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V.:AIA Document G702TM - 1992
<br /> Application and Certificate for Payment
<br /> TO OWNER: PRR JECT: IRC FIRE STA #5 - PART 2 APPLICATION N0:
<br /> INDIAN RIVER COUNTY l8� Distribution to:
<br /> 1840 25TH STREET 6586 US 1 PERIOD TO: 09/30/07
<br /> OWNER
<br /> VERO BEACH, FL 32960 WABASSO, FL 32967 184
<br /> CONTRACT FOR: ARCHITECT ❑
<br /> FROM CONTRACTOR: VIA ARCHITECT: CONTRACT DATE: 06/01 /06
<br /> BARTH CONSTRUCTION, INC. EDLUND & DRITENBAS ARCH. P.A . CONTRACTOR ❑
<br /> 1717 INDIAN RIVER BLVD., SUITE 202A 65 ROYAL PALM BLVD., S. D PROJECT NOS: ❑
<br /> VERO BEACH, FL 32960 VERO BEACH , FL 32960 FIELD
<br /> OTHER ❑
<br /> CONTRACTOR' S APPLICATION FOR PAYMENT The Undersigned Contractor certifies that to the best of the Contractor' s knowledge, information
<br /> Application is made for payment, as shown below, in connection with the Contract. and belief the Work covered by this Application for Payment has
<br /> been completed in accordance
<br /> Continuation Sheet, AIA Document G703, is attached. with the Contract Documents, that all amounts have been paid by the Contractor
<br /> for Work for
<br /> 2, 143 ,51 00 which previous Certificates for Payment were issued and payments received Irom the Owner, and
<br /> 1 . ORIGINAL CONTRACT SUM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ $ that current ay own herein
<br /> is now due.
<br /> 2. Net change by Change Orders . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . $ '334,8151 CONTRA OR:
<br /> 3. CONTRACT SUM TO DATE (Line I t 2) . . . . . . . . . . . . . . . . . . . . . . . . . . .. ..... . .. $ 1 ,808,702 .90 By: Date: �d
<br /> it o
<br /> 4. TOTAL COMPLETED & STORED TO DATE (Column G on 6703) . . . . . . $ 1 ,808,702 .90 St f: ' ���f-�
<br /> 5. RETAINAGE: my of: � / �
<br /> a• % of Completed Work
<br /> (Column D + Eon G703) $ ubscribed and sworn to before
<br /> methis li day oft)Cj� oqi
<br /> b• vin of Stored Material //// �e� 'qk Marion H Tupek
<br /> L - - r+tr Commisabn DD339676
<br /> (Column F on G703) $ Notary Public : �— g l
<br /> / Aptidr Expires July 2i , 2006
<br /> Total Retainage (Lincs Sa + 56 or Total in Column T of G703) . . . . . . . $
<br /> 0.00 My Commission expires: 9 �Zi /�
<br /> 6. TOTAL EARNED LESS RETAINAGE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 118083702.90 ARCHITECT' S CERTIFICATE FOR PAYMENT
<br /> (Linc 4 Less Line 5 Total) In accordance with the Contract Documents, based on on-site observations and the data comprising
<br /> 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT . . . . . . . . . . . . . . . . . . . . . . $ 15773 ,564.91 this application, the Architect certifies to the Owner
<br />that to the best of the Architect' s knowledge,
<br /> (Line 6 from prior Certificate) information and belief the Work has progressed as indicated, the quality of the Work is
<br /> in
<br /> accordance with the Contract Documents, and the Contractor is entitled to payment of the
<br /> 8. CURRENT PAYMENT DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 35, 137.99 AMOUNT CERTIFIED.
<br /> 9. BALANCE TO FINISH, INCLUDING RETAINAGE AMOUNT CERTIFIED . . . . . . .. . .. .. .. . .. .. . . ..... . . ... . . .. . ... . . .:. . ... ... ...
<br />.. .. . $ 1l�; �� 7 1
<br /> . .... . .. . . ... . ... .
<br /> (Linc 3 less Line 6) $ 0.00 (Attach e,rp[ana' amount red diff"ers fi orrt the amount applied. Initial a12,('tgure.c oil this
<br /> Appheatioa an on r e anti ua an Shect Khat fire changed to con/orm with the amount certified j
<br /> CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT•
<br /> Total changes approved in previous months by Owner $ 0.00 $ 253 ,687.40 12 �T 7,e.'t��
<br /> BY: Date:
<br /> Total approved this Month $ 10,692 .27 $ 91 ,819.97 9
<br /> This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor
<br /> TOTALS $ 10,692 .27 $ 345,507.37 named herein . Issuance, payment and acceptance of payment are without prejudice to any rights of
<br /> NET CHANGES by Change Order $ -334, 815 . 10 the Owner or Contractor under this Contract
<br /> CAUTION : You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not be obscured.
<br /> AIA Document G7027e — 1992. Copyright © 1953, 1963, 1965, 1971 , 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING : This AIA®
<br /> Document is protected by U.S. Copyright Law
<br /> and International Treaties. Unauthorized reproduction or distribution of this AIAO Document, or any portion of it, may result in severe civil and criminal penalties, and
<br />will be prosecuted to the maximum extent
<br /> possible under the law. Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AIA Contract Documents,
<br />e-mail The American Institute of Architects' legal
<br /> counsel, copyright@aia.org.
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