFICATION FOR PAYMENT, <br />APPLICATION NO.: <br />8 <br />Containing Contractor's signed Certification is attached. <br />In tabulations below, amounts are stated to the nearest dollar. <br />APPLICATION DATE: <br />07/01/20 <br />PERIOD TO: <br />07/01/20 <br />Hakanson Anderson Associates <br />PROJECT NO.: <br />19520-0033 <br />A ? B C <br />D E <br />F <br />G <br />H <br />I <br />i <br />WORK COMPLETED <br />MATERIALS <br />TOTAL ; <br />ITEM SCHEDULED FROM PREVIOUS <br />DESCRIPTION OF WORK <br />PRESENTLY <br />COMPLETED % <br />BALANCE TO <br />RETAINAGE (IF <br />NUM VALUE APPLICATION (D THIS PERIOD <br />STORED (NOT IN ` AND STORED TO (G + C) ;, <br />FINISH (C - G) <br />VARIABLE RATE) <br />+ E) <br />D OR E) <br />DATE <br />1 Construction Staking $41,280 001 <br />$21,912.001 $1,710.001 <br />$23,622.00 57.22% <br />$17,658.00 <br />$1,181.10 <br />PAYMENT TOTALS $41,280 00 <br />$21,912.00 1 $1,710.00 1 <br />$23,622.00 57.22% 1 <br />$17,658.00 j <br />$1,181.10 <br />Page 1 of 1 <br />