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CONTINUATION SHEET
<br />APPLICATION AND CERTIFICATION FOR PAYMENT,
<br />APPLICATION NO.:
<br />13
<br />containing Contractor's signed Certification is attached.
<br />APPLICATION DATE:
<br />10/20/20
<br />In tabulations
<br />below, amounts are stated to the nearest dollar.
<br />PERIOD
<br />TO:
<br />10/31/20
<br />High Five Erectors II, Inc.
<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 />051200 Structural Steel
<br />$129,841.00
<br />$129,841.00
<br />$129,841.00
<br />100.00%
<br />2
<br />052100 Steel Joists
<br />$100,523.00
<br />$100,523.00
<br />$100,523.00
<br />100.00%
<br />3
<br />053100 Steel Decking
<br />$45,888.00
<br />$45,888.00
<br />$45,888.00
<br />100.00%
<br />4
<br />055000 Metal Fabrications
<br />$8,508.00
<br />$8,508.00
<br />$8,508.00
<br />100.00%
<br />5
<br />055100 Metal Pan Stairs
<br />$43,996.00
<br />$43,996.00
<br />$43,996.00
<br />100.00%
<br />6
<br />055213 Pipe & Tube Railings
<br />$71,614.00
<br />$71,614.00
<br />$71,614.00
<br />100.00%
<br />7
<br />Allowance
<br />$30,000.00
<br />$30,000.00
<br />$30,000.00
<br />100.00%
<br />8
<br />Bond
<br />$5,380.00
<br />$5,380.00
<br />$5,380.00
<br />100.00%
<br />1
<br />Structural Steel Erection (CO
<br />$4,190.00
<br />$4,190.00
<br />$4,190.00
<br />100.00%
<br />#1)
<br />1
<br />Structural Steel Erection (CO
<br />($6,888.15)
<br />($6,888.15)
<br />($6,888.15)
<br />100.00%
<br />#2)
<br />1
<br />Structural Steel Erection (CO
<br />$500.00
<br />$500.00
<br />$500.00
<br />100.00%
<br />#3)
<br />1
<br />Structural Steel Erection (CO
<br />$672.00
<br />$672.00
<br />$672.00
<br />100.00%
<br />#4)
<br />1
<br />Structural Steel Erection (CO
<br />$3,000.00
<br />$3,000.00
<br />$3,000.00
<br />100.00%
<br />#5)
<br />1
<br />Structural Steel Erection (CO
<br />$8,650.00
<br />$8,650.00
<br />$8,650.00
<br />100.00%
<br />#6)
<br />1
<br />Structural Steel Erection (CO
<br />$600.00
<br />$600.00
<br />$600.00
<br />100.00%
<br />#7)
<br />1
<br />Structural Steel Erection (CO
<br />$1,200.00
<br />$1,200.00
<br />$1,200.00
<br />100.00%
<br />#7)
<br />1
<br />Structural Steel Erection (CO
<br />$3,040.00
<br />$3,040.00
<br />$3,040.00
<br />100.00%
<br />#8)
<br />1
<br />Structural Steel Erection (CO
<br />$1,752.00
<br />$1,752.00
<br />$1,752.00
<br />100.00%
<br />#9)
<br />1
<br />Structural Steel Erection (CO
<br />($303.85)
<br />($303.85)
<br />($303.85)
<br />100.00%
<br />#10)
<br />1
<br />Structural Steel Erection (CO
<br />$4,217.00
<br />$4,217.00
<br />$4,217.00
<br />100.00%
<br />#10)
<br />1
<br />Structural Steel Erection (CO
<br />$844.00
<br />$844.00
<br />$844.00
<br />100.00%
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