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AI, D _ 2 ocW ent G702 t - 1992 lic 4-' A 'atio a pp nsand Certificate forPaymenf TO OWNER: PROJECT; APPLICATION NO. , 6 � INDIAN RIVER COUNTY 172 IRC FIRE STA #6 --PART 2pER IOD TO strlbution to DI 1R40`25TH STREET 101 S. HIGHWAY AIA 04/25/06OWNER ❑ VERO BEACH FL32960 VERO BEACH, FL 32963 CONTRACT FOR 172 ARCHITECT .p FROM CONTRACTOR VIA ARCHITECT. `- ' ' BARTH CONSTRUCTION, INC. EDLUND & DRITENBAS ARCH. P.A:; CONTRACT DATE: 07/19%05 CONTRACTOR - O ILVD., SUITE 202A 65 ROYAL PALM BLVD S. D' 170NDIANrRIVER B PROJECT NOS: ` ( FIELD ❑ VERO BEACH, FL 32960 . VERO BEACH, EL'32960 a7 OTHER O CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned contractor certifies that tm the best of the contraetor's knowledge infor anon Application is mad&4or payment as shown below, lin-connecti -on with the Contract. and belief the =Work' covered by this Application -for Payment has;been completed in accordance Continuation Sheei,"NIA Document 6703, is attached. with the Contract Documents, -that all amounts Have been paid by the Contractor for Work for: 1 . ORIGINAL CONTRACT SUM which_ previous Certificates for-Payment were issued and payments received from the Owner, and -«� - - - $ 9R RR4 00?bscrnibed aymenrshown lierein'is now due. 2. Net change by Change Orders . . '. . . $ - 1 ,R5� _ 3. CONTRACT SUM TO DATE (Line 1 + 2)i . . . . . . . $ zq7 ms SR ' 4. TOTAL COMPLETED & STORED TO DATE (Column G on G703) . . . . . . . . . �— Da te:✓ _ Z �6 . : . $- 297,095 5R - _ - ' 5. RETAINAGE: T a. % of Completed Work 6DMai 9Ii 0Cd_ swom to before (ColumnD + Eon G703) - $ me this Nd ' da of ` b % of Stored Material 2 y a non H Tupgk (Column F on G703) - $ . Not Public: Cernrnu"on D 33967 ary U � (.1— , A � � fitprae JuN 21, 2008 7 My Conlrmssion expires: Total Retainage (Lines Sa + 56 or Total in Column I of G703). . . . . . $ - 00 _ 7 j ,�;0� 6. TOTAL EARNED LESS RETAINAGE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 497 ARCHITECT'S- CERTIFICATE FORzPAYMENT' (L t" Less Line 5 Total) - - - _ - -. _ In accordance with the Contract Documents based on on site observations-and the data coidpiising 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT . . . . . $ = this apphcahon, the Arc}u[ect certifies to the Owner that to the best of the Architect' s knowledge, ? ORS NO information and belief the" Work 6 from prior Certificate) Work . has " progressed as indicated, 'the quality of the Work is in accordance with the Contract' Documents - -and 'the Contractor is entitled to payment {of the 8. CURRENT PAYMENT DUE . . . . . . :. . . . . . . . $ AMOUNT CERTIFIED. - a. r 9. BALANCE TO FINISH, INCLUDING RETAINAGE AMOUNT CERTIFIED .... . .. . . ... (Line 3 less Line 6) -.... ...... ... . .. - - $ < $ - - 0M (Attach esplan ' ' n if amour certified differs from the amount applied. Initial a[1 figures orzilirs .- App ication -t e Co nation SIt that are changed to conform with the amount certified:) CHANGE ,ORDER SUMMARY . - - - - - ADDITIONS - .. DEDUCTIONS ARCHIT Total changes approved in previous months by Owner $ Total approvedthisMonth - - 60 By., - Date: f7hO�Q� TOTALS $ " This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor NET CHANGES by Change Order $ - named herein. Issuance, payment and acceptance of payment are without prejudice to any:rightsbf _ the Owner or Contractor under this Contract ` AIA Document G702TM — 1992. Copyright © 1953, 1963, 1965, 1971 , 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING : This AIA® Document is'p b U.S. Co - and International Treaties. Unauthorized reproduction or distribution of this AIA® Document, or an g - and P Y Copyright Law Possible under the law. Purchasers are permitted to reproduce ten 00) copies of this document when completed.d. To report copyright violations of AIA Contractcrim� aDocupenments, e-maties, and il The Amell be scao Insted itute of Aarchitects'elegal t counsel, copyright@aia.org. -