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Page 5 of 5 <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 /> included ( attach additional pages as necessary) : <br /> 00622 - 5 <br /> F:\Public Works\ENGINEERING DIVISION PROJECTS\05501-58th Ave Rdwy Modifications\Admim\bid documents\Addendums\00622 - Contractor's Application for Payment - 03-10 <br /> rev.doc Rev. 05/01 <br />