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PPILICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMErJT c102 ( I n It t r n r dl m 9 l I n tc vc rse sldel Int II, IINI 111I Mli
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<br /> APPI LICA' IION Nll. / Ri(//$edI llslnnul „ nl 111
<br /> PLIHOD I O . LI ( o\ NiI(
<br /> ;? 7 Puo ECT
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<br /> Int I_ Iti1N TRAC. a-O G : I I 'I
<br /> _ 1 ii i� . ryJY' VIA AHCI- ' ECf �',i .Jj'j CON fltnhl DAT R . I
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<br /> ) NTRACTOR ' S APPLICATION FOR PAYMENT I ' beundencigncdCont l ;1co rtNine.slh, ltothaneslofEli C.Imil: 1c„ rrsIn , ., h: ,I�t . in1kIt
<br /> motion and belief the Work covered by this Apph( ;ii on for Pavmuml h :a hecn cumplcicd
<br /> hcn l„ n Is mode for Payment , as shown below, in connection with ( he Contract , In accordance with the Cuntr.tct Documents , th a :dl
<br /> annumts h :I ,C beCII p;ild Is the
<br /> Ilnualiun Sheet , AIA Document G703 , Is attached . ConH'2cu r fur Wo1' 1t far which previous Cel' llfieme5 for I'ayII nt t�•tre
<br /> Issued ,md pac
<br /> ) RIGINAL CONTRACT SUNT . . . . . . . . . . . . . . . . d l `1 .57 mcnLs received front ( lie Ow
<br /> teOw neer, Anil diol curtest psty mrcnl shown licnin
<br /> hesvnherin is nrnv dor
<br /> lel change by Chanye Orders . . . . . . . . Y< CONTRACTOR--�?e”-,�/",,`//.//
<br /> : ONTRACT SUM TO DATE ( Line 1 + 2 ) . . . . . . . . & � `//II YJ .� t; y : ��J l z / - 0_�
<br /> OTAL COMPLETED 5 STORED TO DATE . . . . . . g LL1 o .. O state oIT�
<br /> �nlumn G on G703 ) , P Pl Cynthia A Huy
<br /> ; ETFlINAGE Subticribed and sworn to be re My Commission DD1000DG
<br /> t
<br /> D Co m plc u: J Work one this �' dal, u� 7 aha ,E�Eira4 February lB, 4007
<br /> ( Culumns D S Con G703) D� l/ (�
<br /> _ 96 0l Stored Rlale riot
<br /> ( COILMln F on C703 ) Notary Pub i
<br /> olal Retainage ( Linc Ill + 56 ut
<br /> Total in Column I of G703 ) . . . . . . . . . . . & My Commission xpit it
<br /> OTAL EARNED LESS RETAINAGE ARCHITE, CT ' S CERTIFICATE FOR PAYMENT
<br /> h
<br /> - Ine less Line 5 Total )
<br /> ESS PHEVIOUS CERTIFICATES FOR PAYMENT /1 00 In accordance with the Contract Documents , base ) on omsitt ob.9crv:IHOnS incl the dojo
<br /> . int 0 from prior Certificate) . . . . . . . . . . . . . M 5! 5 comprising this application , the Architect
<br /> certifies to the Owner thnl to the bent of 111-
<br /> Architect 's knowlcdge, information and belief the Work has prokressed ae indicated , the
<br /> URRENT PAYMENT DUE . . . . . . . . . . . . . . SO QQ- quality of the Work is in nri
<br /> accordance will' lk Conlct DUCUmcnls, aHtl IhC' CrtnlydClur
<br /> ALANCE TO FINISH , INCLUDING RETAINAGE --L34 is entitled to payment of [ lie AMOUNT CERTIFIED.
<br /> . inc 3 less Line 6) E __ - AMOUNT CERTIFIED . . . _ . .
<br /> T _ (AIInch evIi Ianal i u if al) GIrnl certified chffelts from Ibr dnrnunl rips licd /pr. IIII, ,Lll
<br /> ANCE ORDER SUA4MAR1' ADDITIONS DEDll C9 ' ONS nil l ores nn Ibis Applicalinrl and wr the cwrlinllaNal ,Steel thol are cbnnpr,d
<br /> In
<br /> al changes appruved Irl c'urr/olm /u Me amouul rerliliecl, ) ' .
<br /> c10t6 1110mlls by Owner ARCHI 'fHGI 'I
<br /> al approved this Mount p} y
<br /> Date _
<br /> l 'Ci)r L1 This Certificate IS not negotiable. The AMOUNT CERTI FIEF) is
<br /> f ( , I IANCGS by Chanhc ONcr payable only to Ihc' Cnn .
<br /> tmunf named herein . Its uanee, payment :In (l , , IIPuler nl Ir.Irmenl :tre r, ilhnul
<br /> prciuJieu w :uiv rir;h is of Ihc Owner nr Gunl rdnnr under this t} Inlract .
<br /> AIA UUCUh1ENT G702 N APPLILAHON AND URI' HICATF FOR PMMENT • 1992 Ellll' IOIv AIA'a © I r2 • 7
<br /> ACENt 'E . NV'. , ts 'ASH1NC, lUN . UC ?unu6. s „ , 91 IIF. nm andN IN.SI'ubject OF ARCHITECTS, gal NEsv PORI(
<br /> 1 WARNING : UnlicenseJ photo
<br /> vlolules U. S, copyright Inws and will Subject the violator In legal pmseculion ,
<br /> c7oz - Igen
<br /> ION : You should use an original AIA document which has this caution pl'Inted in red . An original assures that changes will not be obscured as may occur
<br /> when documents are reproduced ,
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