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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 - Contractors Application for Payment - 03-10 rev <br />00622-5 <br />F:ToblioWo&\BNGR4EU NGDIMONPROJECM1735IRCJadC=MRoofRopkcement-Rep wPtgecfil-Admm\BidDo=W9S%UAaCwhad <br />Docam cntsM22 - Canhadofs Application for Payment - 03-10 mv.doc <br />