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oA <br /> 1A Document G703` - 1992 <br /> Continuation Sheet <br /> AIA Document G702TM, Application and Certification for Payment, APPLICATION NO: 11 <br /> containing Contractor' s signedcertification is attached. APPLICATION DATE : NOV 27 ,2009 <br /> In tabulations below, amounts are stated to the nearest dollar. PERIOD TO : NOV 2592009 <br /> Use Column I on Contracts where variable retainage for line items may apply. <br /> ARCHITECT'S PROJECT N0 : 204 <br /> A B C D E F G H I <br /> WORK COMPLETED TOTAL <br /> MATERIALS COMPLETED BALANCE <br /> SCHEDULED FROM PREVIOUS PRESENTLY AND STORED % TO RETAINAGE <br /> ITEM DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED (G _ C) FINISH (If variable rate) f <br /> NO. (D + E) (Not inDorE) (D+DATE) (C - G) <br /> 803 L/P TANK 9,071 .00 85220 . 86 265 .28 0.00 8,486 . 14 93 .6 584 . 86 0 .00 <br /> ELECTRICAL <br /> 811 ELECTRICAL S .C. 1769800.00 1719664 .79 381 .32 0 .00 172,046 . 11 97.3 4,753 . 89 0 .00 <br /> 820 DATA/COMM SYSTEMS 69000.00 0.00 39901 . 85 0.00 39901 . 85 65 ,0 2,098 . 15 0.00 <br /> 901 CONSTRUCTION FEE 1919151 .00 1919151 .00 0.00 0 .00 1919151 .00 100.0 0.00 0 .00 <br /> 0001 CO # 1 1429838 .77- 0.00 0 .00 0 .00 0 .00 0 .0 142,838 .77- 0 .00 <br /> GRAND TOTAL 23015 , 125 .23 1796 1 fi86 .44 53 ,438 .79 0 .00 290159125 .23 100 .0 0.00 0 .00 <br /> CAUTION : You should sign an original AIA Contract Document, on which this text appears in RED . An original assures that changes will <br /> not be obscured . <br /> AIA Document G703 TM - 1992. Copyright © 1963 , 1965, 1966, 1967 , 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights <br /> reserved. WARNING : This AIA® Document is protected by U .S. Copyright <br /> Law and International Treaties. Unauthorized reproduction or distribution of this AIA® Document, or any portion of it, may result in severe civil <br />and criminal penalties, and 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 <br /> Contract Documents, e-mail The American Institute of Architects' legal <br /> counsel , copyright@aia .org . <br />