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' AlA Document. G703" -1992
<br />Continuation Sheet
<br />AIA Document G702T"-1992, Application and Certificate for Payment, or G732T"L-2009, APPLICATION NO: 6
<br />Application and Certificate for payment, Construction Manager as Adviser Edition, containing Contraigor's signed certification is attached. APFLICAMON DATE: 12272021
<br />In tabulations below, amounts are in US dollars. PEMb TO: 12/27/2021
<br />Use C0lumtr l on.. Contracts where variable retainage for line items may annly. r
<br />A
<br />B
<br />C
<br />H
<br />I
<br />WORK COMPLETED
<br />ITEM
<br />NO
<br />DESCRIPTION OF WORK
<br />SCHEDULED
<br />MATERIALS
<br />PRESENTLY
<br />TOTAL
<br />COMPLETED AND
<br />/1
<br />BALANCE TO
<br />RETAWAGE
<br />FROMPRBVTOUS
<br />VALUE
<br />APPLICATION
<br />THIS PERIOD
<br />STORED
<br />STORED To DATE
<br />(G+C)
<br />FINISH
<br />(C-G)
<br />(IRETAblAGE
<br />e rate)
<br />(D+E)
<br />(Not inDorE)
<br />(D+E+F)
<br />01
<br />Permit, SAC Fee
<br />4,700.00
<br />4,700.00
<br />4,700.00
<br />100.00
<br />235.00
<br />02
<br />Bond, Insurance, Mobilize
<br />10,200.00
<br />10,200.00
<br />10,200.00
<br />100.()0
<br />510.00
<br />03
<br />General Conditions
<br />27,100.00
<br />13,674.66
<br />13,674.66
<br />-Ft.
<br />13,425.34
<br />683.74
<br />04
<br />024119 Demolition
<br />17.000.00
<br />17,000.00
<br />17,000,00
<br />T00i00
<br />850.00
<br />05
<br />033000 Concrete
<br />12,000.00
<br />12,000.00
<br />12,000.00
<br />100.00
<br />600.00
<br />06
<br />055000 Metal Fabrications
<br />8,000.00
<br />07
<br />061000 Rough Carpentry
<br />7,200.00
<br />6,480.00
<br />720.00
<br />7,200.00
<br />100.00
<br />8,000.00
<br />360.00
<br />06
<br />062013 Exterior Rinish Carp
<br />7,800.00
<br />5,850.00
<br />1,170.00
<br />7,020.00
<br />90.00
<br />780.00
<br />351.00
<br />09
<br />083313 Access Doors
<br />300.00
<br />150.00
<br />75.00
<br />225.00
<br />75.00
<br />75.00
<br />11.25
<br />10
<br />i383313 Coiling Doors
<br />5,300.00
<br />1,325.00
<br />1,325-00
<br />25.00
<br />3,975.00
<br />66.25
<br />11
<br />092000 Gypsum Board
<br />12,000.00
<br />6,000.00,
<br />6,000.00
<br />12,0W.00
<br />100,00
<br />60000
<br />12
<br />093000 Tile
<br />7,500.00
<br />7,500.00
<br />7,500.00
<br />100.00
<br />375.00
<br />13
<br />096500 Rubber Floor
<br />4,500.00
<br />4,500.00
<br />4,500.00
<br />100.00
<br />225.00
<br />14
<br />097750 FRP
<br />6,000.00
<br />6,000.00
<br />6,000.00
<br />100.00
<br />300.00
<br />15
<br />099100 Painting
<br />8,500.00
<br />2,750.00
<br />2,750.00
<br />50.00
<br />2,750.00
<br />137.50
<br />16
<br />100000 Div 10 Misc M
<br />1,800.00
<br />1,350.00
<br />1,350.00
<br />75.00
<br />450.00
<br />67.50
<br />17
<br />221316 Underground Plumbing
<br />6,070.00
<br />6,070.00
<br />6,070.00
<br />100,00
<br />303.50
<br />18
<br />221116 Water
<br />9,850.00
<br />4,925.00
<br />4,925.00
<br />50.00..;
<br />4,925.00
<br />24625
<br />19
<br />221316 Waste & Vent
<br />3,760.00
<br />3,760.00
<br />3,7BO.00
<br />100.00
<br />188.00
<br />20
<br />224000 Plumbing Fixtures Matt
<br />2,400.00
<br />1,200.00
<br />1,200.00
<br />50,00
<br />1,200,00
<br />60.00
<br />21
<br />224000 Plumbing Fixtures Labor
<br />4,650.00
<br />2,325.00
<br />2.325200
<br />50.00
<br />2,325.00
<br />116.25
<br />22
<br />230000 HVAC Material
<br />450000
<br />,.4,200.00
<br />2,250.00
<br />t,250-00
<br />50.00
<br />2,250.00
<br />112.50
<br />23
<br />230000 HVAC Labor
<br />L
<br />I 2,10U00
<br />2,100.00,
<br />50.00
<br />2,100.00
<br />105.00
<br />24
<br />260000'UndergroundlSite Elect
<br />13,57C.00
<br />13,570.00I
<br />13,570-00
<br />100.00
<br />678.50
<br />25 1
<br />26053S Elect Rou h In Matl
<br />3.000.00
<br />3,000.00
<br />3,00000
<br />100.00
<br />150.00
<br />GRAND TOTAL
<br />CAUTION:
<br />You should sinn An netnreel AlA r....l....w--
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<br />AIA Document G703- -1992. Copyripht®1963, 1965, 1986,1987, 1970, 1978, 19B3 and 1992 by The American Institute of Architects. All rights reserved, WARNING: This A1000cument is protected by U.S. Copyright
<br />Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any poreon of 1% may resun in severe civil and criminal penalties, and will be prosecuted to the maximum extent
<br />Possible under the O Purchasers are permilt8d to reproduce tan (10) copies of this document when completed. To report copyright violations of AIA Contract Documents, e-mail The American institute of ArddtacW' legal
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