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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 />2 <br />containing Contractor's signed Certification is attached. <br />In tabulations below, amounts are stated <br />to the nearest dollar. <br />APPLICATION DATE: 07/20/20 <br />PERIOD TO: <br />07/31/20 <br />Building Material Supply, Inc. <br />PROJECT NO.: <br />19520-0033 <br />A B <br />C <br />D <br />E F <br />G <br />H <br />WORK COMPLETED <br />( MATERIALS <br />TOTAL <br />3 <br />ITEM <br />DESCRIPTION OF WORK <br />NUM <br />SCHEDULED <br />VALUE <br />FROM PREVIOUS <br />PRESENTLY <br />STORED IN <br />COMPLETED <br />AND STORED TO <br />% <br />+ C) <br />BALANCE TO <br />FINISH <br />RETAINAGE (IF <br />APPLICATION (D <br />THIS PERIOD (NOT <br />y <br />(G <br />(C - G) <br />VARIABLE RATE) <br />+ E) <br />D OR E) <br />DATE <br />Toilet Partitions -Material <br />$41,131.00 <br />$41,131.00 <br />$41,131.00 E <br />100.00% <br />$2,056.55 <br />Toilet Accessories -Material <br />$44,545.00. <br />$44,545.00 <br />$44,545.00 = <br />100.00% j <br />$2,227.251 <br />`Toilet Partitions -Install <br />$26,700.00 E <br />_ <br />$26,700.00 <br />$26,700.00 _ <br />100.00%j <br />$1,335.00 <br />l Toilet Accessory -Install <br />$14,925.00 <br />$14,925.00 <br />$14,925.00 <br />100.00% <br />$746.25 <br />€Bike Racks -Material <br />` <br />$4,887.00 <br />$4,887.00 <br />$4,887.00 <br />100.00% <br />$244.35 <br />Bike Racks -Install <br />$750.00 <br />f <br />$750.00 <br />- <br />i' Insurance -Additional <br />$385.001 <br />$385.00 <br />$385.00 <br />100.00% i <br />$19.25 <br />i' Endorsements <br />3 Lockers (CO #1) <br />$3,448.00 E <br />$3,448.00 E <br />Toilet Partitions and <br />$2,518.00 <br />$2,518.00 <br />I Accessories (CO #2) <br />€ <br />I <br />r 1 1 Toilet Partitions and <br />$1,476.001 <br />$1,476.00 <br />Accessories (CO #3) <br />PAYMENT TOTALS <br />$140,765.00 <br />$127,686.00 i <br />$4,887.00 I <br />$132 573.001 <br />94.18%1 <br />$8,192.00 <br />$6,628.65 1 <br />Page 1 of 1 <br />