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1A = � Document G703TM - 1992 Continuation Sheet AIA Document G702TM, Application and Certification for Payment, APPLICATION NO: 11 containing Contractor' s signed ,certification is attached. APPLICATION DATE : NOV 2792009 In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD T0 : 25 ,2009 204 ARCHITECT'S PROJECT N0 : 204 A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY % TO RETAINAGE VALUE APPLICATION THIS PERIOD STORED AND STORED (G . C) FINISH (if variable rate) NO. + E) (Not in Dor E) TO DATE (D + E + F) (C - G) 618 MARBLE SILLS 366 .00 0.00 0.00 0.00 0 .00 0 .0 366 .00 0.00 622 ACOUSTIC CEILING 89562 .00 8 ,562 .00 0. 00 0.00 8,562.00 100.0 0.00 0.00 638 PAINTING 36,500 .00 28,700.00 0.00 0.00 28,700.00 78 .6 7, 800.00 0 .00 SPECIALTIES 666 TOILET PARTITIONS 69750 .00 6,720.00 0.00 0.00 69720.00 99.6 30.00 0 .00 667 LOUVERS 1 ,500.00 0.00 0.00 0.00 0.00 0 .0 19500 . 00 0.00 669 WALL COR. GUARD ° 19305 .00 955 .00 0.00 0.00 955 .00 73 .2 350 . 00 0.00 671 FIRE EXTINGUISHER/EQUIP 1 , 100.00 0.00 0.00 0 .00 0 .00 0 .0 1 , 100.00 0.00 673 FLAGPOLE 29500.00 11545 .00 0 .00 0. 00 11545 .00 61 . 8 955 .00 0 .00 675 IDENT.DEVICES-MAT. 39200.00 0 . 00 677 . 76 0.00 677 . 76 21 .2 29522 .24 0 .00 685 METAL SHELVING 19000.00 0 .00 441 . 37 0 .00 441 . 37 44. 1 558 .63 0 .00 686 BATH ACC .-MAT. 19525 .00 19638 .73 0 .00 0 .00 11638 . 73 107. 5 113 . 73 - 0.00 688 BATH ACC . -LAB , 500.00 11000 .00 0 .00 0 .00 11000 .00 200.0 500.00- 0 .00 689 CULTURED MARBLE 99068 .00 91067 . 85 0 .00 0. 00 95067 . 85 100.0 0. 15 0.00 EQUIPMENT 714 RESIDENTIAL APPL . 159650 .00 179007 . 10 0.00 0.00 17,007 . 10 108 . 7 19357 . 10- 0.00 723 GEAR HOSE & LOCKER ACCESS 123314 . 00 11 ,709 .00 0 .00 0.00 11 ,709 .00 95 . 1 605 . 00 0.00 FURNISHINGS 742 CASEWORK 389800.00 38,802 .02 0 .00 0 .00 38, 802 . 02 100.0 2 . 02- 0.00 MECHANICAL 785 PLUMBING 43 , 800 .00 43 , 800 .00 0.00 0 .00 435800 . 00 100 .0 0 .00 0.00 788 SPRINKLER SYSTEM 55 , 895 .00 50,675 .00 0 . 00 0 .00 50,675 .00 90. 7 59220 . 00 0.00 793 HVAC 83 ,336 . 00 83 ,421 .00 0 . 00 0 .00 83 ,421 .00 100. 1 85 . 00- 0.00 800 KITCHEN HOOD 14,800 . 00 149800 .00 0 .00 0.00 149800.00 100 .0 0 . 00 0 .00 GRAND TOTAL 338,471 . 00 318 ,402 . 70 1 , 119 . 13 0.00 319, 521 . 83 18 ,949 . 17 0 .00 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 . AIA Document G703T - 1992. Copyright © 1963 , 1965, 1966, 1967, 19702 1978 , 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING : This AIA® Document is protected by U .S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this Ale Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent 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, e-mail The American Institute of Architects' legal counsel , copyright@aia.org .