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CON-INUAT1018SHEET ALI DOCLAWT 0703 PAGE 2 OF 3 PAGES
<br />AIA Domment 0702. APPI.FCATION AND CFRTMCATION FOR PAYMENT. eMmining APPLICATION NOr l 2"127AL
<br />Cortractuis signed ccnificadua is attached. Central Regional W WTF Headwozim Rebab APPLICATION DATE: 4 -Apr -17
<br />In tabulations below, amounts are saved to the nearest do0w. PERIOD TO: 4 -Apr -17
<br />Use Column I on Contracts where variable retainage for line items may apply. ARCHIrECrS PROJECT NO. 2016023
<br />A
<br />B
<br />C
<br />D E F G
<br />H
<br />I
<br />I
<br />K
<br />L
<br />ITEM
<br />NO.,
<br />DESCRIPTION OF WORK
<br />Qttmdty
<br />Unit
<br />Unit Ria
<br />SCHEDULED
<br />VALUE
<br />WORK COIi4PLSTED
<br />MATERIALS
<br />PRESENTLY
<br />STORED
<br />(NOT IN
<br />E OR G)
<br />QTY
<br />TOTAL
<br />COMPIXTED
<br />AND STORED
<br />TO DATE
<br />(E+O+H;)
<br />°r5
<br />(J +C)
<br />BALANCE
<br />TO FMSY-
<br />(C -J)
<br />RETAINAGE
<br />(tF VARUaM
<br />RATE)
<br />FROM PREVIOUS
<br />THIS
<br />IMOD
<br />QTY
<br />Amount
<br />QTY
<br />Amount
<br />1
<br />2
<br />3
<br />4
<br />s
<br />6
<br />7
<br />8
<br />9
<br />to
<br />11
<br />12
<br />13
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<br />is
<br />id
<br />17
<br />is
<br />19
<br />20
<br />21
<br />22
<br />23
<br />24
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<br />26
<br />21/
<br />28
<br />29
<br />30
<br />31
<br />32
<br />33
<br />34
<br />3s
<br />36
<br />'37
<br />38
<br />39
<br />40
<br />41
<br />42
<br />43
<br />`tobili7ation
<br />HeadworksRestoration
<br />Bypass Pretreatment System
<br />Repair Interior Concrete Walls, Floor, Ceiling
<br />Replace SL -1 with Stop Log Assembly
<br />Replace SL -2 with Stop Log Assembly
<br />Replace SL -3 with Stop Log Assembly
<br />Replace SL -4 with Stop Log Assembly
<br />Replace SL -5 Milt Stop Log Assembly
<br />Replace SL -6 with Stop Log Assembly
<br />Replace SL -7 with Stop Log Assembly
<br />Replace SL•g with Stop Log Assembly
<br />Altcrnato1: Add Concrete Deck Tap Rehabiliation
<br />Alternate 2: Add Exterior Walt Repair and Paint
<br />Public Construction Bond
<br />Force Account
<br />GRAND TOTALS
<br />1
<br />I
<br />1
<br />I
<br />1
<br />I
<br />I
<br />1
<br />1
<br />1
<br />1
<br />1
<br />I
<br />1
<br />LS
<br />LS
<br />LS
<br />LS
<br />LS
<br />LS
<br />LS
<br />LS
<br />LS
<br />LS
<br />IS
<br />LS
<br />LS
<br />LS
<br />58,000.00
<br />540,400.00
<br />$8,000.00
<br />$61,100.00
<br />$2-1607-00
<br />$22,602.00
<br />522,602,00
<br />S2_)602.00
<br />S23,602.00
<br />522,602.00
<br />$22,603.00
<br />$77,60100
<br />$18,000.00
<br />512,540.00
<br />51,800.00
<br />520,000.00
<br />1
<br />S8,000,00
<br />S40.40.00
<br />58,000.00
<br />561,100.00
<br />522,602.00
<br />322,602.00
<br />5.32,602.00
<br />SZ -26M.00
<br />$?7,602,00
<br />522,602.00
<br />S=602,00
<br />S22.15M.00
<br />518,000.00
<br />S12,540.00
<br />S1,800.60
<br />520,000.00
<br />$350.656.001
<br />1.0
<br />-1.00
<br />1.00
<br />1
<br />58,000.00
<br />$40400.00
<br />$61,I00.00
<br />$22,603.00
<br />522,602.00
<br />522,602.00
<br />522,602.00
<br />$222,602.00
<br />577,602.00
<br />$22,602.00
<br />522,602.06
<br />SI2,540.00
<br />$1.800.00
<br />$304.6S6.001
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<br />50.00
<br />$18.000.00
<br />$0.00
<br />50.00
<br />$0.00
<br />50.00
<br />50.00
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<br />50.00
<br />50.00
<br />50.00
<br />50.00
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<br />$0.00
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<br />$0.00
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<br />50.00
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<br />0.0
<br />0.0
<br />0.0
<br />0.0
<br />0.0
<br />0.0
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<br />S8,000.00
<br />S40,400.00
<br />SO.00
<br />$61,100.00
<br />S22,602.00
<br />$22,602.00
<br />522,602.00
<br />522.602.00
<br />$22,603.00
<br />522,602.00
<br />522,602.00
<br />577,602.00
<br />S18,00O.Co
<br />512540.00
<br />S1,800.00
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<br />$322,656.00 1
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<br />58,000.00
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<br />528,000.00
<br />5400.00
<br />S2020.00
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<br />S3.055.00
<br />51.130.10
<br />S1.130.10
<br />SI.130.10
<br />S1.130.10
<br />S1.130.10
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