EFTA00610437.pdf

APPLICATION AND CERTIFICATE FOR PAY MENT AIA DOCUMENT G702 TO CONTRACTOR: Lafayette Contractor% LLC PATO I OF 2 FACES PROJECT: LSI Mechem:al LltelIsaa APPLICATION NO.: 5 6100 Red Hook Quarto Sure A2.7 OMEN/too To: S? Thomas. USVI 00102 PERIOD TO: 2LFeb-09 OWNER PROJECT NO.: ARCH/IF-CT FROM: Newnan d Moll Concerto Contractors, Inc. X CONTRACTOR 723 NOM St, Stile I VIA CM: CONTRACT DATE Richmond. Maine 01357 SUBCONTRACT NO.: COLD RAC.T 10R: Cast in plea coca= CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in The und.csigned Contractor certifies tbst to the best of the Connuctor's laouied connection with the Contract ge, info- Continuation Shed. AM Document G703 is ittaChe forma ion and belief the Work anted by this Applica n far Payment has bete d. conapieted in accordance with the Cottram Dom:meets , that all anautits hare been paid by the I. 0 RIGLNAL CONTRACT SUNI... . Contra& for Work for v.-kith previous Certificates for Paymen 689,00000 ments received Dorn &Owner, and that the current payment shown t were Oared sod pay- 2. Net Change by Change Order.. bean is now that CON CTOR: 3. CONTRACT SUM TO DATE ( Line I - Line 2 ) 4. TOTAL COMPLETED & STORED TO DATE.......... (Cob= G on G703) .. S 689.000.00 548,592.40 B of fi Da:a _Way County of: s. RETAENAGE: Subscribed and swam to before a. jid% of Completed Work V il*-4-4 ne this day of ( Column D E on G703) b. 10% of Stored Material ( Column Pon 0703 ) Notary Public: Total Retainage ( Line 5a + 51, or 90 `eit 34 f5&O0 My Commission Expires: 6. TOTAL EARNED LESS RETALNAGE ......... ( Line 4 less Line 5 Total ) ................ S —striar4r CONSTRUCTION MANAGERS CERTIFICATE FOR PAYM ENT 7. LESS PREVIOUS CERTIFICATES FOR 49 3;7 ;3. 14i In accordance with the Contest Docnnxids, bona on on-site carnations and the data PAYMENT core-Qrising thO application, & Architect cedilla to the Comm (Line 6 From prior Certificate). that to the best of the 379,699.60 Are.iteefs keosiedge, information and belief the Work has propessed ss indicated, the 8. CURRENT PAYMENT DUE . . . . . . s 1‘4, r quality of the Work is in accordance with the Conine% is entitled to meant of the &NOUN:ICERTIFIED. Documents, and the Ccetraetor 9. BALANCE TO FINISH, INCLUDING RETALNAGE (Line 3 Less Line 6 ) esti kg 5;11A•673 e,3.5 areetto,t, AMOUNT CERTIFIED ( Attach omit:oration if amow,t aotilled differs from S #42.8) amount applied for. Initial CHANGE ORDER SUMMARY all figura on this application and me the Confirmation Skeet ADDITIONS DEDUCTIONS that are changed to Total changes a conform to the montt cartrfi td in previous months myna S - CONSTR S - By. Total approved this S Dale: - S - This C TO rms s is not cegonablc. The A, ousrr CIMTFIED: payable - S - Contractor nerrad bends Issuance. Parma only to the NET CHANGES by clans order S : and accePtance aPartzni am withc91 - mejolic' to any rights of the Oster ar Coen-x:0r iScr this Cout--a t. AlA Document C 702 G7U2.1992 EFTA00610437  Continuation Sheet AlA DOCUMENT G703 PAGE 2 OF 2 PAGES AlA Document G702, APPLICATION AND GERI LPICATE FOR PAYMaNIT. APPLICATION NO.: 5 containing Conn-actor's signed Certification is attached. In tabulations APPLICATION DATE 25-Feb-09 below, =mats are stated to the nearer dollar. Use Color:all on PERIODTO 28-Feb-09 Contracts where variable multiage for line item may apply. PROJECT NO.: A a C D e F 0 II I WORK COMT.STED MATERIALS TOTAL REM ECSCRIPTION OF w0ItE SCILEDULED IRON ntnvv;)us 2103 MUDD PRUENTLY CMIPLETED % DALAXLT ARTADIADE W. VALUE AP11.1CATKR: STORED ANT) STORED (0! E.) To fir VARIABLE ( D • II ) (NOTES' TO DAM FLNISII RATE) DorE) (D•E•F) ( C - 03 1 Mobilintion $ 20,000 S 20,000.00 S :topoomo 100% - S • $ S - 2 Reinforcing Steel S 125,000 S 106,250.00 S ' I8,750.00 S • 5 125,000.00 100% S - 3 Base slab - Labor S 40,000 S 40,000.00 S - S - 5 40,000.00 100% S - 4 Base slab - Matrrial S 3,000 $ 3,00900 $ - S - $ 3,000.00 100% S - 5 Walls C3' - Labor S 17,000 $ - S - S - S - 0% 5 17,000 6 Walls<8. - Mataiil S 2.000 $ - S - S S 0% - S 2,000 7 Walls>81- Labor $ 140.000 S 84,000.00 5 `35,000.00 $ - S 119,000.00 85% S 21,000 8 Walls>8' - Material S 14,000 S 8,400.00 S . 3,500.00 S S 11,900.00 85% S 2.100 9 Suspended Slab - Labor S 120,000 $ 24,000.00 $ 36,000.00 $ • 60,000.00 S SVY. S 60,000 11 Suspended Slab -Material S 19,440 S 3,888.00 S 5,832.00 S - S 9,720.00 50% S 9,720 12 Misc. Pads - Labor $ 8.000 S 8,000.00 S - S - S 8,000.00 100% S - 13 Misc. Pails • Materials S 1,000 S 1,000.00 $ $ - • $ 1,000.00 100% $ - 14 Equipment S 152,000 S 98,800.00 S 30,400.00 S - S 129,200.00 85% S 22,800 15 Gross Receipts S 27,560 S 16,811.60 S . 4,960.80 S 21,772.40 • S 79% S 5,788 16 S - S - S • S S - 0% S - 17 S - S - S - S - S - 0% $ - 18 $ - S S - S - S - 0% $ - 19 5 - $ - $ - 5 - 5 - 0% S - 20 S S - S - $ - $ - 0% S - S 689,000.00 S 414,149.60 S 134,44220 $ S 548,592.40 S 140,408 $ . A1A DOCE'3117NTDiv G703-1992 EFTA00610438