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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 <br />is attached. <br />APPLICATION DATE: <br />07/17/20 <br />In tabulations below, amounts are stated to the nearest dollar. <br />PERIOD TO: <br />07/31/20 <br />Ebert Construction <br />PROJECT <br />NO.: <br />19520-0033 <br />A B <br />C <br />D <br />E F <br />G <br />H <br />I <br />l <br />WORK COMPLETED MATERIALS <br />TOTAL <br />ITEM <br />DESCRIPTION OF WORK <br />SCHEDULED FROM PREVIOUS <br />PRESENTLY <br />'AND <br />COMPLETED <br />% <br />BALANCE TO <br />RETAINAGE (IF <br />NUM <br />VALUE APPLICATION <br />(D <br />THIS PERIOD RED STONOT IN <br />STORED TO <br />(G + C) <br />FINISH (C - G) <br />VARIABLE RATE) <br />D OR E) <br />DATE <br />1 ;General Conditions/Bond <br />$9,888.00 £ <br />$9,591.36 <br />' <br />$296.64 <br />$9 888.00 I <br />100.00% <br />3 <br />- ; $494.40 <br />2 Selective Demolition <br />$193,912.00 <br />$193,912.00 <br />l <br />$193,912.00 [ <br />100.00% <br />- $9,695.60 <br />3 Allowance <br />$20,000.00 <br />$20,000.00 <br />- <br />$20,000.00 ` <br />100.00% <br />- $1,000.00 <br />1 ;Demolition (CO #1) <br />($3,866.00) <br />($3,866.00) I <br />($3,866.00) a <br />100.00%' <br />- ($193.30) <br />1 Demolition (CO #2) <br />$1,324.40 <br />$1,324.40 <br />- <br />$1,324.40 <br />100.00%- <br />-_ $66.22 <br />12 Demolition (CO #3) <br />($9,000.00) <br />($9,000.00) <br />- <br />($9,000.00) i <br />100.00% <br />- ($450.00) <br />1 Demolition CO #4 <br />($8 206 00) <br />100.00%, <br />- ($410.30) <br />1 Demolition (CO #5) <br />$528.001 <br />$528.00 <br />$528.00 , <br />100.00% <br />$26.40 <br />1 Demolition (CO #7) <br />($9,000.00) k <br />- <br />($9,000.00) <br />2 ; Demolition (CO #6) <br />$9,000.00 , <br />- <br />- <br />$9,000.00 <br />1 Demolition (CO #8) <br />$2,884 00 E <br />$2,884.00 <br />$2 884 00 i <br />100.00% 3 <br />- € $144.2001 <br />PAYMENT TOTALS <br />$207,464.40 <br />$204,283.761 <br />$3,180 64 j <br />$207,464.40 <br />100.00%' <br />-' $10,373.22 <br />Page 1 of 1 <br />