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DocuSign Envelope ID: B21CAEBD-7600-4BB5-BB91-7BFCFA6AOB90
<br />CONTINUATION SHEET
<br />APPLICATION AND CERTIFICATION FOR PAYMENT,
<br />APPLICATION NO.:
<br />8
<br />containing Contractor's signed Certification is attached.
<br />APPLICATION DATE:
<br />09/23/20
<br />In tabulations
<br />below, amounts are stated to the nearest dollar.
<br />PERIOD
<br />TO:
<br />09/23/20
<br />Ebert Construction
<br />PROJECT NO.:
<br />19520-0033
<br />A
<br />B
<br />C
<br />D E
<br />F
<br />G
<br />H 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 RETAINAGE (IF
<br />NUM
<br />VALUE
<br />APPLICATION (D THIS PERIOD
<br />STORED (NOT IN
<br />AND STORED TO
<br />(G + C)
<br />FINISH (C - G) VARIABLE RATE)
<br />+ E)
<br />D OR E)
<br />DATE
<br />1
<br />General Conditions
<br />$14,700.00
<br />$14,700.00
<br />$14,700.00
<br />100.00%
<br />2
<br />MPB - Walks - Materials
<br />$30,617.00
<br />$30,617.00
<br />$30,617.00
<br />100.00%
<br />3
<br />MPB - Walks - Labor
<br />$44,082.00
<br />$44,082.00
<br />$44,082.00
<br />100.00%
<br />4
<br />MPB - Curb - Materials
<br />$18,273.00
<br />$18,273.00
<br />$18,273.00
<br />100.00%
<br />5
<br />MPB - Curb - Labor
<br />$22,333.00
<br />$22,333.00
<br />$22,333.00
<br />100.00%
<br />6
<br />Lion - Walks - Materials
<br />$83,053.00
<br />$83,053.00
<br />$83,053.00
<br />100.00%
<br />7
<br />Lion - Walks - Labor
<br />$123,318.00
<br />$123,318.00
<br />$123,318.00
<br />100.00%
<br />8
<br />Lion - Curb - Materials
<br />$18,461.00
<br />$18,461.00
<br />$18,461.00
<br />100.00%
<br />9
<br />Lion - Curb - Labor
<br />$22,563.00
<br />$22,563.00
<br />$22,563.00
<br />100.00%
<br />10
<br />Allowance
<br />$10,000.00
<br />$10,000.00
<br />$10,000.00
<br />100.00%
<br />1
<br />Site Concrete (CO #1)
<br />$3,311.40
<br />$3,311.40
<br />$3,311.40
<br />100.00%
<br />1
<br />Site Concrete (CO #2)
<br />($1,570.47)
<br />($1,570.47)
<br />($1,570.47)
<br />100.00%
<br />1
<br />Site Concrete (CO #3)
<br />($4,286.00)
<br />($4,286.00)
<br />($4,286.00)
<br />100.00%
<br />1
<br />Site Concrete (CO #4)
<br />($1,561.90)
<br />($1,561.90)
<br />($1,561.90)
<br />100.00%
<br />1
<br />Site Concrete (CO #5)
<br />($10,522.07)
<br />($10,522.07)
<br />($10,522.07)
<br />100.00%
<br />1
<br />Site Concrete (CO #6)
<br />$3,937.50
<br />$3,937.50
<br />$3,937.50
<br />100.00%
<br />1
<br />Site Concrete (CO #7)
<br />($3,947.42)
<br />($3,947.42)
<br />($3,947.42)
<br />100.00%
<br />1
<br />Site Concrete (CO #8)
<br />$6,032.25
<br />$6,032.25
<br />$6,032.25
<br />100.00%
<br />1
<br />Site Concrete (CO #9)
<br />$1,266.47
<br />$1,266.47
<br />$1,266.47
<br />100.00%
<br />PAYMENT TOTALS
<br />$380,059.76
<br />$378,793.29 $1,266.47
<br />$380,059.76
<br />100.00%
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