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CONTINUATION SHEET AIA DOCUMENTG703 PAGE 2 OF 2 PAGES <br />AIA Document G702, APPLICA'T'ION ANL) CER ITH A PION FOR PAYMENI, containing APPLICATION NO: 2 <br />Contractor's signed certification is attached. APPLICATION DATE: 2/28/2019 <br />In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 2/28/2019 <br />Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: <br />A <br />B <br />C <br />D 1 E <br />F <br />G <br />H <br />I <br />1 <br />ITEM <br />NO. <br />DESCRIPTION OF WORK <br />SCHEDULED <br />VALUE <br />WORK COMPLETED <br />MATERIALS <br />PRESENTLY <br />STORED <br />(NOT IN <br />D OR E) <br />TOTAL <br />COMPLETED <br />AND STORED <br />TO DATE <br />(D+E+F) <br />% <br />(G + C) <br />BALANCE <br />TO FINISH <br />(C - G) <br />RETAINAGE <br />IF VARIABLE <br />RATE) <br />'ROM PREVIOUTHIS <br />APPLICATION <br />(D + E) <br />PERIOD <br />1 <br />MOB/DEMOB <br />$28,000.00 <br />$28,000.00 <br />50.00 <br />$0.00 <br />$28,000.00 <br />100.00% <br />50.00 <br />50.00 <br />2 <br />DRILL AND COMPLETE WELL 6 <br />544,000.00 <br />$44,000.00 <br />50.00 <br />50.00 <br />$44,000.00 <br />100.00% <br />$0.00 <br />$0.00 <br />3 <br />FURNISH WELLHEAD FOR WELL <br />6 <br />$8,600.00 <br />$8,600.00 <br />$0.00 <br />$0.00 <br />$8,600.00 <br />100.00% <br />50.00 <br />50.00 <br />4 <br />MODIFY WELL 1 <br />$8,600.00 <br />$8,600.00 <br />50.00 <br />$0.00 <br />$8,600.00 <br />100.00% <br />$0.00 <br />50.00 <br />5 <br />INSTALL FPL SERVICE <br />53,200.00 <br />50.00 <br />53,200.00 <br />$0.00 <br />$3,200.00 <br />0.00% <br />$0.00 <br />50.00 <br />6 <br />ELECTRICAL <br />$5,000.00 <br />50.00 <br />$5,000.00 <br />$0.00 <br />$5,000.00 <br />100.00% <br />$0.00 <br />$0.00 <br />CONTINGENCY <br />$9,740.00 <br />50.00 <br />$0.00 <br />50.00 <br />50.00 <br />50.00 <br />_ 50.00 <br />CO CONTINGENCY NOT USED <br />($9,740.00)• <br />, <br />GRAND TOTALS <br />597,400.00 <br />$89,200.00 <br />58,200.00 <br />50.00 <br />597,400.00 <br />100% <br />50.00 <br />50.00 <br />Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity <br />92 <br />