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SECTION 00622 - Contractor's Application for Payment. doc Application for Payment No . For Work Accomplished through the period of through To : Indian River County (OWNER) From : (CONTRACTOR) Contract: 2008062 Project: 1St Road from 35th Avenue to 32"d Avenue and 10th Court SW from Oslo Road to 7th Street SW OWNER' s Contract No . 0522 , 0436 ENGINEER' s Contract No . N/A ENGINEER Indian River County 1 . Original Contract Price : $ 2 . Net change by Change Orders and Written Amendments (+ or -) : $ 3 . Current Contract Price ( 1 plus 2) : $ 4 . Total Work to date : 4 . a Percentage of Work completed to date : 4 . b Total Work completed to date : $ 4 . c Total equipment and material stored to date : $ ( 1 ) 4 . d Total Work completed and stored to date : (4 . b plus 4 . c) $ 5 . Retainage (per Agreement) : 5 . a 10% of completed Work (0 . 10 x 4 . b) : $ 5 . b 20% of stored equipment and material (0 . 20 x 4 . c) : $ 5 . c Total Retainage (5 . a plus 5 . b) : $ 6 . Total Work completed and stored to date less retainage (4 . d minus 5 . c) : $ 7 . Previous Payments : $ 8 . AMOUNT DUE THIS APPLICATION 6 MINUS 7 ) : $ ( 1 ) Attach detailed schedule and copies of all paid invoices . 1 . Original Contract Price : 2 . Net change by Change Orders and Written Amendments (+ or -) : 3 . Current Contract Price ( 1 plus 2) : 4 . Total completed and stored to date : 5 . Retainage (per Agreement) : of completed Work: $ % of stored material : $ Total Retainage : 6 . Total completed and stored to date less retainage (4 minus 5) : 7 . Less previous Application for Payments : Be DUE THIS APPLICATION J6 MINUS 7) : 00622 - Contractor's Application for Payment 00622 - 1 FAEngineering\Petition Paving\0522 1 st Rd. from 32nd Ave. to 35th Ave\Bid Documents\00622 - Contractors Application for Paymentdoc Rev. 05101