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. CCN E INUATGON SZ -MET <br />AIA DOCUMENT G703 <br />AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing <br />Contractor's signed Certification is attached. <br />In tabulations below, amounts are stated to the nearest dollar. <br />Use Column I on Contracts where variable retainage for line items may apply. <br />FACE 6 rr 32 rAGES <br />APPLICATION NUMBER: 21 <br />APPLICATION DATE: 1 2/3 0/81 <br />PERIOD FROM: 12/10/81 C2) - <br />TO: 12/31/81 0) <br />ARCHITECT'S PROJECT NO: 9303 t•-.••4 <br />A <br />B <br />C <br />D <br />E <br />F <br />j G <br />H. <br />�Q. <br />ITE <br />ITEM <br />No. <br />OF WORK <br />- <br />SCHEDULED <br />VALUE <br />WORK COMPLETED'TOTAL <br />COMPLETED <br />AND STORED <br />TO DATE <br />(D-I-E-FF1 <br />% <br />(G=C) <br />BALANCE <br />FINISH <br />`C—C;) <br />RETAINAGE <br />� <br />PreviousTO <br />Applications <br />This Application <br />'Work in Place <br />Stored Materials <br />l <br />(not in D or E) <br />092 <br />094 <br />ROOFING ELEV. ROOF NO. <br />55,000.00 <br />55,000.00 <br />55,000.00 <br />100 <br />5,500.00 <br />t <br />• <br />• <br />PAGE TOTAL <br />55,000.00 <br />55,000.60 <br />55,000.00 <br />100 <br />5,500.03 <br />TOTAL OR SUB TOTAL <br />331,350.00 <br />381,350.00 <br />331,350.00 <br />38,135.09; <br />AIA [)r)C.Ut.1CNT 6703 • CONTINUATIQN SHEET • APRIL 1978 EDITION • AIA • © 1978 <br />THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 <br />G703 —1g73 <br />