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Page 5 of 6 <br /> ATTACHMENT A <br /> 1 . List of all subcontractors , laborers , materialmen and suppliers who have not been <br /> paid from the payment received from the last Pay Request and the reason why <br /> they were not paid (attach additional pages as necessary) : <br /> 2 . List of all subcontractors , laborers , materialmen and suppliers for which a signed <br /> release of lien form (partial or final as applicable) is not included with this Pay <br /> Request, together with an explanation as to why the release of lien form is not <br /> W <br /> ncluded (attach additional pages as necessary) : <br /> 00622 - Contractor's Application for Payment - 03-10 rev.doc <br /> 00622 - 5 <br /> F:1Public Works%ENGINEERING DIVISION PROJECTS%1131-IR Blvd Resurfacing 41 st St to 53rd St-SEE PROD 0927Wdmim\Contract Documents\00622 - Contractors Application <br /> for <br /> Payment = 03-10 rev.doc Rev. 05/01 <br />