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HomeMy WebLinkAbout2007-386 `J ® = :=AIA Document G704TM - 2000 Certificate of Substantial Completion PROJECT: PROJECT NUMBER: 070105VB/ OWNER: (Name and address): CONTRACT FOR: General Construction ARCHITECT: ❑ IRCFD Station #4 CONTRACT DATE: 06/01/06 1500 9" Street SW CONTRACTOR: Vero Beach, FL 32962 FIELD: ❑ TO OWNER: TO CONTRACTOR: (Name and address): (Name and address): OTHER: ❑ Indian River County Barth Construction 1840 25" Street 1717 Indian River Blvd., Ste 202-A Vero Beach, FL 32960 Vero Beach, FL 32960 PROJECT OR PORTION OF THE PROJECT DESIGNATED FOR PARTIAL OCCUPANCY OR USE SHALL INCLUDE: The Work performed under this Contract has been reviewed and found, to the Architect' s best knowledge, information and belief, to be substantially complete. Substantial Completion is the stage in the progress of the Work when the Work or designated portion is sufficiently complete in accordance with the Contract Documents so that the Owner can occupy or utilize the Work for its intended use. The date of Substantial Completion of the Project or portion designated above is the date of issuance established by this Certificate, which is also the date of commencement of applicable warranties required by the Contract Documents, except as stated below: Warranty Date of Commencement Edlund, Dritenbas, Hinkley June 28, 2007 Architects & Assoc., P.A. ARCHITECT BY DATE OF ISSUANCE A list of items to be completed or corrected is attached hereto. The failure to include any items on such list does not alter the responsibility of the Contractor to complete all Work in accordance with the Contract Documents. Unless otherwise agreed to in writing, the date of commencement of warranties for items on the attached list will be the date of issuance of the final Certificate of Payment or the date of final payment. �r Cost estimate of Work that is incomplete or defective: $ 0.00 / Odol! 4 /f/ T a.W11 Z� . P D The Contractor will complete or correct the Work on the list of items attached hereto within Zero ( 0 ) days from the above date of Substantial Completion. / —7 ,84tzttF ConS�LtuL?IsN GIZY�/ O CONTRACTOR p E _t The Owner accepts the Work or designated portion as substantially to andwill assume full possession at (time) on (date). Indian River County r 11 / 06 /07 OWNER DATE The responsibilities of the Owner and Contra or for security, p y; fiaintenanei heat, utilities, damage to the Work and insurance shall be as follows: (Note: Owner 's and Contractor's legal and insurance counsel should determine and review insurance requirements and coverage.) AIA Document G704TM — 2000. Copyright © 1963, 1978, 1992 and 2000 by The American Institute of Architects. All rights reserved. WARNING: This Al e Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA° Document, or any 1 portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 08:23:02 on 06/28/2007 under Order No.1000299470_1 which expires on 4/29/2008, and is not for resale. User Notes: (788564186) `J ® = :=AIA Document G704TM - 2000 Certificate of Substantial Completion PROJECT: PROJECT NUMBER: 070105VB/ OWNER: (Name and address): CONTRACT FOR: General Construction ARCHITECT: ❑ IRCFD Station #4 CONTRACT DATE: 06/01/06 1500 9" Street SW CONTRACTOR: Vero Beach, FL 32962 FIELD: ❑ TO OWNER: TO CONTRACTOR: (Name and address): (Name and address): OTHER: ❑ Indian River County Barth Construction 1840 25" Street 1717 Indian River Blvd., Ste 202-A Vero Beach, FL 32960 Vero Beach, FL 32960 PROJECT OR PORTION OF THE PROJECT DESIGNATED FOR PARTIAL OCCUPANCY OR USE SHALL INCLUDE: The Work performed under this Contract has been reviewed and found, to the Architect' s best knowledge, information and belief, to be substantially complete. Substantial Completion is the stage in the progress of the Work when the Work or designated portion is sufficiently complete in accordance with the Contract Documents so that the Owner can occupy or utilize the Work for its intended use. The date of Substantial Completion of the Project or portion designated above is the date of issuance established by this Certificate, which is also the date of commencement of applicable warranties required by the Contract Documents, except as stated below: Warranty Date of Commencement Edlund, Dritenbas, Hinkley June 28, 2007 Architects & Assoc., P.A. ARCHITECT BY DATE OF ISSUANCE A list of items to be completed or corrected is attached hereto. The failure to include any items on such list does not alter the responsibility of the Contractor to complete all Work in accordance with the Contract Documents. Unless otherwise agreed to in writing, the date of commencement of warranties for items on the attached list will be the date of issuance of the final Certificate of Payment or the date of final payment. �r Cost estimate of Work that is incomplete or defective: $ 0.00 / Odol! 4 /f/ T a.W11 Z� . P D The Contractor will complete or correct the Work on the list of items attached hereto within Zero ( 0 ) days from the above date of Substantial Completion. / —7 ,84tzttF ConS�LtuL?IsN GIZY�/ O CONTRACTOR p E _t The Owner accepts the Work or designated portion as substantially to andwill assume full possession at (time) on (date). Indian River County r 11 / 06 /07 OWNER DATE The responsibilities of the Owner and Contra or for security, p y; fiaintenanei heat, utilities, damage to the Work and insurance shall be as follows: (Note: Owner 's and Contractor's legal and insurance counsel should determine and review insurance requirements and coverage.) AIA Document G704TM — 2000. Copyright © 1963, 1978, 1992 and 2000 by The American Institute of Architects. All rights reserved. WARNING: This Al e Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA° Document, or any 1 portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 08:23:02 on 06/28/2007 under Order No.1000299470_1 which expires on 4/29/2008, and is not for resale. User Notes: (788564186) aillie Document G7061111111111111wAIA TN — 1994 Contractor's Affidavit of Payment of Debts and Claims PROJECT: (Name and address) ARCHITECT'S PROJECT NUMBER: OWNER: ❑ IRC Fire Station #4 ARCHITECT: ❑ 1500 9th Street SW CONTRACT FOR: General Construction CONTRACTOR: ❑ Vero Beach, FL 32960 SURETY: ❑ TO OWNER: (Name and address) CONTRACT DATED: 5/24/06 OTHER: ❑ Indian River County 1840 25th Street Vero Beach, FL 32960 STATE OF: Florida COUNTY OF: Indian River The undersigned hereby certifies that, except as listed below, payment has been made in full and all obligations have otherwise been satisfied for all materials and equipment furnished, for all work, labor, and services performed, and for all known indebtedness and claims against the Contractor for damages arising in any manner in connection with the performance of the Contract referenced above for which the Owner or Owner' s property might in any way be held responsible or encumbered. EXCEPTIONS: SUPPORTING DOCUMENTS ATTACHED HERETO: CONTRACTOR: (Name and address) 1 . Consent of Surety to Final Payment. Whenever Barth Construction, Inc . Surety is involved, Consent of Surety is 1717 Indian River Blvd., Suite 202A required. AIA Document G707, Consent of Vero Beach, FL 32960 Surety, may be used for this purpose Indicate Attachment ® Yes ❑ No BY: fl� The following supporting documents should be attached (Signatr re of authorized representative) hereto if required by the Owner: ASo { 1 . Contractor' s Release or Waiver of Liens, (Printed name and title) conditional upon receipt of final payment. 2. Separate Releases or Waivers of Liens from Subscribed and sworn to before me on this date: Subcontractors and material and equipment suppliers, to the extent required by the Owner, accompanied by a list thereof. Notary Public: 3. Contractor' s Affidavit of Release of Liens My Commission Expires: (AIA Document G706A). AIA Document G706's — 1994. Copyright ® 1970 and 1994 by The American Institute of Architects. All rights reserved. WARNING: This Al a Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA® 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. This document was produced by AIA software at 08:48:37 on 10/17/2007 under Order No. 1000304448_1 which expires on 5129/2008, and is not for resale. User Notes: (319378398) aillie Document G7061111111111111wAIA TN — 1994 Contractor's Affidavit of Payment of Debts and Claims PROJECT: (Name and address) ARCHITECT'S PROJECT NUMBER: OWNER: ❑ IRC Fire Station #4 ARCHITECT: ❑ 1500 9th Street SW CONTRACT FOR: General Construction CONTRACTOR: ❑ Vero Beach, FL 32960 SURETY: ❑ TO OWNER: (Name and address) CONTRACT DATED: 5/24/06 OTHER: ❑ Indian River County 1840 25th Street Vero Beach, FL 32960 STATE OF: Florida COUNTY OF: Indian River The undersigned hereby certifies that, except as listed below, payment has been made in full and all obligations have otherwise been satisfied for all materials and equipment furnished, for all work, labor, and services performed, and for all known indebtedness and claims against the Contractor for damages arising in any manner in connection with the performance of the Contract referenced above for which the Owner or Owner' s property might in any way be held responsible or encumbered. EXCEPTIONS: SUPPORTING DOCUMENTS ATTACHED HERETO: CONTRACTOR: (Name and address) 1 . Consent of Surety to Final Payment. Whenever Barth Construction, Inc . Surety is involved, Consent of Surety is 1717 Indian River Blvd., Suite 202A required. AIA Document G707, Consent of Vero Beach, FL 32960 Surety, may be used for this purpose Indicate Attachment ® Yes ❑ No BY: fl� The following supporting documents should be attached (Signatr re of authorized representative) hereto if required by the Owner: ASo { 1 . Contractor' s Release or Waiver of Liens, (Printed name and title) conditional upon receipt of final payment. 2. Separate Releases or Waivers of Liens from Subscribed and sworn to before me on this date: Subcontractors and material and equipment suppliers, to the extent required by the Owner, accompanied by a list thereof. Notary Public: 3. Contractor' s Affidavit of Release of Liens My Commission Expires: (AIA Document G706A). AIA Document G706's — 1994. Copyright ® 1970 and 1994 by The American Institute of Architects. All rights reserved. WARNING: This Al a Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA® 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. This document was produced by AIA software at 08:48:37 on 10/17/2007 under Order No. 1000304448_1 which expires on 5129/2008, and is not for resale. User Notes: (319378398) sale T Document G706A � I - 1994 Contractor's Affidavit of Release of Liens PROJECT: (Name and address) ARCHITECT'S PROJECT NUMBER: OWNER: ❑ IRC Fire Station #4 1500 91" Street SW CONTRACT FOR: General ARCHITECT: ❑ Vero Beach, FL 32962 Construction CONTRACTOR: ❑ TO OWNER: (Name and address) CONTRACT DATED: 5/24/06 SURETY: ❑ Indian River County 1840 25th Street OTHER: ❑ Vero Beach, FL 32960 STATE OF: Florida COUNTY OF: Indian River The undersigned hereby certifies that to the best of the undersigned' s knowledge, information and belief, except as listed below, the Releases or Waivers of Lien attached hereto include the Contractor, all Subcontractors, all suppliers of materials and equipment, and all performers of Work, labor or services who have or may have liens or encumbrances or the right to assert liens or encumbrances against any property of the Owner arising in any manner out of the performance of the Contract referenced above. EXCEPTIONS: SUPPORTING DOCUMENTS ATTACHED HERETO: CONTRACTOR: (Name and address) 1 . Contractor' s Release or Waiver of Liens, Barth Construction, Inc. conditional upon receipt of final payment. 1717 Indian River Blvd . , Suite 202A Vero Beach, FL 32960 2. Separate Releases or Waivers of Liens from BY: 6li7 Subcontractors and material and equipment " nature o authorized suppliers, to the extent required by the Owner, epresentative)y� accompanied by a list thereof. (Printed name and title) Subscribed and sworn to before me on this date: Notary Public: My Commission Expires: AIA Document G706A"' — 1994. Copyright ® 1982 and 1994 by The American Institute of Architects. All rights reserved. WARNING : This AIA® Document is protected by U.S. Copyright Law and International Treaties. Unau horized reproduction or distribution of this AIA® Document, or any 1 portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 08:52:45 on 10/17/2007 under Order No. 1000304448_1 which expires on 5/29/2008, and is not for resale. User Notes: (3928998993) CONSENT OF OWNER ❑ SURETY. COMPANY ARCHITECT ❑ TO FINAL PAYMENT CONTRACTOR ❑ SURETY ❑ AIA DOCUMENT G707 OTHER ❑ PROJECT: Design Build Expansion and Renovation to the Indian River County Dept. of (name, address) Emergency Services Fire Station #4, 1500 Oslo Road , Vero Beach , FL 32960 TO (Owner) : Indian River County, Florida ARCHITECT'S PROJECT NO: CONTRACT FOR: Construction BOND NO: 54-161352 CONTRACT DATE: 0410412006 CONTRACTOR: Barth Construction , Inc. In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (here insert name and address of Surety Company) United Fire & Casualty Company 118 Second Avenue SE , Cedar Rapids , IA 52401 (319) 399 -5700 SURETY COMPANY, on bond of (here insert name and address of Contractor) Barth Construction , Inc. 1717 Indian River Blvd , Suite #202A, Vero Beach , FL 32960 (772) 778-3072 CONTRACTOR, hereby approves of the final payment to the Contractors, and agrees that final payment to the Contractor shall not relieve the Surety Company of any of its obligations to (here insert name and address of Owner) Indian River County, Florida 1840 25th St. ( BOCC address) , Vero Beach , FL 32960 (772) 567 -8000 OWNER, as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 18th day of October, 2007 . United Fire & Casualty Company Surety Company &A M. A;Attest: � Signature of Authorized Representative (Seal): � � Leslie M . Donahue, Attorney-In-Fact & Florida Title Licensed Resident Agent Inquiries: (407) 786- 7770 NOTE: This form is to be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS, Current Edition AIA DOCUMENT G707 • CONSENT OF SURETY COMPANY TO FINAL PAYMENT • APRIL 1970 EDITION • AIAO ONE PAGE O 1970 9 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 New York Ave., NW, WASHINGTON, D.C. 20006 I sale T Document G706A � I - 1994 Contractor's Affidavit of Release of Liens PROJECT: (Name and address) ARCHITECT'S PROJECT NUMBER: OWNER: ❑ IRC Fire Station #4 1500 91" Street SW CONTRACT FOR: General ARCHITECT: ❑ Vero Beach, FL 32962 Construction CONTRACTOR: ❑ TO OWNER: (Name and address) CONTRACT DATED: 5/24/06 SURETY: ❑ Indian River County 1840 25th Street OTHER: ❑ Vero Beach, FL 32960 STATE OF: Florida COUNTY OF: Indian River The undersigned hereby certifies that to the best of the undersigned' s knowledge, information and belief, except as listed below, the Releases or Waivers of Lien attached hereto include the Contractor, all Subcontractors, all suppliers of materials and equipment, and all performers of Work, labor or services who have or may have liens or encumbrances or the right to assert liens or encumbrances against any property of the Owner arising in any manner out of the performance of the Contract referenced above. EXCEPTIONS: SUPPORTING DOCUMENTS ATTACHED HERETO: CONTRACTOR: (Name and address) 1 . Contractor' s Release or Waiver of Liens, Barth Construction, Inc. conditional upon receipt of final payment. 1717 Indian River Blvd . , Suite 202A Vero Beach, FL 32960 2. Separate Releases or Waivers of Liens from BY: 6li7 Subcontractors and material and equipment " nature o authorized suppliers, to the extent required by the Owner, epresentative)y� accompanied by a list thereof. (Printed name and title) Subscribed and sworn to before me on this date: Notary Public: My Commission Expires: AIA Document G706A"' — 1994. Copyright ® 1982 and 1994 by The American Institute of Architects. All rights reserved. WARNING : This AIA® Document is protected by U.S. Copyright Law and International Treaties. Unau horized reproduction or distribution of this AIA® Document, or any 1 portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 08:52:45 on 10/17/2007 under Order No. 1000304448_1 which expires on 5/29/2008, and is not for resale. User Notes: (3928998993) WWWWW mom UNITED FIRE & CASUALTY COMPANY HOME OFFICE - CEDAR RAPIDS, IOWA CERTIFIED COPY OF POWER OF ATTORNEY (Original on file at Home Office of Company, See Certification ) KNOW ALL MEN BY THESE PRESENTS, That the UNITED FIRE & CASUALTY COMPANY, a corporation duly organized and existing :under the laws of the State of Iowa , and having,.its principal office in Cedar Rapids, State of Iowa, does make, constitute and appoint LESLIE M DONAHUE , OR KIM E . NIV , OR JEFFREY W REICH , OR SUSAN L` REICH ,- OR TERESA L DURHAM , OR PATRICIA L SLAUGHTER , OR J. GREGORY MACKENZIE -, OR WALTER N MYERS , OR . GLORIA A .RICHARDS , OR DON BRAMLAGE OF DAYTONA BEACH FL , ALL INDIVIDUALLY of MAITLAND FL its true and lawful Attorney( s)-in-Fact with power and authority hereby conferred to sign, seal and execute in its behalf all lawful ' '. ' bonds, undertakings and: other obligatory instruments of similar nature as follows: Any and Al I Bonds and to bind, UNITED FIRE & CASUALTY COMPANY thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of UNITED FIRE & CASUALTY COMPANY and all the acts of said Attorney, pursuant to the authority hereby given are hereby ratified and confirmed. The Authority hereby granted is continuous and shall remain in full force and effect until revoked by UNITED FIRE & CASUALTY COMPANY ' This power of Attorney is made and executed pursuantto and by authority of the following By-Law duty adopted by Board of Directors of the Company on April, 18, 1973. "Article V - Surety Bonds and Undertakings" Section 2, Appointment of Attorney-in-Fact. 'The President or any Vice President, or any other officer of the Company may, from time to time, appoint by written certificates attorneys-in-fact to act in behalf of the Company in the execution of policies of insurance, bonds, undertakings and other obligatory instruments of like nature. The signature of any officer authorized - herebyand the Corporate seal , may be affixed by facsimile to any power of attomeyor special power of attorney or : certification of either authorized hereby, such signature and seal, when so used , being adopted by :the Company as the original signature of such '. officer and the original seal of the Company, to be valid and binding upon the Company with the . same force and effect asthough manually affixed . Such attorneys-in fact, subject to the limitations set forth in their respective certificates of authority shall have full power to bind the Company by their signature and execution of any such Instruments and to attach the seal of the Company thereto. The President or any Vice President, the Board of Directors or any otherofficer of the Company may at any time revoke all power and authority previously given to any. attorney-in-fact. \",11,,,,,, IN WITNESS WHEREOF, the UNITED FIRE & CASUALTY COMPANY has caused these presents to be signed by \ * its vice president and its corporate seal to be hereto affixed this 15t h day of May , 2007 UERI = UNITED FIRE & CASUALTY COMPANY By State of Iowa) County of Linn, ss, C/ YfjJ/ On 15th day Of May . ; 2007 , before me personally came Dennis J . Richmann Vice President to me known , who being by me duly sworn, did depose and say, that he resides in Cedar Rapids, State of Iowa ; that he is a Vice President of the UNITED FIRE &. CASUALTY COMPANY, the corporation described in and which executed the above instrument; that ' he knows the seal of said corporation, that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the.. Board of. Directors of said corporation and that . he :signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation �p t fiiICHELLE WILSON _ M^ L COYNI8810N NumSEN 704745 • • I MV COMM SSIQB E%PINE$ — " dQ Notary Public - I , the undersigned officer of the UNITED FIRE & CASUALTY COMPANY, do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit and the copy of the Section of the by-laws of said Company as set forthin said Power of Attorney, with'. the ORIGINALS ON FILE IN THE HOME OFFICE OF SAID COMPANY and that the same are correct transcripts thereof, and of the whole of the said originals, and that the said Power of Attorney has not been revoked and is now in full force and effect \a"«u" led, In testimony whereof I have hereunto subscribed my name and affixed the corporate seal of the said Company this 1Rth day of October 20 � . r`EOFIY)kAFF r , SERI Secreta ry BPOA00190706 CHANGE ORDER Distribution to : AIA DOCUMENT G701 OWNER ARCHITECT CONTRACTOR FIELD OTHER — Donadio PROJECT : CHANGE ORDER NUMBER: 1 I . R.C . Fire Station 44 1500 Oslo Road Vero Beach, FL 32960 INITIATION DATE : 10/01 /07 TO (Contractor): I— —i ARCHITECT' S PROJECT NO : Barth Construction, Inc. 1717 Indian River Blvd. CONTRACT FOR: Suite 202A L Vero Beach, FL 32960 -1 CONTRACT DATE : You are directed to make the following changes in this Contract: This Change Order will adjust the Contract to match the final cost of the Project. Final Cost of Construction (Including Contractor' s Fee) $2, 130,096.03 Less Current Contract Amount <$2, 182.645 .00> Change Order Amount <$ 525548 .97> Not valid until signed by both the Architect and Owner. Signature of the Contractor indicates his agreement herewith, including any adjustment in the Contract Sum or Contract Time The Original (Contract Sum) (r_. ..._....teed- lirla iFfl m Cost) was . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $2, 182,645 . 00 Net change by previously authorized Change Orders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -$ 0 The (Contract Sum) (GRaFanteed " "..lA.. ufn Cost) prior to this Change Order was . . . . . . . . . . . . $2, 182,645 . 00 The (Contract Sum ) (r-. . .._.. nteea Ma*i.. ufn Cost` will be d) (decreased"• • -nom . hanged) by this Change Order . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -$ 52,548 .97 The new (Contract Sum) (Guaranteed Maximum Cost including this Change Order will be $2, 130,096. 03 The Contract Time will be (increased) (decreased) (unchanged) by ( ) Days The Date of Substantial Completion as of the date of this Change Order therefore is ARCHITECT CONTRACTOR OWNER Edlund, Dritenbas, Binklev, Arch . Barth Construction Indian River County Dept. of Emer. 65 Royal Palm Pointe, Suite D 1717 Indian River Blvd. 1840 25`h Street Vero Be L 3;960 Suite 202A Vero Beach, FL 32960 Vero Beach, FL 32960 BY: PAUL 41- .4 17SuBf/S BY: - c— BYc DATE : aocT2�� DAT �O ' I ' o� DATE: AIA DOCUMENT G701 * CHANGE ORDER * APRIL 1978 EDITION * AIA * 1978 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE. , N .W., WASHINGTON, D.C . 20006 CONSENT OF OWNER ❑ SURETY. COMPANY ARCHITECT ❑ TO FINAL PAYMENT CONTRACTOR ❑ SURETY ❑ AIA DOCUMENT G707 OTHER ❑ PROJECT: Design Build Expansion and Renovation to the Indian River County Dept. of (name, address) Emergency Services Fire Station #4, 1500 Oslo Road , Vero Beach , FL 32960 TO (Owner) : Indian River County, Florida ARCHITECT'S PROJECT NO: CONTRACT FOR: Construction BOND NO: 54-161352 CONTRACT DATE: 0410412006 CONTRACTOR: Barth Construction , Inc. In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (here insert name and address of Surety Company) United Fire & Casualty Company 118 Second Avenue SE , Cedar Rapids , IA 52401 (319) 399 -5700 SURETY COMPANY, on bond of (here insert name and address of Contractor) Barth Construction , Inc. 1717 Indian River Blvd , Suite #202A, Vero Beach , FL 32960 (772) 778-3072 CONTRACTOR, hereby approves of the final payment to the Contractors, and agrees that final payment to the Contractor shall not relieve the Surety Company of any of its obligations to (here insert name and address of Owner) Indian River County, Florida 1840 25th St. ( BOCC address) , Vero Beach , FL 32960 (772) 567 -8000 OWNER, as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 18th day of October, 2007 . United Fire & Casualty Company Surety Company &A M. A;Attest: � Signature of Authorized Representative (Seal): � � Leslie M . Donahue, Attorney-In-Fact & Florida Title Licensed Resident Agent Inquiries: (407) 786- 7770 NOTE: This form is to be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS, Current Edition AIA DOCUMENT G707 • CONSENT OF SURETY COMPANY TO FINAL PAYMENT • APRIL 1970 EDITION • AIAO ONE PAGE O 1970 9 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 New York Ave., NW, WASHINGTON, D.C. 20006 T Q.-RAIA Document G702T" - 1992 Application and Certificate for Payment TO OWNER: PROJECT: INDIAN RIVER COUNTY 182 IRC FIRE STA #4 - PART 2 APPLICATION N0: Distribution to: PERIOD T0: 1840 25TH STREET 1500 9TH STREET SW 09/30/07 OWNER X VERO BEACH, FL 32960 VERO BEACH, FL 32962 CONTRACT FOR: 182 ARCHITECT El CONTRACTOR: VIA ARCHITECT: CONTRACT DATE: 06/01 /06 BARTH CONSTRUCTION, INC. EDLUND & DRITENBAS ARCH . P.A. CONTRACTOR ❑ 1717 INDIAN RIVER BLVD., SUITE 202A 65 ROYAL PALM BLVD., S. D PROJECT NOS: FIELD ❑ VERO BEACH, FL 32960 VERO BEACH, FL 32960 OTHER ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractors knowledge, information Application is made for payment, as shown below, in connection with the Contract. and belief the Work covered by this Application for Payment has been completed in accordance Continuation Sheet, AIA Document G703, is attached. with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and 1 . ORIGINAL CONTRACT SUM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2, 182,645 .00 that current payment shown herein is now due. 2. Net change by Change Orders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ -52,548.97 CONTRACT R: 3. CONTRACT SUM TO DATE (Linc 1 ± 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . ... . $ 2 130.096.03 By F f! Date: �O ) 6 4. TOTAL COMPLETED $ STORED TO DATE (Column G on 6703) . . . . . . $ 2. ] 30,096.03 to ` � � 5. RETAINAGE: C my a• % of Completed Work / 37✓ " UcA� (Column D + E on G703) $ me this day of Subscribed and sworn to before s r b. % of Stored Material ` C' l ow Marion H Tupek P my commiaabn DD339676 (Column F on G703) $ Notary Public:��.,�,i aJ . My Commission expires: 7�Zi /� ora. Expires July 21 , 2006 Total Retainage (Lines 5a + 5b or Total in Column I of G703) . . . . . .. $ 0.00 6. TOTAL EARNED LESS RETAINAGE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2. 130.096.03 ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 Less Line 5 Total) In accordance with the Contract Documents, based on on-site observations and the data comprising 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT . . . . . . . . . . . . . . . . . . . . . . $_2 099.907 23 this application, the Architect certifies to the Owner that to the best of the Architect' s knowledge, (Line 6 from prior Certificate) information and belief the 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 S. CURRENT PAYMENT DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 30 188 .80 AMOUNT CERTIFIED. /y 9. BALANCE TO FINISH, INCLUDING RETAINAGE AMOUNT CERTIFIED .. . .. . .. . .. .. . .. . .. . .... .. . .... . .. . .... .... . ., . . , ... ... . .. .. . .. $ . ... . ... . ... . .. (Line 3 less Line 6) $ 000 (Attach expla if amoun ertified differs from the amount applied. Initial all figures on this Application ad o th ti ation .Sheet that are changed to conform with the amount certified ) CHANGE ORDER SUMMARY. ADDITIONS DEDUCTIONS ARCHIT Total changes approved in previous months by Owner $ 0.00 $ 0.00 By: Date: Total approved this Month $ $ 52 548 .97 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the on actor TOTALS $ $ 52 548 .97 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 4 7 the Owner or Contractor under this Contract 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 G702ra — 1992. Copyright © 1953, 1963, 1965, 1971 , 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 -_=AIA Document G7027M - 1992 Instructions Application and Certificate for Payment GENERAL INFORMATION Purpose and Related Documents AIA Document G702, Application and Certificate for Payment, is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed to be used on a Project where a Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201 , General Conditions of the Contract for Construction. Use of Current Documents Prior to using any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA). To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel, copyright@aia.org. COMPLETING THE G702 FORM After the Contractor has completed AIA Document G703 , Continuation Sheet, summary information should be transferred to AIA Document G702, Application and Certificate for Payment. The Contractor should sign G702, have it notarized, and submit it, together with G703 , to the Architect. The Architect should review G702 and G703 and, if they are acceptable, complete the Architect' s Certificate for Payment on G702 . The Architect may certify a different amount than that applied for, pursuant to Sections 9. 5 and 9 .6 of A201 . The Architect should then initial all figures on G702 and G703 that have been changed to conform to the amount certified and attach an explanation. The completed G702 and G703 should be forwarded to the Owner. MAKING PAYMENT The Owner should make payment directly to the Contractor based on the amount certified by the Architect on AIA Document G702, Application and Certificate for Payment. The completed form contains the name and address of the Contractor. Payment should not be made to any other party unless specifically indicated on G702. EXECUTION OF THE DOCUMENT Persons executing the document should indicate the capacity in which they are acting (i .e., president, secretary, partner, etc.) and the authority under which they are executing the document. Where appropriate, a copy of the resolution authorizing the individual to act on behalf of the firm or entity should be attached. AIA Document G7027a — 1992. Copyright © 1953, 1963, 1965, 1971 , 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 AIA® 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 Architectslegal counsel, copyright@aia.org. WWWWW mom UNITED FIRE & CASUALTY COMPANY HOME OFFICE - CEDAR RAPIDS, IOWA CERTIFIED COPY OF POWER OF ATTORNEY (Original on file at Home Office of Company, See Certification ) KNOW ALL MEN BY THESE PRESENTS, That the UNITED FIRE & CASUALTY COMPANY, a corporation duly organized and existing :under the laws of the State of Iowa , and having,.its principal office in Cedar Rapids, State of Iowa, does make, constitute and appoint LESLIE M DONAHUE , OR KIM E . NIV , OR JEFFREY W REICH , OR SUSAN L` REICH ,- OR TERESA L DURHAM , OR PATRICIA L SLAUGHTER , OR J. GREGORY MACKENZIE -, OR WALTER N MYERS , OR . GLORIA A .RICHARDS , OR DON BRAMLAGE OF DAYTONA BEACH FL , ALL INDIVIDUALLY of MAITLAND FL its true and lawful Attorney( s)-in-Fact with power and authority hereby conferred to sign, seal and execute in its behalf all lawful ' '. ' bonds, undertakings and: other obligatory instruments of similar nature as follows: Any and Al I Bonds and to bind, UNITED FIRE & CASUALTY COMPANY thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of UNITED FIRE & CASUALTY COMPANY and all the acts of said Attorney, pursuant to the authority hereby given are hereby ratified and confirmed. The Authority hereby granted is continuous and shall remain in full force and effect until revoked by UNITED FIRE & CASUALTY COMPANY ' This power of Attorney is made and executed pursuantto and by authority of the following By-Law duty adopted by Board of Directors of the Company on April, 18, 1973. "Article V - Surety Bonds and Undertakings" Section 2, Appointment of Attorney-in-Fact. 'The President or any Vice President, or any other officer of the Company may, from time to time, appoint by written certificates attorneys-in-fact to act in behalf of the Company in the execution of policies of insurance, bonds, undertakings and other obligatory instruments of like nature. The signature of any officer authorized - herebyand the Corporate seal , may be affixed by facsimile to any power of attomeyor special power of attorney or : certification of either authorized hereby, such signature and seal, when so used , being adopted by :the Company as the original signature of such '. officer and the original seal of the Company, to be valid and binding upon the Company with the . same force and effect asthough manually affixed . Such attorneys-in fact, subject to the limitations set forth in their respective certificates of authority shall have full power to bind the Company by their signature and execution of any such Instruments and to attach the seal of the Company thereto. The President or any Vice President, the Board of Directors or any otherofficer of the Company may at any time revoke all power and authority previously given to any. attorney-in-fact. \",11,,,,,, IN WITNESS WHEREOF, the UNITED FIRE & CASUALTY COMPANY has caused these presents to be signed by \ * its vice president and its corporate seal to be hereto affixed this 15t h day of May , 2007 UERI = UNITED FIRE & CASUALTY COMPANY By State of Iowa) County of Linn, ss, C/ YfjJ/ On 15th day Of May . ; 2007 , before me personally came Dennis J . Richmann Vice President to me known , who being by me duly sworn, did depose and say, that he resides in Cedar Rapids, State of Iowa ; that he is a Vice President of the UNITED FIRE &. CASUALTY COMPANY, the corporation described in and which executed the above instrument; that ' he knows the seal of said corporation, that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the.. Board of. Directors of said corporation and that . he :signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation �p t fiiICHELLE WILSON _ M^ L COYNI8810N NumSEN 704745 • • I MV COMM SSIQB E%PINE$ — " dQ Notary Public - I , the undersigned officer of the UNITED FIRE & CASUALTY COMPANY, do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit and the copy of the Section of the by-laws of said Company as set forthin said Power of Attorney, with'. the ORIGINALS ON FILE IN THE HOME OFFICE OF SAID COMPANY and that the same are correct transcripts thereof, and of the whole of the said originals, and that the said Power of Attorney has not been revoked and is now in full force and effect \a"«u" led, In testimony whereof I have hereunto subscribed my name and affixed the corporate seal of the said Company this 1Rth day of October 20 � . r`EOFIY)kAFF r , SERI Secreta ry BPOA00190706 - =AIT A Document G703TM - 1992 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 14 containing Contractor' s signed certification is attached. APPLICATION DATE : In tabulations below, amounts are stated to the nearest dollar. OCT 0252007 Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: SEP 30,2007 ARCHITECT'S PROJECT N0E82 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE PRESENTLY COMPLETED - RETAINAGE ITDESCRIPTION OP WOkK SCHEDULED FROM PREVIOUS STORED ANDSTORED l TO (IP VARIABLE NO VALUE APPLICATION THIS PERIOD 1NOTIN TO DATE (GSC) FINISH RATE) (D + E) DOR E) (D+L+F) (C - C) ENERAL CONDITIONS 25 DAVIS BACON ADMIN - ACCTG 105320.00 3, 173 . 10 570. 15 0.00 3 ,74325 36.3 6,576.75 0.00 27 DAVIS BACON ADMIN - ADMIN 7,740.00 3,015 .00 450.00 0.00 35465.00 44. 8 41275 .00 0.00 28 FIELDSUPERVISION 755680.00 85, 174.32 2,859.94 0.00 88,034.26 116.3 12,354 .26- 0.00 29 FROJECT MANAGEMENT 869000.00 615031 .77 5,243 .44 0.00 66,275 .21 77. 1 19,724. 79 0.00 34 FERMANENT POWER 11000.00 0.00 0.00 0.00 0.00 0.0 11000.00 0.00 36 7 RAILER RENTAL 2,800.00 31484.37 0.00 0.00 3 ,484.37 124.4 684 .37- 0.00 40 . EMP. POWER 15200 .00 0.00 0.00 0.00 0.00 0.0 11200.00 0.00 42 TELEPHONE 11600.00 13372.78 179.27 0.00 1,552.05 97.0 47.95 0.00 44 1 EMPORARY TOILET 19600.00 11134.45 24.97 0 .00 ' 1 , 159.42 72. 5 440.58 0.00 50 FROJECT SIGN 11000.00 558.26 0.00 0.00 558.26 55 . 8 441 . 74 0.00 52 TEMPORARY FENCE 21500.00 0.00 0.00 0.00 0.00 0.0 21500.00 0.00 54 FIELD OFFICE SUPPLIES 125 .00 0.00 0.00 0.00 0.00 0.0 125 .00 0.00 58 1 EMP. PROTECTION 2,000.00 912 .73 0.00 0.00 912.73 45.6 11087.27 0.00 n \ 68 FIRST AID 50.00 0.00 0.00 0.00 0.00 0.0 50.00 0.00 70 SAFETY 250.00 0.00 0.00 0.00 0.00 0.0 250 .00 0.00 71PRINTING/POSTAGE 5,000.00 3, 111 . 16 40.63 0.00 31151 .79 63 .0 1 ,848.21 0.00 74 PHOTOGRAPHY 150.00 0.00 0.00 0.00 0.00 0.0 150.00 0.00 77 ARCHITECTURAL FEES 761011 .00 76,010.40 0.00 0.00 76,010.40 100.0 0.60 0.00 D 78 ENGINEERING 18 ,000.00 17,508.00 418 . 12 0.00 17,926. 12 99.6 73 . 88 0.00 I 80 SOIL TESTING 25500.00 2,795 .00 0.00 0.00 21795 .00 111 .8 295 .00- 0.00 82 ONCRETE TESTING 21200.00 982. 50 0 .00 0.00 982.50 44.7 1 ,217.50 0.00 88 SM . TOOL/SUPPLIES 2,800.00 1 ,029.77 244 .45 0.00 11274.22 45 . 5 11525 .78 0.00 92• 1 OUSEKEEPING LABOR 4,750.00 15169.00 0 .00 0.00 1 , 169.00 24.6 31581 .00 0.00 1 305 � 76 00 10 462 61 M030 97 000 272 493 5R 32 79142 1-100 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 G703TM - 1992. Copyright © 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIAe Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIAe 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. 1.10AIA Document G703TM - 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702, Application and Certificate for Payment, is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201 , General Conditions of the Contract for Construction . Use of Current Documents. Prior to using any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions. This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA). To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel. copyright@aia.org . COMPLETING THE G703 FORM Heading: This information should be completed in a manner consistent with similar information on AIA Document G702, Application and Certificate for Payment. Columns A, B & C: These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted. The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially, this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project, Column D: Enter in this column the amount of completed Work covered by the previous application (columns D & E from the previous application). Values from column F (Materials Presently Stored) from the previous application should not be entered in this column. Column E: Enter here the value of Work completed at the time of this application , including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored (column F). Column F : Enter here the value of Materials Presently Stored for which payment is sought. The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stored materials does not result in a deduction from this column. Only as materials are incorporated Into the Project is their value deducted from this column and incorporated into column E (Work Completed—This Period .) Column G : Enter here the total of columns D, E and F . Calculate the percentage completed by dividing column G by column C . Column H: Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date). Column I: This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done. Usually, Change Orders are listed separately, either on their own G703 form or at the end of the basic schedule . The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form . Construction Change Directives: Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201 . The following is an example of Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illustrative purposes only, and are not intended to reflect actual construction costs. A B o F r rIT I NOKK COMPI FT Fn MATERIAL) TOTAL PRFxVIIY AND RET RIAGE TOM SCVAR- FJJ FROM T PRL\ f )T 4 !O NO O[$CWFIIOF' OP WORK VAR- VPPI I( \ I OA HIS PFRI00 RTOAFD AFD SIORCD G SC PI61tiH Of VARIABLE ,D + E, DOF RroDAm ;r n IEATLI D OR D+F+PI 1 , M08TLIZATI0N 5000 5000 0 0 5000 '00 2 STUMP REMOVAL 5,000 5,000 0 0 5000 100 C 3 EAl WORK 15000 13 ox 5000 0 15,000 100 0 4 LOWER RETAINING WALL 10000 0 5000 0 5000 50 5,000 5 CURBS & MTSC CONC. 5000 0 0 C 0 0 5000 6 PAVING, UPPER DRIVE 2^,000 0 0 0 0 C 20000 PAVING, LOWER DRIVE 2p000 0 0 0 0 0 20000 8 PAVERS 20000 0 0 10,000 10000 50 10000 9 BRICKWORK 5000 0 0 0 0 5,000 11 ID5000 20000 1p000 10000 40,000 65000 AIA Document G703TM - 1992. Copyright 01963. 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA$ Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA$ 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. CHANGE ORDER Distribution to : AIA DOCUMENT G701 OWNER ARCHITECT CONTRACTOR FIELD OTHER — Donadio PROJECT : CHANGE ORDER NUMBER: 1 I . R.C . Fire Station 44 1500 Oslo Road Vero Beach, FL 32960 INITIATION DATE : 10/01 /07 TO (Contractor): I— —i ARCHITECT' S PROJECT NO : Barth Construction, Inc. 1717 Indian River Blvd. CONTRACT FOR: Suite 202A L Vero Beach, FL 32960 -1 CONTRACT DATE : You are directed to make the following changes in this Contract: This Change Order will adjust the Contract to match the final cost of the Project. Final Cost of Construction (Including Contractor' s Fee) $2, 130,096.03 Less Current Contract Amount <$2, 182.645 .00> Change Order Amount <$ 525548 .97> Not valid until signed by both the Architect and Owner. Signature of the Contractor indicates his agreement herewith, including any adjustment in the Contract Sum or Contract Time The Original (Contract Sum) (r_. ..._....teed- lirla iFfl m Cost) was . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $2, 182,645 . 00 Net change by previously authorized Change Orders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -$ 0 The (Contract Sum) (GRaFanteed " "..lA.. ufn Cost) prior to this Change Order was . . . . . . . . . . . . $2, 182,645 . 00 The (Contract Sum ) (r-. . .._.. nteea Ma*i.. ufn Cost` will be d) (decreased"• • -nom . hanged) by this Change Order . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -$ 52,548 .97 The new (Contract Sum) (Guaranteed Maximum Cost including this Change Order will be $2, 130,096. 03 The Contract Time will be (increased) (decreased) (unchanged) by ( ) Days The Date of Substantial Completion as of the date of this Change Order therefore is ARCHITECT CONTRACTOR OWNER Edlund, Dritenbas, Binklev, Arch . Barth Construction Indian River County Dept. of Emer. 65 Royal Palm Pointe, Suite D 1717 Indian River Blvd. 1840 25`h Street Vero Be L 3;960 Suite 202A Vero Beach, FL 32960 Vero Beach, FL 32960 BY: PAUL 41- .4 17SuBf/S BY: - c— BYc DATE : aocT2�� DAT �O ' I ' o� DATE: AIA DOCUMENT G701 * CHANGE ORDER * APRIL 1978 EDITION * AIA * 1978 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE. , N .W., WASHINGTON, D.C . 20006 AIA Document G703TM - 1992 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 14 containing Contractor's signed certification is attached. APPLICATION DATE: In tabulations below, amounts are stated to the nearest dollar. OCT 02,2007 Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: SEP 30,2007 ARCHITECT'S PROJECT NOf82 A B C D E F' G H I WORKCOMPLETED MATERIALS 'TOTAL BALANCE PRESENTLY COMPLETED RETAINAGE SCHEDULED FROM PREVIOUS % TO (IC VARIABLE ITEM DESCRIPTION OF WORK STORED AND STORED NO. VALUE APPLICATION THIS PERIOD (NOT IN TO DATE (G + C) FINISH RATE) (D + E) D OR E) (D+E+F) (C - G) 94 1 INAL CLEANING 2,400.00 1 ,797.60 0.00 0.00 15797.60 74.9 602.40 0.00 10 SOLID WASTE FEE 500.00 0.00 0.00 0.00 0.00 0.0 500.00 0.00 18 SURVEYING 10,000.00 8,209 .60 21639.45 0.00 10,849.05 108.5 849.05- 0.00 24 COMMON LABOR 45750.00 21,776. 15 0.00 0.00 2,776. 15 58.4 11973 . 85 0.00 26 DUMPCHARGES 12,000.00 7,091 .73 0.00 0.00 71,091 .73 59. 1 4,908 .27 0.00 40 UNCH-OUT LABOR 700.00 0.00 0.00 0.00 0.00 0.0 700.00 0 .00 44 E UILDERS RISK 91000.00 8,073 .00 0.00 0.00 8,073 .00 89.7 927 .00 0.00 48 L LABILITY INSURANCE 29800.00 21800.00 0.00 0.00 - 2,800.00 100.0 0.00 0.00 50 CONTINGENCY 509000.00 27,051 . 81 93420.72 0.00 36,472.53 72.9 13 ,527.47 0.00 52 F UILDING PERMIT 61750.00 31206. 11 635.22 0.00 3,841 . 33 56.9 2,908.67 0.00 56 G.C . BOND 159500.00 15,384.00 0.00 0.00 15,384.00 99.3 116.00 0 .00 64 ASBESTOS ABATEMENT 2,750.00 3,325 .00 0 .00 0.00 3 ,325.00 120.9 575 .00- 0.00 SITE WORK 68 SITE DELEVOPMENT 3195350.00 319,624.40 41136.00- 0.00 315,488.40 98. 8 3,861 .60 0.00 76 DEMOLITION 400.00 2,600.00 0.00 0.00 21600.00 50.0 21200.00- 0.00 80 CREASE TRAP/D.F. 5,000.00 4, 125 .50 0 .00 0.00 4, 125.50 82. 5 874 .50 0.00 1 46 I ZRIGATION 209500.00 0.00 0 .00 0.00 0.00 0.0 209500.00 0.00 t 50 LANDSCAPING 37,850.00 49,382.71 796.60- 0.00 48,586. 11 28.4 10,736. 11 - 0.00 62 FENCING 165422.00 141,920.00 0.00 0.00 149920.00 90.9 11502.00 0 .00 CONCRETE / n 74 C ONCRETE SUB-CONTR 146,506.00 150,376 .00 107970.00 0.00 161 ,346.00 110. 1 141,840.00- 0.00 MASONRY 28 MASONRY SUB-CONTR. 97,594 .00 99,570.80 0.00 0.00 99,570. 80 102.0 15976. 80- 0.00 56• TASONRY INSULATION 2,377 .00 25377.00 0.00 0.00 2,377,00 100.0 0.00 0.00 I1 71ri 1149 off 72? 691 41 19 732 79 1 000 1741 424 20 1 21 724 80 000 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 G703n" - 1992. Copyright © 1963, 1965, 1966, 1967, 1970, 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 AIA" 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 It 0) 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. AIA Document G703TM - 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702, Application and Certificate for Payment, is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201 , General Conditions of the Contract for Construction . Use of Current Documents. Prior to using any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions. This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document,. nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA) . To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel , copyright@aia.org. COMPLETING THE G703 FORM Heading: This information should be completed in a manner consistent with similar information on AIA Document G702, Application and Certificate for Payment. Columns A, B & C: These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted . The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required . Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially, this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D: Enter in this column the amount of completed Work covered by the previous application (columns D & E from the previous application). Values from column F (Materials Presently Stored) from the previous application should not be entered in this column. Column E: Enter here the value of Work completed at the time of this application , including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored (column F). Column F : Enter here the value of Materials Presently Stored for which payment is sought. The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stared materials does not result in a deduction from this column. Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E (Work Completed—This Period.) Column G Enter here the total of columns D, E and F. Calculate the percentage completed by dividing column G by column C. Column H : Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date). Column I: This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done. Usually, Change Orders are listed separately, either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form. Construction Change Directives: Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201 . The following is an example of Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illustrative purposes only, and are not intended to reflect actual construction costs. A B C D F F G I I I N'ORK CONPIFLED NIATER1A13 TOTAL AI AN('F PRESENTLY COMPLETAND IFIARTABl ITEM SCHEDULED IROMPRLA�OLS TO Nn DFSC31FTI060P WUNK yALLL AYYLIC4T:OY THIS PERIOn 610RE� ANp pTpkED G `C� FIM1ISH `IFV 3RIiRIF 'D + LP .NORIA 10 DATE RATE 1 MOBRIZATION 5000 `000 0 0 5,000 100 0 2 STUMP REMOVAL 50X 5000 0 0 5000 [00 0 3 ENRTFI WORK 15000 10,000 5000 0 15,000 100 0 4 LOWER RETAINING WALL 10000 0 5000 0 5000 50 5000 5 CURBS A MISC. CONC. 5000 0 0 0 0 0 5000 6 PAVING, UPPER DRIVE 20,000 0 0 0 0 0 20,X0 7 PAVING, LOWER DRIVE 20,000 0 0 0 0 0 20,000 e PAVERS 20,X0 0 0 IDOoO 10000 50 1 100X 9 BRICK WORK 5,000 0 0 0 0 0 50X 10 11 1050X 20000 10,000 10000 40000 65000 AIA Document G703TM — 1992. Copyright © 1963, 1965.. 1966, 1967, 1970, 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 AIA® 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 Architectslegal counsel , copyright@)aia.org. T Q.-RAIA Document G702T" - 1992 Application and Certificate for Payment TO OWNER: PROJECT: INDIAN RIVER COUNTY 182 IRC FIRE STA #4 - PART 2 APPLICATION N0: Distribution to: PERIOD T0: 1840 25TH STREET 1500 9TH STREET SW 09/30/07 OWNER X VERO BEACH, FL 32960 VERO BEACH, FL 32962 CONTRACT FOR: 182 ARCHITECT El CONTRACTOR: VIA ARCHITECT: CONTRACT DATE: 06/01 /06 BARTH CONSTRUCTION, INC. EDLUND & DRITENBAS ARCH . P.A. CONTRACTOR ❑ 1717 INDIAN RIVER BLVD., SUITE 202A 65 ROYAL PALM BLVD., S. D PROJECT NOS: FIELD ❑ VERO BEACH, FL 32960 VERO BEACH, FL 32960 OTHER ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractors knowledge, information Application is made for payment, as shown below, in connection with the Contract. and belief the Work covered by this Application for Payment has been completed in accordance Continuation Sheet, AIA Document G703, is attached. with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and 1 . ORIGINAL CONTRACT SUM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2, 182,645 .00 that current payment shown herein is now due. 2. Net change by Change Orders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ -52,548.97 CONTRACT R: 3. CONTRACT SUM TO DATE (Linc 1 ± 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . ... . $ 2 130.096.03 By F f! Date: �O ) 6 4. TOTAL COMPLETED $ STORED TO DATE (Column G on 6703) . . . . . . $ 2. ] 30,096.03 to ` � � 5. RETAINAGE: C my a• % of Completed Work / 37✓ " UcA� (Column D + E on G703) $ me this day of Subscribed and sworn to before s r b. % of Stored Material ` C' l ow Marion H Tupek P my commiaabn DD339676 (Column F on G703) $ Notary Public:��.,�,i aJ . My Commission expires: 7�Zi /� ora. Expires July 21 , 2006 Total Retainage (Lines 5a + 5b or Total in Column I of G703) . . . . . .. $ 0.00 6. TOTAL EARNED LESS RETAINAGE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2. 130.096.03 ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 Less Line 5 Total) In accordance with the Contract Documents, based on on-site observations and the data comprising 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT . . . . . . . . . . . . . . . . . . . . . . $_2 099.907 23 this application, the Architect certifies to the Owner that to the best of the Architect' s knowledge, (Line 6 from prior Certificate) information and belief the 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 S. CURRENT PAYMENT DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 30 188 .80 AMOUNT CERTIFIED. /y 9. BALANCE TO FINISH, INCLUDING RETAINAGE AMOUNT CERTIFIED .. . .. . .. . .. .. . .. . .. . .... .. . .... . .. . .... .... . ., . . , ... ... . .. .. . .. $ . ... . ... . ... . .. (Line 3 less Line 6) $ 000 (Attach expla if amoun ertified differs from the amount applied. Initial all figures on this Application ad o th ti ation .Sheet that are changed to conform with the amount certified ) CHANGE ORDER SUMMARY. ADDITIONS DEDUCTIONS ARCHIT Total changes approved in previous months by Owner $ 0.00 $ 0.00 By: Date: Total approved this Month $ $ 52 548 .97 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the on actor TOTALS $ $ 52 548 .97 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 4 7 the Owner or Contractor under this Contract 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 G702ra — 1992. Copyright © 1953, 1963, 1965, 1971 , 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 11AIA Document G703TM - 1992 Continuation Sheet AIA Document G702, APPLICA'T'ION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 14 containing Contractor' s signed certification is attached. APPLICATION DATE: Our 02,2007 In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: SEP 30,2007 ARCHITECT'S PROJECT NOt82 A B C D E F G H I WORKCOMPLETED MATERIALS TOTAL BALANCE PRESENTLY COMPLE'T'ED RETAINAGESCHEDULED FROM PREVIOUS % TO (IF VARIABLE ITEM DESCRIPTION OF WORK STORED AND STORED NO VALUE APPLICATION 'PHIS PERIOD (NOT IN TO DA"fE (G - C) PINISH RAIL) (D + E) D OR F7 (D+E+F) (C - G) METALS 74 ALUMINUM RAILINGS 51610.00 51550.00 0.00 0.00 5 ,550.00 98 .9 60.00 0.00 82 MUTTERS/AWNINGS 65307.00 61306.59 0.00 0.00 69306.59 100.0 0.41 0.00 94 FIPE BUMBERS 750.00 605 .49 0.00 0.00 605 .49 80.7 144.51 0.00 CARPENTRY 02 N 1001) & LUMBER 28,550.00 23,045 .43 128.07 0.00 23 , 173.50 81 .2 55376. 50 0.00 12 TRUSSES 23,500.00 23,476.00 0.00 0.00 23,476.00 99.9 24.00 0.00 14 F OUGH CARPENTRY 64,600.00 64, 847. 50 0.00 0.00 64;847. 50 100.4 247.50- 0.00 94 TAINLESS TOPS 6,500.00 6,325 .20 0.00 0.00 61325.20 97 . 3 174. 80 0.00 THERMAL/MOISTURE 02 CAULKING 4,000.00 76.48 0.00 0.00 76.48 1 .9 33923 . 52 0.00 04 I SULATION 51850.00 55824.00 0.00 0.00 51824.00 99.6 26.00 0.00 14 ROOFING S.C . 26,205.00 32,073 .00 0.00 0.00 329073.00 122.4 57868 .00- 0.00 24 UTTERS/D. S. 21819.00 29819.00 0.00 0.00 2,819.00 1 DO.0 0.00 0.00 DORS AND WINDOWS 50 M . DOOR - LABOR 51000.00 4,000.00 0.00 0.00 45000.00 80.0 11000.00 0.00 52 .M./WOOD/HDW PKG 42,500.00 48,766.00 0.00 0.00 489766.00 114.7 61266.00- 0.00 1 62 OVERHEAD DOORS 16,500.00 15,730.40 0.00 0.00 15,730.40 95 .3 769.60 0.00 nnn t J 78 INDOWS,GLASS & GLAZING 11 ,575 .00 119275 .00 0.00 0.00 11 ,275.00 97.4 300.00 0.00 �0 D� INISHES op 04 STUCCO 34, 155 .00 43 ,975 .00 0 .00 0.00 43 ,975.00 18. 8 9,820.00- 0.00 0 06 DRYWALL 615290.00 62,612.00 0.00 0.00 62,612.00 1 )2.2 1 ,322.00- 0.00 f 10TILE/MARBLE 27,935 .00 28,201 .00 0 .00 0.00 28,201 .00 I)1 .0 266.00- 0.00 18 MARBLE SILLS ' 266.00 0 .00 0.00 0.00 0.00 0.0 266.00 0.00 373,912 .00 385 ,508 .09 128 .07 0.00 3851636. 16 11 ,724. 16- 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 G703714 - 1992. Copyright © 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING : This Ale 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. C=AI Document G703TN - 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702, Application and Certificate for Payment, is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201 , General Conditions of the Contract for Construction. Use of Current Documents. Prior to using any AIA Contract Document, users should consult www.ala.org or a local AIA component to verify the most recent edition . Reproductions. This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703 , but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA). To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel , copyright@aia.org. COMPLETING THE G703 FORM Heading: This information should be completed in a manner consistent with similar information on AIA Document G702, Application and Certificate for Payment. Columns A, B & C : These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted. The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required . Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially, this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D: Enter in this column the amount of completed Work covered by the previous application (columns D & E from the previous application). Values from column F (Materials Presently Stored) from the previous application should not be entered in this column. Column E: Enter here the value of Work completed at the time of this application , including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stared (column F). Column F : Enter here the value of Materials Presently Stored for which payment is sought. The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stored materials does not result in a deduction from this column. Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E (Work Completed—This Period.) Column G: Enter here the total of columns D, E and F. Calculate the percentage completed by dividing column G by column C. Column H: Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date). Column I: This column is normally used only for contracts where variable retainage is permitted on aline-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project. this is not normally done. Usually, Change Orders are listed separately, either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form . Construction Change Directives : Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201 . The following is an example of a Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illustrative purposes only, and are not intended to reflect actual construction costs. A tl D L F G H I AWRK COMPLL I LU NIITRIALS TOTAL PRPlRTLY C01PL[IED RLI AINAGC ITEM SCIICDLLED IAOAi PRFVIOCS `+ 10 VO. DISCRIITION OF WORK VALCE AD PI IC STI06 IHIS PLRIOD SIORLU AND STORED 't IG-( ITAISH , 11 YpWApLE iNO IIN TO DATE IUTLI ID- 6 pORG [D+CFI ,GG. 1 MOBILIZATION 500e 5,000 0 0 5000 loo 0 2 STUMP REMOVAL 5000 5,000 0 0 500 100 0 3 EARTH WORK 150o0 10000 5,000 0 '5000 100 0 4 LOWER RETAINING WALL mcw 0 5,000 0 5000 50 5,000 5 CURBS d MISC. cow 5000 0 O 0 0 0 5000 6 PAVING, UPPER DRIVE 20000 0 F 0 0 0 201000 7 PAVING, LOWER DRIVE 20000 0 0 0 0 0 20000 8 . PAVERS 20,000 0 0 10,000 100W 50 10000 9 BRICKWORK 5000 0 0 0 0 0 5,000 10 :1 105,000 20,000 10,000 10,000 40000 65.000 AIA Document G703TA — 1992. Copyright © 1963, 1965, 1966, 1967, 1970, 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 AIA® 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. -_=AIA Document G7027M - 1992 Instructions Application and Certificate for Payment GENERAL INFORMATION Purpose and Related Documents AIA Document G702, Application and Certificate for Payment, is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed to be used on a Project where a Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201 , General Conditions of the Contract for Construction. Use of Current Documents Prior to using any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA). To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel, copyright@aia.org. COMPLETING THE G702 FORM After the Contractor has completed AIA Document G703 , Continuation Sheet, summary information should be transferred to AIA Document G702, Application and Certificate for Payment. The Contractor should sign G702, have it notarized, and submit it, together with G703 , to the Architect. The Architect should review G702 and G703 and, if they are acceptable, complete the Architect' s Certificate for Payment on G702 . The Architect may certify a different amount than that applied for, pursuant to Sections 9. 5 and 9 .6 of A201 . The Architect should then initial all figures on G702 and G703 that have been changed to conform to the amount certified and attach an explanation. The completed G702 and G703 should be forwarded to the Owner. MAKING PAYMENT The Owner should make payment directly to the Contractor based on the amount certified by the Architect on AIA Document G702, Application and Certificate for Payment. The completed form contains the name and address of the Contractor. Payment should not be made to any other party unless specifically indicated on G702. EXECUTION OF THE DOCUMENT Persons executing the document should indicate the capacity in which they are acting (i .e., president, secretary, partner, etc.) and the authority under which they are executing the document. Where appropriate, a copy of the resolution authorizing the individual to act on behalf of the firm or entity should be attached. AIA Document G7027a — 1992. Copyright © 1953, 1963, 1965, 1971 , 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 AIA® 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 Architectslegal counsel, copyright@aia.org. - =AIT A Document G703TM - 1992 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 14 containing Contractor' s signed certification is attached. APPLICATION DATE : In tabulations below, amounts are stated to the nearest dollar. OCT 0252007 Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: SEP 30,2007 ARCHITECT'S PROJECT N0E82 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE PRESENTLY COMPLETED - RETAINAGE ITDESCRIPTION OP WOkK SCHEDULED FROM PREVIOUS STORED ANDSTORED l TO (IP VARIABLE NO VALUE APPLICATION THIS PERIOD 1NOTIN TO DATE (GSC) FINISH RATE) (D + E) DOR E) (D+L+F) (C - C) ENERAL CONDITIONS 25 DAVIS BACON ADMIN - ACCTG 105320.00 3, 173 . 10 570. 15 0.00 3 ,74325 36.3 6,576.75 0.00 27 DAVIS BACON ADMIN - ADMIN 7,740.00 3,015 .00 450.00 0.00 35465.00 44. 8 41275 .00 0.00 28 FIELDSUPERVISION 755680.00 85, 174.32 2,859.94 0.00 88,034.26 116.3 12,354 .26- 0.00 29 FROJECT MANAGEMENT 869000.00 615031 .77 5,243 .44 0.00 66,275 .21 77. 1 19,724. 79 0.00 34 FERMANENT POWER 11000.00 0.00 0.00 0.00 0.00 0.0 11000.00 0.00 36 7 RAILER RENTAL 2,800.00 31484.37 0.00 0.00 3 ,484.37 124.4 684 .37- 0.00 40 . EMP. POWER 15200 .00 0.00 0.00 0.00 0.00 0.0 11200.00 0.00 42 TELEPHONE 11600.00 13372.78 179.27 0.00 1,552.05 97.0 47.95 0.00 44 1 EMPORARY TOILET 19600.00 11134.45 24.97 0 .00 ' 1 , 159.42 72. 5 440.58 0.00 50 FROJECT SIGN 11000.00 558.26 0.00 0.00 558.26 55 . 8 441 . 74 0.00 52 TEMPORARY FENCE 21500.00 0.00 0.00 0.00 0.00 0.0 21500.00 0.00 54 FIELD OFFICE SUPPLIES 125 .00 0.00 0.00 0.00 0.00 0.0 125 .00 0.00 58 1 EMP. PROTECTION 2,000.00 912 .73 0.00 0.00 912.73 45.6 11087.27 0.00 n \ 68 FIRST AID 50.00 0.00 0.00 0.00 0.00 0.0 50.00 0.00 70 SAFETY 250.00 0.00 0.00 0.00 0.00 0.0 250 .00 0.00 71PRINTING/POSTAGE 5,000.00 3, 111 . 16 40.63 0.00 31151 .79 63 .0 1 ,848.21 0.00 74 PHOTOGRAPHY 150.00 0.00 0.00 0.00 0.00 0.0 150.00 0.00 77 ARCHITECTURAL FEES 761011 .00 76,010.40 0.00 0.00 76,010.40 100.0 0.60 0.00 D 78 ENGINEERING 18 ,000.00 17,508.00 418 . 12 0.00 17,926. 12 99.6 73 . 88 0.00 I 80 SOIL TESTING 25500.00 2,795 .00 0.00 0.00 21795 .00 111 .8 295 .00- 0.00 82 ONCRETE TESTING 21200.00 982. 50 0 .00 0.00 982.50 44.7 1 ,217.50 0.00 88 SM . TOOL/SUPPLIES 2,800.00 1 ,029.77 244 .45 0.00 11274.22 45 . 5 11525 .78 0.00 92• 1 OUSEKEEPING LABOR 4,750.00 15169.00 0 .00 0.00 1 , 169.00 24.6 31581 .00 0.00 1 305 � 76 00 10 462 61 M030 97 000 272 493 5R 32 79142 1-100 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 G703TM - 1992. Copyright © 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIAe Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIAe 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. a T IA Document G703TM - 1992 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 14 containing Contractor's signed certification is attached. APPLICATION DATE: OCT 02,2007 In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: SEP 30,2007 ARCHITECT'S PROJECT NOW A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE SCHEDULEDPRESENTLY COMPLETED (IF ITEM DESCRIPTION OF WORK FROM PREVIOUS STORED AND STORED % TO (IP VARIABLE NO. VALUE APPLICATION THIS PERIOD (NOT IN TO DATE (G = C) FINISH RATE) (D + E) D OR E) (D+E+F) (C - G) 22 A COUSTIC CEILING 9,500.00 93175 .00 0.00 0.00 9, 175 .00 96.6 325 .00 0.00 38 FAINTING 3,5,000.00 349220.00 0.00 0.00 34,220.00 97.8 780.00 0.00 SPECIALTIES 66 1 OILET PARTITIONS 5,585 .00 5 ,585 .00 0.00 0 .00 5,585 .00 100.0 0.00 0.00 71 FIRE EXTINGUISHER/EQUIP 500.00 1 ,003 .45 0.00 0.00 1 ,003 .45 200.7 503 .45- 0.00 73 FLAGPOLE 21000.00 1 ,573 .25 0.00 0.00 15573 .25 78. 7 426.75 0 .00 75 I ENT.DEVICES-MAT. 3,050.00 584 .80 0.00 0.00 584.80 19.2 2,465 .20 0.00 85 METAL SHELVING 19000.00 426 .72 0.00 0.00 426.72 42 .7 573 .28 0.00 86 F ATH ACC:-MAT. 41100.00 39282.75 0.00 0.00 39282 . 75 80. 1 817.25 0.00 88 F ATH ACC.-LAB. 800.00 0.00 0 .00 0.00 0.00 0.0 800.00 0.00 89 ULTURED MARBLE 8,060.00 7,779.34 0.00 0.00 7,779.34 96.5 280.66 0.00 14 F F,SIDENTIAL APPL. 15 ,900.00 15 ,469. 78 377.65 0.00 15,847.43 N.7 52 .57 0.00 23 GEAR HOSE & LOCKER ACCESS 13 ,000.00 9,498 .00 526.64 0.00 10,024.64 77. 1 21,975.36 0.00 42 C ASEWORK 341,264.00 34,264.38 0.00 0.00 349264.38 1 DO.0 0.38- 0.00 MECHANICAL 85 FLUMBING 39,226.00 39,226.00 0.00 0.00 39,226.00 1 )0.0 0.00 0.00 88 SPRINKLER SYSTEM 521,800.00 53,800.00 0.00 0.00 53 ,800.00 1 ) 1 . 9 1 ,000.00- 0. 00 93 I VAC 102,885 .00 1021,885 .00 44 .00 0.00 1021,929.00 1 )0.0 44 .00- 0.00 00 KITCHEN HOOD 12,898.00 13,084 .45 0 .00 0.00 135084.45 1 1 .4 186.45- 0.00 n 03 /P TANK 71055 .00 6,784.27 267.83 0.00 7,052. 10 1 J0.0 2 .90 0.00 ►l LECTRICAL (10� 11 F LECTRICAL S.C. 1571,622.00 155,659.93 80 . 85 0.00 155,740.78 8. 8 1 ,881 .22 0.00 Y � r 27 GENERATORS 381,500.00 38,380.00 0.00 0.00 38,380.00 9.7 120.00 0 . 00 01 ONSTRUCTION FEE 1965563 .00 191 0.00 0.00 196,563 .00 1 )0.0 0 .00 0.00 740,308.00 729,245 . 12 1 ,296 .97 0.00 7301,542 .09 91765 .91 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, a 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING : This Al Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA® 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, a-mail The American Institute of Architects' legal counsel, copyright@aia.org. -AI Document G703TM - 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702. Application and Certificate for Payment., is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201 , General Conditions of the Contract for Construction. Use of Current Documents. Prior to using any AIA Contract Document.. users should consult www.aia .org or a local AIA component to verify the most recent edition . Reproductions. This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA). To report copyright violations of AIA Contract Documents. e-mail The American Institute of Architects' legal counsel , copyright@aia.org. COMPLETING THE G703 FORM Heading: This information should be completed in a manner consistent with similar information on AIA Document G702, Application and Certificate for Payment. Columns A, B & C: These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted . The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially, this total should equal the original Contract Sum . The total of column C may be adjusted by Change Orders during the Project. Column D: Enter in this column the amount of completed Work covered by the previous application (columns D & E from the previous application). Values from column F (Materials Presently Stored) from the previous application should not be entered in this column . Column E: Enter here the value of Work completed at the time of this application, including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored (column F) . Column F: Enter here the value of Materials Presently Stored for which payment is sought. The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stored materials does not result in a deduction from this column . Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E (Work Completed—This Period.) Column G: Enter here the total of columns D, E and F. Calculate the percentage completed by dividing column G by column C. Column H: Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date) . Column I: This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done. Usually, Change Orders are listed separately, either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form. Construction Change Directives: Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201 . The following is an example of a Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illustrative purposes only, and are not intended to reflect actual construction costs. A e C D F I G I I WORK CONPLELF D �4 TERIAIS IOIAL 9 \6f F PRESCNTLY CONPI FILD _ RP 141NAGB ITEM SCHEDRFD FRONPRPAIOV4 DESCRIPTIO,- OF RORK )TORED FVASIORPD (IF , ARIANW TO NO FAEIE ,PPI IF I ON TIESPERIOD F MORIN TODAFY C-C FINISH AN G, RAIEI IDI DORS m«e+e. 1 MOBILIZATION 5,000 5,000 0 0 5000 100 0 2 5I. MP REMOVAL 5,000 50W 0 0 5000 100 0 3 EARTHWORK 20 ,000 IC000 Sam 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5000 0 5000 50 5,000 5 CURBS 6 MISC. CONIC. 5 000 0 0 0 0 0 5,000 6 PAVING, UPPER DRIVE 20000 0 0 0 00 20000 7 PAVING, LOWER DRIVE 20000 c 0 0 0 0 20000 b PAVERS 2000C 0 10000 10000 50 EC00 9 BRICKWORK 5000 0 0 .. 0 5005 0 It tC5000 20000 10000 IC Pro 40,000 65,000 AIA Document G703M - 1992. Copyright © 1963, 1965.. 1966, 1967, 1970, 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 AIAO 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 If 0) copies of this document when completed. To report copyright violations of AIA Contract Documents.. e-mail The American Institute of Architects legal counsel. copyright(jaia.org. 1.10AIA Document G703TM - 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702, Application and Certificate for Payment, is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201 , General Conditions of the Contract for Construction . Use of Current Documents. Prior to using any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions. This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA). To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel. copyright@aia.org . COMPLETING THE G703 FORM Heading: This information should be completed in a manner consistent with similar information on AIA Document G702, Application and Certificate for Payment. Columns A, B & C: These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted. The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially, this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project, Column D: Enter in this column the amount of completed Work covered by the previous application (columns D & E from the previous application). Values from column F (Materials Presently Stored) from the previous application should not be entered in this column. Column E: Enter here the value of Work completed at the time of this application , including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored (column F). Column F : Enter here the value of Materials Presently Stored for which payment is sought. The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stored materials does not result in a deduction from this column. Only as materials are incorporated Into the Project is their value deducted from this column and incorporated into column E (Work Completed—This Period .) Column G : Enter here the total of columns D, E and F . Calculate the percentage completed by dividing column G by column C . Column H: Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date). Column I: This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done. Usually, Change Orders are listed separately, either on their own G703 form or at the end of the basic schedule . The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form . Construction Change Directives: Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201 . The following is an example of Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illustrative purposes only, and are not intended to reflect actual construction costs. A B o F r rIT I NOKK COMPI FT Fn MATERIAL) TOTAL PRFxVIIY AND RET RIAGE TOM SCVAR- FJJ FROM T PRL\ f )T 4 !O NO O[$CWFIIOF' OP WORK VAR- VPPI I( \ I OA HIS PFRI00 RTOAFD AFD SIORCD G SC PI61tiH Of VARIABLE ,D + E, DOF RroDAm ;r n IEATLI D OR D+F+PI 1 , M08TLIZATI0N 5000 5000 0 0 5000 '00 2 STUMP REMOVAL 5,000 5,000 0 0 5000 100 C 3 EAl WORK 15000 13 ox 5000 0 15,000 100 0 4 LOWER RETAINING WALL 10000 0 5000 0 5000 50 5,000 5 CURBS & MTSC CONC. 5000 0 0 C 0 0 5000 6 PAVING, UPPER DRIVE 2^,000 0 0 0 0 C 20000 PAVING, LOWER DRIVE 2p000 0 0 0 0 0 20000 8 PAVERS 20000 0 0 10,000 10000 50 10000 9 BRICKWORK 5000 0 0 0 0 5,000 11 ID5000 20000 1p000 10000 40,000 65000 AIA Document G703TM - 1992. Copyright 01963. 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA$ Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA$ 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. AIA Document G703TM - 1992 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 14 containing Contractor's signed certification is attached. APPLICATION DATE: In tabulations below, amounts are stated to the nearest dollar. OCT 02,2007 Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: SEP 30,2007 ARCHITECT'S PROJECT NOf82 A B C D E F' G H I WORKCOMPLETED MATERIALS 'TOTAL BALANCE PRESENTLY COMPLETED RETAINAGE SCHEDULED FROM PREVIOUS % TO (IC VARIABLE ITEM DESCRIPTION OF WORK STORED AND STORED NO. VALUE APPLICATION THIS PERIOD (NOT IN TO DATE (G + C) FINISH RATE) (D + E) D OR E) (D+E+F) (C - G) 94 1 INAL CLEANING 2,400.00 1 ,797.60 0.00 0.00 15797.60 74.9 602.40 0.00 10 SOLID WASTE FEE 500.00 0.00 0.00 0.00 0.00 0.0 500.00 0.00 18 SURVEYING 10,000.00 8,209 .60 21639.45 0.00 10,849.05 108.5 849.05- 0.00 24 COMMON LABOR 45750.00 21,776. 15 0.00 0.00 2,776. 15 58.4 11973 . 85 0.00 26 DUMPCHARGES 12,000.00 7,091 .73 0.00 0.00 71,091 .73 59. 1 4,908 .27 0.00 40 UNCH-OUT LABOR 700.00 0.00 0.00 0.00 0.00 0.0 700.00 0 .00 44 E UILDERS RISK 91000.00 8,073 .00 0.00 0.00 8,073 .00 89.7 927 .00 0.00 48 L LABILITY INSURANCE 29800.00 21800.00 0.00 0.00 - 2,800.00 100.0 0.00 0.00 50 CONTINGENCY 509000.00 27,051 . 81 93420.72 0.00 36,472.53 72.9 13 ,527.47 0.00 52 F UILDING PERMIT 61750.00 31206. 11 635.22 0.00 3,841 . 33 56.9 2,908.67 0.00 56 G.C . BOND 159500.00 15,384.00 0.00 0.00 15,384.00 99.3 116.00 0 .00 64 ASBESTOS ABATEMENT 2,750.00 3,325 .00 0 .00 0.00 3 ,325.00 120.9 575 .00- 0.00 SITE WORK 68 SITE DELEVOPMENT 3195350.00 319,624.40 41136.00- 0.00 315,488.40 98. 8 3,861 .60 0.00 76 DEMOLITION 400.00 2,600.00 0.00 0.00 21600.00 50.0 21200.00- 0.00 80 CREASE TRAP/D.F. 5,000.00 4, 125 .50 0 .00 0.00 4, 125.50 82. 5 874 .50 0.00 1 46 I ZRIGATION 209500.00 0.00 0 .00 0.00 0.00 0.0 209500.00 0.00 t 50 LANDSCAPING 37,850.00 49,382.71 796.60- 0.00 48,586. 11 28.4 10,736. 11 - 0.00 62 FENCING 165422.00 141,920.00 0.00 0.00 149920.00 90.9 11502.00 0 .00 CONCRETE / n 74 C ONCRETE SUB-CONTR 146,506.00 150,376 .00 107970.00 0.00 161 ,346.00 110. 1 141,840.00- 0.00 MASONRY 28 MASONRY SUB-CONTR. 97,594 .00 99,570.80 0.00 0.00 99,570. 80 102.0 15976. 80- 0.00 56• TASONRY INSULATION 2,377 .00 25377.00 0.00 0.00 2,377,00 100.0 0.00 0.00 I1 71ri 1149 off 72? 691 41 19 732 79 1 000 1741 424 20 1 21 724 80 000 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 G703n" - 1992. Copyright © 1963, 1965, 1966, 1967, 1970, 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 AIA" 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 It 0) 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. Document G703TMVAIA - 1992 Continuation Sheet AIA Document 6702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 14 containing Contractor' s signed certification is attached. APPLICATION DATE: OCT 02,2007 In tabulations below, amounts are stated w the nearest dollar, Use Colman 1 on Contracts where variable retainage for line items may apply. PERIOD TO: SEP 30,2007 ARCHITECT'S PROJECT NO{ 82 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE. 1'I'HM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED y RETAINAGE TO ( IF VARIABLE STORED AND STORED NO. VALUE APPLICA'r10N THIS PERIOD (NOTIN TO DATE (G + C) FINISH RATE) (D + E) DOR E) (D+E+P) (C - G) 30DOI C0911 52,548.97- 0.00 0.00 0.00 0.00 0.0 52,548.97- 0.00 R �d 1 � , 1305096.03 ,0995907.23 303188. 80 1 0 .00 2130,096.03 100.0 0.00 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 G708re — 1992. Copyright © 1963, 1965, 1966, 1967, 1970, 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 AIAW 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. T 0aw 1A Document G703T" - 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702, Application and Certificate for Payment, is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201 , General Conditions of the Contract for Construction . Use of Current Documents. Prior to using any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions. This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document. nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above. except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA). To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel , copyright@aia.org . COMPLETING THE G703 FORM Heading: This information should be completed in a manner consistent with similar information on AIA Document G702, Application and Certificate for Payment. Columns A, B & C: These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted. The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially, this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D: Enter in this column the amount of completed Work covered by the previous application (columns D & E from the previous application) . Values from column F (Materials Presently Stored) from the previous application should not be entered in this column. Column E: Enter here the value of Wolk completed at the time of this application , including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored (column F). Column F: Enter here the value of Materials Presently Stored for which payment is sought. The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stored materials does not result in a deduction from this column. Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E (Work Completed—This Period ,) Column G: Enter here the total of columns D, E and F. Calculate the percentage completed by dividing column G by column C. Column H: Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date). Column I : This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done. Usually, Change Orders are listed separately, either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form . Construction Change Directives : Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201 . The following is an example of a Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illustrative purposes only, and are not intended to reflect actual construction costs. R C D L F G NpRK ( OMPLETRD MATERIALS TOT AI- a \ITO II'[M SCHPDLLLD INORiHENRI 5 ANC F YRL) REL) AND rTO YD RYIAIAAGL DP_SCRINIIOV OF WORK lIORGLI AND STORED NI , IY FINI LII NO VALLA APPLICATION IHIS PERIOD DNO I I\OREj TO DATE IC +C FINISH RAIL, IDr6 DOR EI ,I)Y+YI I MOBILIZATION 5,000 5000 0 5,000 100 0 2 STOMP REMOVAL 5,000 5,000 0 0 50000 0 3 EARTHWORK 15000 10000 5000 0 15000 co D 4 LOWER RETAINING WALL 14000 0 i 5000 0 5000 - 5,000 5 CURBS & MIK CONC. 5,000 0 0 0 0 0 5000 6 PAVIN6, UPPER DRIVE 20000 0 0 . 0 C 2C 000 7 PAVING, LOWER DRIVE 28000 0 0 0 0 24000 8 PAVERS 20000 0 0 j 1Dow 10,000 50 10000 9 BRICKWORK 5OOD 0 0 0 0 0 5000 10 11 105,000 20000 :0000 10000 40000 6500C AIA Document G703T" — 1992. Copyright C 1963, 1965, 1966, 1967. 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AAA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA$ 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 . AIA Document G703TM - 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702, Application and Certificate for Payment, is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201 , General Conditions of the Contract for Construction . Use of Current Documents. Prior to using any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions. This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document,. nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA) . To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel , copyright@aia.org. COMPLETING THE G703 FORM Heading: This information should be completed in a manner consistent with similar information on AIA Document G702, Application and Certificate for Payment. Columns A, B & C: These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted . The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required . Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially, this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D: Enter in this column the amount of completed Work covered by the previous application (columns D & E from the previous application). Values from column F (Materials Presently Stored) from the previous application should not be entered in this column. Column E: Enter here the value of Work completed at the time of this application , including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored (column F). Column F : Enter here the value of Materials Presently Stored for which payment is sought. The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stared materials does not result in a deduction from this column. Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E (Work Completed—This Period.) Column G Enter here the total of columns D, E and F. Calculate the percentage completed by dividing column G by column C. Column H : Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date). Column I: This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done. Usually, Change Orders are listed separately, either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form. Construction Change Directives: Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201 . The following is an example of Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illustrative purposes only, and are not intended to reflect actual construction costs. A B C D F F G I I I N'ORK CONPIFLED NIATER1A13 TOTAL AI AN('F PRESENTLY COMPLETAND IFIARTABl ITEM SCHEDULED IROMPRLA�OLS TO Nn DFSC31FTI060P WUNK yALLL AYYLIC4T:OY THIS PERIOn 610RE� ANp pTpkED G `C� FIM1ISH `IFV 3RIiRIF 'D + LP .NORIA 10 DATE RATE 1 MOBRIZATION 5000 `000 0 0 5,000 100 0 2 STUMP REMOVAL 50X 5000 0 0 5000 [00 0 3 ENRTFI WORK 15000 10,000 5000 0 15,000 100 0 4 LOWER RETAINING WALL 10000 0 5000 0 5000 50 5000 5 CURBS A MISC. CONC. 5000 0 0 0 0 0 5000 6 PAVING, UPPER DRIVE 20,000 0 0 0 0 0 20,X0 7 PAVING, LOWER DRIVE 20,000 0 0 0 0 0 20,000 e PAVERS 20,X0 0 0 IDOoO 10000 50 1 100X 9 BRICK WORK 5,000 0 0 0 0 0 50X 10 11 1050X 20000 10,000 10000 40000 65000 AIA Document G703TM — 1992. Copyright © 1963, 1965.. 1966, 1967, 1970, 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 AIA® 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 Architectslegal counsel , copyright@)aia.org. 11AIA Document G703TM - 1992 Continuation Sheet AIA Document G702, APPLICA'T'ION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 14 containing Contractor' s signed certification is attached. APPLICATION DATE: Our 02,2007 In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: SEP 30,2007 ARCHITECT'S PROJECT NOt82 A B C D E F G H I WORKCOMPLETED MATERIALS TOTAL BALANCE PRESENTLY COMPLE'T'ED RETAINAGESCHEDULED FROM PREVIOUS % TO (IF VARIABLE ITEM DESCRIPTION OF WORK STORED AND STORED NO VALUE APPLICATION 'PHIS PERIOD (NOT IN TO DA"fE (G - C) PINISH RAIL) (D + E) D OR F7 (D+E+F) (C - G) METALS 74 ALUMINUM RAILINGS 51610.00 51550.00 0.00 0.00 5 ,550.00 98 .9 60.00 0.00 82 MUTTERS/AWNINGS 65307.00 61306.59 0.00 0.00 69306.59 100.0 0.41 0.00 94 FIPE BUMBERS 750.00 605 .49 0.00 0.00 605 .49 80.7 144.51 0.00 CARPENTRY 02 N 1001) & LUMBER 28,550.00 23,045 .43 128.07 0.00 23 , 173.50 81 .2 55376. 50 0.00 12 TRUSSES 23,500.00 23,476.00 0.00 0.00 23,476.00 99.9 24.00 0.00 14 F OUGH CARPENTRY 64,600.00 64, 847. 50 0.00 0.00 64;847. 50 100.4 247.50- 0.00 94 TAINLESS TOPS 6,500.00 6,325 .20 0.00 0.00 61325.20 97 . 3 174. 80 0.00 THERMAL/MOISTURE 02 CAULKING 4,000.00 76.48 0.00 0.00 76.48 1 .9 33923 . 52 0.00 04 I SULATION 51850.00 55824.00 0.00 0.00 51824.00 99.6 26.00 0.00 14 ROOFING S.C . 26,205.00 32,073 .00 0.00 0.00 329073.00 122.4 57868 .00- 0.00 24 UTTERS/D. S. 21819.00 29819.00 0.00 0.00 2,819.00 1 DO.0 0.00 0.00 DORS AND WINDOWS 50 M . DOOR - LABOR 51000.00 4,000.00 0.00 0.00 45000.00 80.0 11000.00 0.00 52 .M./WOOD/HDW PKG 42,500.00 48,766.00 0.00 0.00 489766.00 114.7 61266.00- 0.00 1 62 OVERHEAD DOORS 16,500.00 15,730.40 0.00 0.00 15,730.40 95 .3 769.60 0.00 nnn t J 78 INDOWS,GLASS & GLAZING 11 ,575 .00 119275 .00 0.00 0.00 11 ,275.00 97.4 300.00 0.00 �0 D� INISHES op 04 STUCCO 34, 155 .00 43 ,975 .00 0 .00 0.00 43 ,975.00 18. 8 9,820.00- 0.00 0 06 DRYWALL 615290.00 62,612.00 0.00 0.00 62,612.00 1 )2.2 1 ,322.00- 0.00 f 10TILE/MARBLE 27,935 .00 28,201 .00 0 .00 0.00 28,201 .00 I)1 .0 266.00- 0.00 18 MARBLE SILLS ' 266.00 0 .00 0.00 0.00 0.00 0.0 266.00 0.00 373,912 .00 385 ,508 .09 128 .07 0.00 3851636. 16 11 ,724. 16- 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 G703714 - 1992. Copyright © 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING : This Ale 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. C=AI Document G703TN - 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702, Application and Certificate for Payment, is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201 , General Conditions of the Contract for Construction. Use of Current Documents. Prior to using any AIA Contract Document, users should consult www.ala.org or a local AIA component to verify the most recent edition . Reproductions. This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703 , but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA). To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel , copyright@aia.org. COMPLETING THE G703 FORM Heading: This information should be completed in a manner consistent with similar information on AIA Document G702, Application and Certificate for Payment. Columns A, B & C : These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted. The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required . Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially, this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D: Enter in this column the amount of completed Work covered by the previous application (columns D & E from the previous application). Values from column F (Materials Presently Stored) from the previous application should not be entered in this column. Column E: Enter here the value of Work completed at the time of this application , including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stared (column F). Column F : Enter here the value of Materials Presently Stored for which payment is sought. The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stored materials does not result in a deduction from this column. Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E (Work Completed—This Period.) Column G: Enter here the total of columns D, E and F. Calculate the percentage completed by dividing column G by column C. Column H: Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date). Column I: This column is normally used only for contracts where variable retainage is permitted on aline-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project. this is not normally done. Usually, Change Orders are listed separately, either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form . Construction Change Directives : Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201 . The following is an example of a Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illustrative purposes only, and are not intended to reflect actual construction costs. A tl D L F G H I AWRK COMPLL I LU NIITRIALS TOTAL PRPlRTLY C01PL[IED RLI AINAGC ITEM SCIICDLLED IAOAi PRFVIOCS `+ 10 VO. DISCRIITION OF WORK VALCE AD PI IC STI06 IHIS PLRIOD SIORLU AND STORED 't IG-( ITAISH , 11 YpWApLE iNO IIN TO DATE IUTLI ID- 6 pORG [D+CFI ,GG. 1 MOBILIZATION 500e 5,000 0 0 5000 loo 0 2 STUMP REMOVAL 5000 5,000 0 0 500 100 0 3 EARTH WORK 150o0 10000 5,000 0 '5000 100 0 4 LOWER RETAINING WALL mcw 0 5,000 0 5000 50 5,000 5 CURBS d MISC. cow 5000 0 O 0 0 0 5000 6 PAVING, UPPER DRIVE 20000 0 F 0 0 0 201000 7 PAVING, LOWER DRIVE 20000 0 0 0 0 0 20000 8 . PAVERS 20,000 0 0 10,000 100W 50 10000 9 BRICKWORK 5000 0 0 0 0 0 5,000 10 :1 105,000 20,000 10,000 10,000 40000 65.000 AIA Document G703TA — 1992. Copyright © 1963, 1965, 1966, 1967, 1970, 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 AIA® 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. a T IA Document G703TM - 1992 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 14 containing Contractor's signed certification is attached. APPLICATION DATE: OCT 02,2007 In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: SEP 30,2007 ARCHITECT'S PROJECT NOW A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE SCHEDULEDPRESENTLY COMPLETED (IF ITEM DESCRIPTION OF WORK FROM PREVIOUS STORED AND STORED % TO (IP VARIABLE NO. VALUE APPLICATION THIS PERIOD (NOT IN TO DATE (G = C) FINISH RATE) (D + E) D OR E) (D+E+F) (C - G) 22 A COUSTIC CEILING 9,500.00 93175 .00 0.00 0.00 9, 175 .00 96.6 325 .00 0.00 38 FAINTING 3,5,000.00 349220.00 0.00 0.00 34,220.00 97.8 780.00 0.00 SPECIALTIES 66 1 OILET PARTITIONS 5,585 .00 5 ,585 .00 0.00 0 .00 5,585 .00 100.0 0.00 0.00 71 FIRE EXTINGUISHER/EQUIP 500.00 1 ,003 .45 0.00 0.00 1 ,003 .45 200.7 503 .45- 0.00 73 FLAGPOLE 21000.00 1 ,573 .25 0.00 0.00 15573 .25 78. 7 426.75 0 .00 75 I ENT.DEVICES-MAT. 3,050.00 584 .80 0.00 0.00 584.80 19.2 2,465 .20 0.00 85 METAL SHELVING 19000.00 426 .72 0.00 0.00 426.72 42 .7 573 .28 0.00 86 F ATH ACC:-MAT. 41100.00 39282.75 0.00 0.00 39282 . 75 80. 1 817.25 0.00 88 F ATH ACC.-LAB. 800.00 0.00 0 .00 0.00 0.00 0.0 800.00 0.00 89 ULTURED MARBLE 8,060.00 7,779.34 0.00 0.00 7,779.34 96.5 280.66 0.00 14 F F,SIDENTIAL APPL. 15 ,900.00 15 ,469. 78 377.65 0.00 15,847.43 N.7 52 .57 0.00 23 GEAR HOSE & LOCKER ACCESS 13 ,000.00 9,498 .00 526.64 0.00 10,024.64 77. 1 21,975.36 0.00 42 C ASEWORK 341,264.00 34,264.38 0.00 0.00 349264.38 1 DO.0 0.38- 0.00 MECHANICAL 85 FLUMBING 39,226.00 39,226.00 0.00 0.00 39,226.00 1 )0.0 0.00 0.00 88 SPRINKLER SYSTEM 521,800.00 53,800.00 0.00 0.00 53 ,800.00 1 ) 1 . 9 1 ,000.00- 0. 00 93 I VAC 102,885 .00 1021,885 .00 44 .00 0.00 1021,929.00 1 )0.0 44 .00- 0.00 00 KITCHEN HOOD 12,898.00 13,084 .45 0 .00 0.00 135084.45 1 1 .4 186.45- 0.00 n 03 /P TANK 71055 .00 6,784.27 267.83 0.00 7,052. 10 1 J0.0 2 .90 0.00 ►l LECTRICAL (10� 11 F LECTRICAL S.C. 1571,622.00 155,659.93 80 . 85 0.00 155,740.78 8. 8 1 ,881 .22 0.00 Y � r 27 GENERATORS 381,500.00 38,380.00 0.00 0.00 38,380.00 9.7 120.00 0 . 00 01 ONSTRUCTION FEE 1965563 .00 191 0.00 0.00 196,563 .00 1 )0.0 0 .00 0.00 740,308.00 729,245 . 12 1 ,296 .97 0.00 7301,542 .09 91765 .91 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, a 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING : This Al Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA® 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, a-mail The American Institute of Architects' legal counsel, copyright@aia.org. -AI Document G703TM - 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702. Application and Certificate for Payment., is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201 , General Conditions of the Contract for Construction. Use of Current Documents. Prior to using any AIA Contract Document.. users should consult www.aia .org or a local AIA component to verify the most recent edition . Reproductions. This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA). To report copyright violations of AIA Contract Documents. e-mail The American Institute of Architects' legal counsel , copyright@aia.org. COMPLETING THE G703 FORM Heading: This information should be completed in a manner consistent with similar information on AIA Document G702, Application and Certificate for Payment. Columns A, B & C: These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted . The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially, this total should equal the original Contract Sum . The total of column C may be adjusted by Change Orders during the Project. Column D: Enter in this column the amount of completed Work covered by the previous application (columns D & E from the previous application). Values from column F (Materials Presently Stored) from the previous application should not be entered in this column . Column E: Enter here the value of Work completed at the time of this application, including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored (column F) . Column F: Enter here the value of Materials Presently Stored for which payment is sought. The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stored materials does not result in a deduction from this column . Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E (Work Completed—This Period.) Column G: Enter here the total of columns D, E and F. Calculate the percentage completed by dividing column G by column C. Column H: Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date) . Column I: This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done. Usually, Change Orders are listed separately, either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form. Construction Change Directives: Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201 . The following is an example of a Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illustrative purposes only, and are not intended to reflect actual construction costs. A e C D F I G I I WORK CONPLELF D �4 TERIAIS IOIAL 9 \6f F PRESCNTLY CONPI FILD _ RP 141NAGB ITEM SCHEDRFD FRONPRPAIOV4 DESCRIPTIO,- OF RORK )TORED FVASIORPD (IF , ARIANW TO NO FAEIE ,PPI IF I ON TIESPERIOD F MORIN TODAFY C-C FINISH AN G, RAIEI IDI DORS m«e+e. 1 MOBILIZATION 5,000 5,000 0 0 5000 100 0 2 5I. MP REMOVAL 5,000 50W 0 0 5000 100 0 3 EARTHWORK 20 ,000 IC000 Sam 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5000 0 5000 50 5,000 5 CURBS 6 MISC. CONIC. 5 000 0 0 0 0 0 5,000 6 PAVING, UPPER DRIVE 20000 0 0 0 00 20000 7 PAVING, LOWER DRIVE 20000 c 0 0 0 0 20000 b PAVERS 2000C 0 10000 10000 50 EC00 9 BRICKWORK 5000 0 0 .. 0 5005 0 It tC5000 20000 10000 IC Pro 40,000 65,000 AIA Document G703M - 1992. Copyright © 1963, 1965.. 1966, 1967, 1970, 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 AIAO 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 If 0) copies of this document when completed. To report copyright violations of AIA Contract Documents.. e-mail The American Institute of Architects legal counsel. copyright(jaia.org. Document G703TMVAIA - 1992 Continuation Sheet AIA Document 6702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 14 containing Contractor' s signed certification is attached. APPLICATION DATE: OCT 02,2007 In tabulations below, amounts are stated w the nearest dollar, Use Colman 1 on Contracts where variable retainage for line items may apply. PERIOD TO: SEP 30,2007 ARCHITECT'S PROJECT NO{ 82 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE. 1'I'HM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED y RETAINAGE TO ( IF VARIABLE STORED AND STORED NO. VALUE APPLICA'r10N THIS PERIOD (NOTIN TO DATE (G + C) FINISH RATE) (D + E) DOR E) (D+E+P) (C - G) 30DOI C0911 52,548.97- 0.00 0.00 0.00 0.00 0.0 52,548.97- 0.00 R �d 1 � , 1305096.03 ,0995907.23 303188. 80 1 0 .00 2130,096.03 100.0 0.00 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 G708re — 1992. Copyright © 1963, 1965, 1966, 1967, 1970, 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 AIAW 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. T 0aw 1A Document G703T" - 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702, Application and Certificate for Payment, is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201 , General Conditions of the Contract for Construction . Use of Current Documents. Prior to using any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions. This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document. nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above. except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA). To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel , copyright@aia.org . COMPLETING THE G703 FORM Heading: This information should be completed in a manner consistent with similar information on AIA Document G702, Application and Certificate for Payment. Columns A, B & C: These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted. The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially, this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D: Enter in this column the amount of completed Work covered by the previous application (columns D & E from the previous application) . Values from column F (Materials Presently Stored) from the previous application should not be entered in this column. Column E: Enter here the value of Wolk completed at the time of this application , including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored (column F). Column F: Enter here the value of Materials Presently Stored for which payment is sought. The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stored materials does not result in a deduction from this column. Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E (Work Completed—This Period ,) Column G: Enter here the total of columns D, E and F. Calculate the percentage completed by dividing column G by column C. Column H: Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date). Column I : This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done. Usually, Change Orders are listed separately, either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form . Construction Change Directives : Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201 . The following is an example of a Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illustrative purposes only, and are not intended to reflect actual construction costs. R C D L F G NpRK ( OMPLETRD MATERIALS TOT AI- a \ITO II'[M SCHPDLLLD INORiHENRI 5 ANC F YRL) REL) AND rTO YD RYIAIAAGL DP_SCRINIIOV OF WORK lIORGLI AND STORED NI , IY FINI LII NO VALLA APPLICATION IHIS PERIOD DNO I I\OREj TO DATE IC +C FINISH RAIL, IDr6 DOR EI ,I)Y+YI I MOBILIZATION 5,000 5000 0 5,000 100 0 2 STOMP REMOVAL 5,000 5,000 0 0 50000 0 3 EARTHWORK 15000 10000 5000 0 15000 co D 4 LOWER RETAINING WALL 14000 0 i 5000 0 5000 - 5,000 5 CURBS & MIK CONC. 5,000 0 0 0 0 0 5000 6 PAVIN6, UPPER DRIVE 20000 0 0 . 0 C 2C 000 7 PAVING, LOWER DRIVE 28000 0 0 0 0 24000 8 PAVERS 20000 0 0 j 1Dow 10,000 50 10000 9 BRICKWORK 5OOD 0 0 0 0 0 5000 10 11 105,000 20000 :0000 10000 40000 6500C AIA Document G703T" — 1992. Copyright C 1963, 1965, 1966, 1967. 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AAA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA$ 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 .