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NONSENSE <br /> wrrLl � w ,t ,tiun YUR PAYMENT NO . <br /> r To <br /> Contract for OWNER) <br /> OWNER ' s Project No . . ENGINEER' s Project No . <br /> For Work accomplished through the date of <br /> ' MEQ CONT1tdC70R's Schedule of Yatves Wort CoS,"edE <br /> Veit Price Quantity Ammat Quantity <br /> S S S <br /> r <br /> r <br /> .r <br /> ' Tocol S <br /> (Orig. Contract) S <br /> C . O . No . 1 <br /> rC . O . No . 2 . <br /> eye <br /> rAccompanying Documentation : GROSS AMOUNT DUE . . . . . . . . . . . . . . . . . . . . . . . S <br /> LESS % RETAINAGE . . . . . . . . . . . . . . . . . . . S <br /> ' AMOUNT DUE TO DATE . . . . . . . . . . . . . . . . . . . . . S <br /> LESS PREVIOUS PAYMENTS . . . . . . . . . . . . . . . . S <br /> AMOUNT DUE THIS APPLICATION . . . . . . . . . S <br /> r <br /> CONTRACTOR' S Certification : <br /> The undersigned CONTRACTOR certifies that ( 1 ) all previous progress payments received from OWNER on account of <br /> Work done under the Contract referred to above have been applied to discharge in full all obligations of CONTRACTOR <br /> incurred in connection with Work covered by prior Applications for Payment numbered I through inclusive ; and <br /> ' (2) title to all materials and equipment incorporated in said Work or otherwise listed in or covered by this Application <br /> for <br /> Payment will pass to OWNER at time of payment free and clear of all liens , claims , security interests and encumbrances <br /> (except such as covered by Bond acceptable to OWNER) : <br /> 1 • - <br /> Dated . 19 = <br /> CONTRACTOR <br /> 1 By <br /> r • <br /> Payment of the above AMOUNT DUE THIS APPLICATION is recommended . <br /> 1 <br /> Dated . 19 <br /> ' ENGINEER - <br /> By <br /> EJCDC No . 1910.8- E ( 1987 Edition ) . <br /> Prepared by the Engineers ' Joint Contractboeuments Committee and endorsed by The Associated General Contractors or America . <br /> 00800 — 10 <br />