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189646 09/14/2010 CITY OF CARMEL, INDIANA VENDOR. 363750 Page 1 of 1 ONE CIVIC SQUARE ERMCO INC CHECK AMOUNT: $137,602.51 t t,. CARMEL, INDIANA 46032 PD Box 1507 INDIANAPOLIS IN 46206 CHECK NUMBER: 189646 CHECK DATE: 911412010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMO D ESCRIPTION 902 4460807 APP 26A 137,602.51 PAC JUNE s, TM Document G702ICMa —1 992 Application and Certificate' °for Payment Construction Manager- Adviser Edition TO OWNER: Carmel Redevelopment CommisRWECT: Parcel 7A, Regional Performing ArtsAPPLICATION NO 26 Distribution to: 1 Civic. Square Center Interior Rough PERIOD TO 6/30/2010 OWNER Carmel, IN 46032 Construction Package P4 CONSTRUCTION MANAGER FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: ARCHITECT ERMCO, INC. PROJECT NOS: 1 CONTRACTOR El P'O. Box 1507 Shiel Sexton 2695 -320 Indianapolis; IN 46206 VIA ARCHITECT: 'FIELD El C CSO Architects CON F o ,triral Inctallatinn Pr niprt It 7F,R1 n1d CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment, as shown below, in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Continuation Sheet, AIA Document G703, is attached. 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 that current 1. ORIGINAL CONTRACT SUM x ,505,000.00 Payment shown herein is now due. 2. Net change by Change Orders (467,808.00) CONTRACW MC 3. CONTRACT SUM TO DATE (Erne 1 2 037 192 00 By: Date: 6111/2010 d. TOTAL COMPLETED STORED TObATE (Column G on G703) 585,898 78 State of: Indiana 5. RETAINAGE County of: Marlon a. of Completed Work Subscribed and sworn to:'before (Column b E on G703) 351, 8 9.60 me this 11th day of 'une, 2010 b. of Stored Material Notary Public' (Column F on G703) My Commission expires: 12/19/2015 Total Retainage (Lines 5a 5b or Total in Column I of G703) 351,859.60 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on -site observations and the data comprising 6. TOTAL EARNED LESS RETAINAGE 6,234,039.1$ this application, the Construction Manager and Architect certify to the Owner that to the best of their (Line 4' Less Line 5 Total) knowledge, information and belief the Work has progressed as indicated, the!quality of the Work is in 7. LESS PREVIOUS CERTIFICATES 6,096;43 FOR PAYMENT 6.67 accordance with the Contract Documents, and the:Contractor is entitled to payment of the AMOUNT CERTIFIED. (Line 6 from prior Certificate) a 5 8. CURRENT PAYMENT DUE Is 137,602.51 AMOUNT CERTIFIED 1 3 7, 'V 2 Appl icatron f and ortt i j' a nt ou nt tinu S! e nrn than ed ynt Initial all figures on this 9. BALANCE TO FINISH, INCLUDING RETAINAGE conform with the t certified.) (Line 3 less Line 6) 803,1 52.82 CONS UCTIO M N By: Date: CHANGE-ORDER SUMMARY ADDITIONS DEDUCTIONS ARC T. Total changes approved in previous months by Owner -k1 499 639,307.00 By: Date: -er Total approved tF is Month This Certi Cate is no egotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS 71,499:00 S 639,307.00) named rein. Issu e, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order (467 ,808.00) the Ow er or C racior 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 G7021CMaTM 1992. Copyright 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 ieproductibn 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 G702/CMa`- 1992 Instructions Application and Certificate for Payment Construction Manager Adviser Edition A. General Information AIA Document G7021CMa, Application and Certificate for Payment, Construction Manager- Adviser Edition, is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner, but not as a constructor, and where multiple Contractors have direct Agreements with the Owner. Procedures for their use are covered in AIA Document A201 1CMa, General Conditions of the Contract for Construction, Construction Manager- Adviser Edition, 1992 Edition. B. 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 /CMa, 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. C. Completing the G7021CMa Form After the Contractor has completed AIA Document G703, Continuation Sheet, summary information should be transferred to AIA Document G702 /CMa, Application and Certificate for Payment, Construction Manager Adviser Edition. The Contractor should sign G7021CMa, have it notarized and submit it, together with G703, to the Construction Manager and Architect. The Construction Manager and Architect should review G702 /CMa and G703 and, if they are acceptable, complete the Certificate for Payment on G702 /CMa. The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A201 1CMa. They should then initial all figures on G7021CMa and G703 that have been changed to conform to the amount certified and attach an explanation. The completed G702 /CMa and G703 should be forwarded to the Owner. D. Completing the G703 Form Heading: This information should be completed to be consistent with similar information on AIA Document G702 1CMa, Application and Certificate for Payment, Construction Manager- Adviser Edition. Columns A, B C: These columns should be completed by identifying the various portions of the Project and their scheduled value 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 into the project which 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 /CMa 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 /CMa. E. Making Payment The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager and Architect on AIA Document G702 /CMa, Application and Certificate for Payment, Construction Manager- Adviser Edition. 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 /CMa. AIA Document G7021CMaTM 1992. Copyright 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 ERMCO Contract 2695 -4320 124070 l —D-ocu went G703 9.92 Continuation Sheet �6 AIA Document G702TM, Application and Certification for Payment APPLICATION''NO` 6/11/2010 containing Contractor's signed certification is attached. APPLICATION DATE: 6130/2010 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: ARCHITECT'S PROJECT NO: A B C D E F G H i WORK COMPLETED TOTAL MATERIALS BALANCE COMPLETED SCHEDULED FROM PREVIOUS PRESENTLY TO RETAINAGE VALUE ITEM DESCRIPTION OF WORK AND STORED NO. APPLICATION THIS PERIOD STORED (G C) FINISH (If variable rate) D E F) (D +E) (Not inDoi- E) (C— G) 00 5 100 00. 02 P.M. 200,000.00 173,570.00 4 177,975.00 89 22,025.00 00003 CAD ENG 80,000.00 80,000.00 80,000.00 100 00.004 TEMP L 75,000.00 71,078.00 2,000.00 73,078.00 97: 1,922.00 00 005 TEMP M 45,000.00 43,125.00 1,000.00 44,125.00 98'. 875.00 00 006 CLEAN UP 15,000.00 11,420.00 500.00 11,920.00 79 3,080.00 00.007 BOND 72,000.00 72,000.00 72,000.00 100 00 008 TESTING 18,000.00 12,000.00 3,000.00 15,000.00 83 3,000.00 00 009 SITE OFFICE 23,000.00 22,400.00 21400.00 97 600.00 00 010 DEMOBILIZATION 5 5,000.00 0001 A LOWANCE 12 550,000.00 433,772.00 30,000.00 463 84 86,228.00 00 012 A LOWNACE 13 350,000.00 270,585.27 4,307.51 274,892.78 79 75,107.22 00 013 ALLOWANCE 14 100,000.00 75 75,000.00 75 25,000.00 00 014 ALLOWANCE 15 5,000.00 5,000.00 5,000.00 100 00 015 ALLOWANCE 16 10,000.00 10,000.00 10,000.00 100 00 016 E0.1 1 00 017 M T 10,000.00 10,000.00 10,000.00 100 00 018 LABOR 6,000.00 6,000.00 6,000.00 100 00 019 EXCAVATION 35,000.00 35,000.00 35,000.00 100 00 020 E0 .12 00 025 BRANCH R M 500.00 500.00 500.00 00 026 BRANCH R L 1,500.00 1,500.00 1,500.00 100 00 027 BRANCH F M 100.00 100.00 GRAND TOTAL CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not be obscur 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 Int9mational 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. 1 1 1 1, Document G703"— 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702rm, 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 A201TM, 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 G703 -1992 Heading. This information should be completed in a manner consistent with similar information on AIA Document G702, Application and Certificate for Payment. Columns A, R 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 E. 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 T. 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 nose that dollar amounts shown below arefor illustrative purposes only, and are not intended to reflect actual construction costs. A 13 c I) F. I; G II I WORK 'OA PLETED 'TOTAL MA 1'F IIALANCIi CONIP7.5TF,D I AL O K RD FROM ICA N I'RkSI?N "TLY NI RET D AIN ITEM SC ESCRU"r [ON OF WORK NO. VALl1L APE'LLCA'I'ION Ti1151'GRIOU STOP GI) TO DATI. /G -CJ F[NISH (IJ'.wriuhte ruse) (U +F) ZInlj,vFj (D +G +FI is C) 1 MOBILIZATION 5,000 5,000 0 0 5.000 100 C 2 STVMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15.000 10,000 5,000 0 15,000 Io0 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS d MISC. CONC. 5,000 0 0 0 0 0 5,000 6 PAVING, UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING, LOWER DRIVE 20,000 0 0 0 0 0 20,000 8 PAVERS 20.000 0 0 10,000 1c,000 50 10,000 I BRICK WORK 5,000 0 0 0 0 0 5.000 10 1 11 GRANDTOTAL ID5.000 20,000 10,000 10000 40,000 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 Ale 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, ERMCO Contract 2695 -4320 124070 TM AIA-m-o-cument G703 1 -992 Continuation Sheet AIA Document G702Tm, Application and Certification for Payment, APPLICATION N0: 6/11/2010 containing Contractor s sil "ned, certification is attached. APPLICATION DATE: 6/30/2010 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: ARCHITECT'S PROJECT NO: A B C D E F G H I WORK COMPLETED, TOTAL MATERIALS` BALANCE COMPLETED ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY TO RETAINAGE NO. TO DATE VALUE APPLICATION THIS PERIOD STORED AND STORED (G C) FINISH (If variable rate) (D E) (Not in D or E) (D E F) (C G) 00. j28 BRAN6H F 00. 29 E .01 00. 30 FEEDER M 975,000.00 975,000.00 975,000.00 106 00.)31 FEEDER L 600,000.00 600,000.00 600,000.00 100 00,)32 E'.02 00. 33 EO M 250,000.00 249000.00 1,000.00 250,000 00 100 00. 34 E L 150,000:00 148,500.00 1,500.00 15Q;000.04 100 00. 35 E1.03 00. 36 E 0 R M 10,000.00 10,000.00 10.000.00 100 00.)37 EO R L 15,000.00 15,000.00 15,000.00 100 00-)38 EO F -M 30,000.00 29,000.00 1,000.00 30,000.00 100 00+)39 E F L 8,000.00 6,500.00 1,500.00 8,000.00 100 00. 40 E1.04 00. 41 E R M 10,000.00 10,000.00 10,000.00 100 00,)42 EO R L 15,000.00 14 750,00 15,000.00 100 00. 43 EO F M 25,000.00 23,000.00 1,000.00 24,000.00 96 1,000.00 00.)44 EO F L 8,000.00 7,000.00 500.00 7,500.00 94 500.00 00.)45 E1.05 00.)46 EO R M 5.000.00 5,000.00 5.000.00 100 00. 47 _EO R L 5.000.00 4,000.00 1.000.00 5.000.00 100 00. 48 E 0 F M 35,000.00 32,500.00 1,500.00 34,000.00 97 1,000.00 00-)49 E 0 F L 8,000.00 7,000.00 500:00 7 00 94 500.00 00. 50 E2.00 A P GRAND TOTAL CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes w 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 Ale 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 AEA Contract Documents, e-mail The American Institute of Architects' legal counsel, copyright @aia.org. Document G703"— 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702TM 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 A20 Fm, 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 ofAIA Contract Documents, e -mail The American Institute of Architects' legal counsel, copyright @aia.org. COMPLETING G703 -1992 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. Thefollowing is an example of a Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illuslrcuive purposes only, and are not intended to reflect actual construction costs. A C D r 1' G 11 I WOKK (m PL.IE_D OF TOTAL MATERIALS LS BALANCE COMI'Lli 1'ED No. ll SCAT)ULPD FROM PREVIOUS PRfSP.NTI,V AND tiT TO RI?7',VNAGG 1:5CK11'l'fON' WORK [,)R [iD No. VALUE APPLICATION THIS PERIOD S'l 1) tG —CJ f —G) i!(�nriaAk rote/ YO r0rrt ��yN L�D.,E) DATC rC —Gl /U +L 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 t00 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 O 4 LOWER RETAINING WALL 10,000 0 5,000 0 5.000 50 5,000 5 CUR 95 6 MISC. CONC, 5,000 D 0 0 4 0 5 000 6 PAVING, UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING, LOWER DRIVE 20,000 0 0 0 0 C 20,000 8 PAVER5 20,000 0 0 10000 10,000 50 10,000 9 BRICKWORK 5,000 0 0 0 0 0 5,000 10 11 GRANDTOTAL 105,000 20000 10,000 10,000 40.000 65,000 AIA Document G703 TM 1992. Copyright 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AlODocument 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. ERMCO Contract 2695 -4320 124070 J; All F rm AIA —D-o-cument G703 1 -992 Continuation Sheet AIA Document G702T"' Application and Certification for Payment, APPLICATION"NO: 6/11/2010 containing Contractor's signed certification is attached. APPLICATION DATE: 6/30/2010 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: ARCHITECT'S PROJECT NO: A B C D E F G H I WORK COMPLETED TOTAL MATERIALS BALANCE ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED TO RETAINAGE NO. VALUE APPLICATION THIS PERIOD STORED AND STORED (G C) FINISH (!f variable rate) (D +E) (Not inDorE) TO DATE (C G) (D +E +F) 0 0(,052 ED R M 30,000.00 30,000.00 30,000.00 100 0 .053 ED R L 20,000.00 19,000.00 1,000.00 20.000.00 100 0(.054 ED F M "575,000.00 572,500.00 1,500.00 574.000.00 100 1,000.00 0(.055 ED F L 30,000.00 26,500.00 1,500.00 28,000.00 93 2,000.00 0( .056 BRANCH R M 17.000.00 17,000.00 17.000.00 100 0(.057 BRANCH R L 13,000.00 12,300.00 500.00 12.800 00 98 200.00 0(.058 BRANCH F M 7,000.00 6,000.00 500.00 6,500.00 93 500.00 0(.059 BRANCH F',:- 1- 5,000.00 3,500.00 500.00 4,000.00 80 1,000.00 0(.060 F EDER. R M 550,000.00 550,000.00 550,000.00 100 0(.061 F EEPER R L 250,000.00 250,000.00 250,000.00 100 0 .062 FE EDER F M 6,000.00 6,000.00 6,000.00 100 01063 F EEDER F L 10,000.00 10,000.00 10.000.00 100 0(.064 E2.01 E2.02 0(.065 RIGGING 10,000.00 10,000.00 10,000.00 100 0(.070 BRANCH R M 15,000.00 15,000.00 15,000.00 100 0(.071 BRANCH R L 8,000.00 7,080.00 500.00 7,580.00 95 420.00 0 .072 BRANCH F M 2,500.00 200.00 500.00 2,500.00 100 0(.073 BRANCH F L 3,500.00 1,500.00 1,000.00 2,500.00 71 1,000.00 0( .074 E2.03 A 0( .075 BRANCH R M 20,000.00 18,900.00 500.00 19,400.00 97 600.00 0(.076 BRANCH R L 16,000.00 14,320.00 1-000.00 15,320.00 -96 680.00 0(.077 BRANCH F M 1,000.00 1,000.00 J 000.00 100 GRAND TOTAL CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will n be o bscured. AIA Document G703 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. Document G703 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702TM, 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 A201TM, 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 G703 -1992 Heading. This information should be completed in a manner consistent with similar information on AIA Document 6702, 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 R, 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 R C I) 1; F G H 1 WORK CC MPLETIM TOFAL MATERIALS RAI.ANCk: 1 No SCHEDULED FROM PREVIOUS PRF,G COMPLETED FhTLY TO RL'l'AINAGF NO DESCRIPTION OF WORK VALllE APPLICATfON THIS PERIOD STORED AN1 DATED /G «0 FINISH (If —whk rmeJ (D F, E I Fl +E) (N,mb,DwE) D (C G) 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5.000 100 0 3 EARTH WORK 15,000 10000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5.000 0 5,000 50 5,000 5 CURBS 6 MISC. CONC., 5,000 0 0 0 0 0 5,000 6 PAVING. UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING, LOWER DRIVE 20,000 0 0 0 0 0 20,000 B PAVERS 20,000 0 0 20,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 GxAIND'COTAI. 105,000 20,000 10,000 10,000 40,000 1 65.000 AIA Document G703 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. ERMCO Contract 2695 4320 TM 124070 w� AI A.. D-ocu rent G703 -1 -992 Continuation Sheet 26 AIA Document G702Tm, Application and Certification for Payment, APPLICATION' NO: 6/11/2010 containing Contractor's .signed certification is attached. In tabulations below, amounts are stated to the nearest dollar. APPLICATION DATE: 6/30/2010 Use Column I on..Contracts where variable retainage for line items may apply. PERIOD TO: ARCHITECT'S PROJECT NO: A B C D E F' G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY TO RETAINAGE NO AND STORED VALUE APPLICATION THIS PERIOD STORED (G C) FINISH (/fvariable rate) (D +E) (Not inDorE) TO DATE (C G) (D +E +F) 0 00.079 FEEDER R M 65,000.00 65,000.00 65,000.00 100 00.080 FEEDER R L 45,000.00 45,000.00 45,000.00 100 0(.081 FEEDER F M 2,500.00 1500.00 1500.00 100. o .082 FEEDER F L 5,000.00 5,000.00 5.000.00 lOq 0(_083 E 2.04 0 .084 ERANCH R M 6,000.00 5,170.00 500.00 _5,670.0 95 330.00 0 .085 ERANCH R L_ 8,000.00 6,860.00 500.00 7,360:00 92 640.00 0 .086 ERANCH. F M 1.000.00 750.00 250.00 1.000.00 100 01.087 RANCH F L 2,500.00 1.200.00 750.00 1 78 550.00 Am E 2.05„ 0 .089 ERANCH R M 15,000.00 14,050.00 950.00 15,000.00 100 0 .090 ERANCH R L t4,000.00 12,780.00 750.00 13,530.00 97 470.00 0 .091 ERANCH F M 800.00 800.00 0).092 ERANCH F L 1.500.00 1.500.00 0).093 E 2.06 0 .094 ERANCH R M 4,000.00 3,030.00 970.00 4,000.00 100 0 095 ERANCH R L 6,000.00 5,200.00 800.00 6,000.00 100 0 096 ERANCH F M 600.00 600.00 0).097 ERANCH F L 1,200.00 1,200.00 0).098 E 2.07 0 o99 ERANCH R M 8,000.00 7,060.00 940M 8,000.00 100 0100 ERANCH R L 10,000.00 9,500.00 500.00 10:000.00 100 GRAND TOTAL 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 Ale 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. iDocument G703" -1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702TM, 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 T M, 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 AlA 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 pennission 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 G703 -1992 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 C. 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 L 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 illustralive purposes only, and are not intended to reflect actual construction costs. A 11 C D F G H I WORK OOP S 1) To,I'AS. MATERIALS RALANL'.1; COMPLEMD I'l Em SC13F.DIlLFD PROM PRF.V IOUti PRESENTLY TO RL'I'AIN'AGf n DESCRIPTION OF WORK VALUE_ \YPLICATIU\ TI {IS PPRIOD STORED AT DATE +CI FINI51[ IlJvnri�hle role/ (D EJ (N'e w b's F) 1 'O 4 (c GJ (D +F.'i FJ 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15.000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS 3 MISC. CONC. 5.000 0 0 0 0 0 5,000 6 PAVING, UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING, LOWER DRIVE 20,000 0 0 0 0 0 20,000 a PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 C 0 0 5,000 10 11 GRAND TOTAL 105,000 20,000 10,000 1 10,000 40,000 65,000 AIA Document G703 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. ERMCQ Contract 2695 -4320 124070 11 -11 AI G703TM _1.992__ Continuation Sheet a� AIA Document G702T Application and Certification for Payment APPLICATION NO. 6/1 1/2010 containing Contractor's. signed certification is attached. APPLICATION DATE: 6/30/2010 In tabulations below, amounts are stated to the nearest dollar. Use Column] on Contracts where variable retainage for line items may apply. PERIOD TO: ARCHITECT'S PROJECT NO: A B C D E E G H WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY TO RETAINAGE NO, VALUE APPLICATION THIS PERIOD STORED AND STORED (G- C) FINISH (If variable rare) (D +E) (Not inDorE) IODATE (C (D +F +F) 0. F o .102 B ANCH F L 2,500.00 2,500.00 0(,103 E 2.07A O .104 B ANCH R M 15,000.00 13,750.00 1,250.00 15,000.00 100 0(.105 BRANCH R L 20,000.00 18,700.00 1,300.00 20,000.00 100 0 .106 BRANCH F M 9,000.00 6,500.00 6,500.00 72 2,500.00 0(.107 BRANCH F L 10,000.00 6,500.00 6;500.00 65 3,500.00 0(.108 E2.08 0 .109 BRANCH.. R`= M 6,000.00 5,420.00 580.00 6,000.00 100 0( .1 10 RANCH R L 8,000.00 7,500.00 500.00 8,000.00 100 0 .I 11 BRANCH F M 2,000.00 1,000.00 1,000.00 50 1,000.00 0(.112 BRANCH F L 3,500.00 1,500.00 1,500.00 43 2,000.00 0(.113 E2.09 0(.114 EQ R M 8.000.00 8,000.00 8,000.00 100 0(.115 EO R L 10,000.00 10,000.00 10,000.00 100 0( .1 16 EQ F M 2,500.00 2,500.00 2,500.00 100 0( .117 E Q F L 1000.00 2,000.00 2,000.00 67 1,000.00 o( I 18 2.10 0(.119 BRANCH R M 1,000.00 1,000.00 1,000.00 100 0( .120 E RANCH R L 2,500.00 2,000.00 2,000.00 8Q 500.00 0(.121 E RANCH F M 100.00 100.00 0(.122 ERANCH F L 500.00 500.00 0(.123 EQ R M' 6,000.00 6,000.00 .6;000.00 100 GRAND TOTAL CAUTION: You should sign a original AIA Contract•Document, on which thi text appea in RED. An original as sures that change will not be obscured. AIA Document G703T" 1992. Copyright (D 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. =1111 Document G703"- 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702T 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 TM, General Conditions of the Contract for Construction. Use of Current Documents. Prior to using any A] A 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 G703 -1992 Heading. This information should be completed in a manner consistent with similar information on AIA Document G702, Application and Certificate for Payment. Columns A, R 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 1. 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 0702 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. Thefollowing 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 B C U In F G 11 I WORK COMPLETED VALUE TOTAL MATE COMPLETED RIALS BALANCE I SC UF:D FROM PREVIOUS E'RESENTLS' RETA[NAOE NO. NO DESCRIPTION OF WORK VALUEI= AIAPPLICATION TnIS I'E RIOU STORED AND STORED /G +C1 I'INI NISII (7jvnriahtc role•) (lJ +EJ (Axa uiDor F,) TO DATE rC —Cj (U' r'� r) 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0. 5,000 100 0 3 EARTH WORK 15,000 10,000 5.000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5.000 50 5,000 5 CURBS A MI5C. CONC. 5,000 0 0 0 0 0 5,000 6 PAVING, UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING. LOWER DRI VE 20,000 0 0 0 0 0 20,000 B PAVERS 20,000 C 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 L tl C3RAND'I'01'n 1. 105,000 20,000 10,000 10,000 40,000 65,000 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 Architects' legal counsel, copyright @aia.org. AIA–Do—cument ERMCO Contract 2695 -4320 124070 'U G703TM -1.992 Cvntinuati ©n Sheet AIA Document G702 "m, Application and Certification for Payment, APPLICATION' NO 6 /11 /2010 containing Contractor's signed certification is attached. APPLICATION DATE: 6/30/2010 In tabulations below, amounts are stated to the nearest dollar. Use Column 1 on Contracts where variable retainage for line items may apply. PERIOD T0. ARCHITECT'S PROJECT NO: A B C D E F G H I WORK COMPLETED TOTAL MATERIALS BALANCE SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED TO RETAINAGE ITEM DESCRIPTION OF WORK VALUE AND STORED NO APPLICATION THIS PERIOD STORED (G =C) FINISH (If variable rate) (D +E +F) (D E) (Aloa in D or E) DATE (C G) 0 0(.125 EQ F M 1,500.00 1,500.00 0(.126 EQ F L 2,000.00 2,000.00 0(.162 E4.00 &A &P 0(.163 SOUND R M 75,000.00 74,250.00 750.00 75,000.00 100 0(,164 SOUND R L 60,000.00 59,00090 500.00 59,500.00 99 500.00 0(.165 E4,01 &A 01166 SOUND R M 40,000.00 38,500.00 1,500.00 40,000.00 100 0(,167 SOUND R „L. 25,000.00 24,500.00 250.00 24,750.00 99 250.00 0(.168 E4.02.& A 0(.169 SOUND R M 40,000.00 37,800.00 2,200.00 40,000.00 100 0(.170 SOUND R L 25,000.00 21,000.00 2,000.00 23,000.00 92 2,000.00 0(.171 E4.03 0(.172 SOUND R M 25,000.00 24,000.00 1,000.00 25,000.00 100 0( .173 OUND R L 18,000.00 15,400.00 1,300.00 16,700.00 93 1,300.00 0(.174 E 4.04 0(.175 SOUND R M 25,000.00 24,250.00 750.00 25,000.00 100 0 .176 SOUND R L 18,000.00 17,500.00 250.00 17 99 250.00 0(-177 E 4.05 .Of .07 .09 0(,178 SOUND R M €50,000.00 77,100.00 2,900.00 80 100 0(.179 SOUND R L 65,000.00 62,000.00 1,500.00 63,500.00 98 1,50090 O .180 E5M P O(.181 F.A, R M 15,000.00 14,250.00 14;250.00 95 750.00 GRAND TOTAL 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. G703 T11 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. r Document G703"- 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702T", 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 A201TM, 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 G703 1992 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 1. 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 6702 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. Thefollowing is an example ofa 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 Il C D WO ti TOTAL MATERIALS BALANCE COMPLETED ITEM SC DULED FROM PREY IOUS PRF,Br;NTI.Y TO KE7A]NAGE NIA ULS['RII'1'ION OF WORK yALUE APPLICATION THIS PERIOD STORED AND STORED (G' CI FINISH (If,n iu8le rnee) (0 +E) ivrq P�x'F.1 TO DATE (C —G) (D +F +F) 1 MOBILIZATION 5,000 5,000 0 0 5000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS d MISC. CONC. 5.000 0 0 0 0 0 5.000 6 PAVING, UPPER DRIVE 20,000 0 0 0 0 D 20,000 7 PAVING, LOWER DRIVE 20,000 0 0 0 0 0 20000 8 PAVERS 20,000 0 0 10.000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 H 1111 11 GRAND TOTAI, 105,000 20,000 10,D00 10,000 40000 65,000 AIA Document G703 TM 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 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. ERMCO Contract 2695 -4320 TM 124070 Document G703-- 1.992_ Continuation Sheet y AIA Document G702TM, Apphcatro.ri °and Certification For Payment, APPLICATIOWNO 6/11/2010 containing Contractor's signed certification is attached. APPLICATION DATE: In tabulations below, amounts are stated to the nearest dollar. 6/30/2010 Use Column I on Contracts where variable retainage for line items may apply. PERIOD T0: ARCHITECT'S PROJECT NO: A B C D E F G H WORK COMPLETED TOTAL MATERIALS BALANCE SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED TO RETAINAGE ITEM DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED (G C) FINISH (/f variable rate) NO. (D +E) (Not inDorE) TO ATE (C -G) 00.182 9,000.00 8,500.00 94 50 00.183 FA. F M 20.000.00 16,500.00 16,500.00 83 3,500.00 00.184 F. k F L 5,000.00 5,000.00 00.185 E5.01 &.02 &.03 00.186 F. 4. R M 17,000.00 15,840.00 15,840.00 93 1,160.00 00.187 F. 4. R L 10,000.00 8,250.00 8,250 00 83 1,750.00 00.188 F. k F M 20.000.00 16,500.00 16,500.00 83 3,500.00 00.189 F. k F L 5 5,000.00 00.190 E .04 .05 .06 00.191 F. A. M 20 18,900.00 18,900.00 95 1,100.00 00.192 F. R L 17,000.00 14,000.00 14,000.00 82 3,000.00 00 193 F. k F M 20,000.00 17,500.00 17,500.00 88 2 00 194 F. 4. F L 5,000.00 5,000.00 00.195 E5.07 &.08 &.09 &.10. 00 196 F. R M 20,000.00 18,400.00 18,400.00 92 1,600.00 00 197 F. A. R L 15,000.00 12,750.00 12,750.00 85 2,250.00 00 198 F. A. F M 16,000.00 13,500.00 13,500.00 84 2,500.00 00 199 F. A. F L 3,000.00 3,000.00 00200 E6.02 00201 EQ M 55,000 .00 52,500.00 2,500.00 55,000.00 100 00202 110 L 20,000.00 12,500.00 12,500.00 63 7,500.00 00203 CABLE M 35,000.00 32,500.00 2,500.00 35.000.0.0; 100 00 204 CABLE L 45,000.00 20,000.00 5,000.00 25,000.00 56 20,000.00 GRAND TOTAL CAUTION: You should sign an o riginal AIA Contract Document, on which this t ext appears in RED. An original assu res that chang will not be obscured. AIA Document G703 1992. Copyright 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIODocument 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 AlA Contract Documents, a -mail The American Institute of Architects" legal counsel, copyright @aia.org. ly AI A Document G703 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702TM, 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 TM, 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 froth 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 often 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 G703 1992 Heading, This information should be completed in a manner consistent with similar information on AIA Document 6702, 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 at? example qfa Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illustrative purposes onl v, and are not intended to reflect actual construction costs. A d C D le F G H I WORK COMPL:TF,U TOTAL MATFRIALS BAL ANCI? COA1PLti1'IiD FEE SCIIAULI:U FROMIHOUS I'RCSLNF CI TO f m N NO DESCRIPTION OF WORK VALVALUE APPLICC APPLICATION 'I'11151'13KIOU $TOKEI, AND STO /C =Cj 1 F] (Ifiarinhl ru�eJ N- F.I pawu�tlnr F) TO EA' (ll +L'iFJ 1 MOBILIZATION 5,000 5,000 0 0 5.000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15.000 100 O 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CUR85 4 M15C, CONC. 5,000 0 0 0 0 0 5,000 6 PAVING, UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING, LOWER DRIVE 20,000 0 0 0 0 0 20,000 8 PAVER5 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5000 0 0 0 C 0 5,000 10 11 6KAN'D TOTAL 105 000 20,000 10 000 10,000 -00,000 65,000 AIA Document G703TM 1992. Copyright OO 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 A1013ocument, 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. ERMCO Contract 2695 -4320 TM 124070 Do cument G703._- 1992 Continuation Sheet AfA Document G702TM, Application and Certification for Payment, APPLICATION'NO: containing Contractor's signed certification is attached. 6/11/2010 APPLICATION DATE: In tabulations below, amounts are stated to the nearest dollar. 6130/2010 Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: ARCHITECT'S PROJECT NO: A B C D E F G H I WORK COMPLETED TOTAL MATERIALS BALANCE SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED TO RETAINAGE ITEM DES OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED (C C) FINISH (Ifvariable pale) (D E) (Nor in D or E) TO DATE (C— Cl) (D +F +F) 00205 G i M 5,000.00 100.00 4,900.00 5 100 00206 G R L 2,000.00 2,000.00 00 207 E6.03 00 208 SECURITY R M 40,000.00 25,800.00 7,500.00 33,300.00 83 6,700.00 00 209 S CURITY R L 20,000.00 11,000.00 1,000.00 12.000.00 60` 8,000.00 00210 S CURITY F M 18,000.00 18,000.00 00211 S CURITY F -:L 6,000.00 6,000.00 00 212 E i.05 00213 D MMING M 60,000.00 57,000.00 3,000.00 60,000.00 100 00 214 D MMING L 45,000.00 35,350.00 35,350.00 79 9,650.00 00 215 E6:06 00 216 O DTIC SENSOR M 8,000.00 8,000.00 8,000.00 1.00 00217 OPTIC SENSOR L 4,000.00 1,000.00 1,500.00 2,500.00 63 1,500.00 00 218 E 7.09 00 219 S C M 100,000.00 96,000.00 2,000.00 98,000.00 98 2,000.00 00 220 S C L 80,000.00 70,500.00 4 75,000.00 94 5,000 00 221 E8.00 00 222 LIGHTNING PRO M 42 42,000.00 42,000.00 100 00 223 LIGHTNING PRO L 18,000.00 18,000.00 18 100 00224 ALLOWANCE 17 40,000.00 1.0,765.00 10 27 29,235.00 00 225 CHANGE ORDER #1 00226 O ULUS ALTERNATE 1,000.00 1,000.00 1,000.60::;., 100 OC.227 CHANGE ORDER #2 GRAND TOTAL 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 G703 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 AA Contract Documents, e-mail The American Institute of Architects' legal counsel, copyright @aia.org. AI A Document G703 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702TM, 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 A201TN 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 a aia.org. COMPLETING G703 1992 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 C. 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. Thefullorrdng is an example ofa Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illustrative purposes only, and are not intended to reflect actrai construction costs. A 0 C 1) P. P G. 0 f WORK (OMPLFTEII TOTAL t`4A'fk: RIALS iSALANCIi ITEM SCHEDULED FROM I'RI VIOUC I'RI:SlNI'L7' TO RETAININE U F.tiCR IPTION Ol' WORK AN sTOR ED NO. VALUE AI'E'LICATICIN 'fills l'I;RIC,In STORED (G =C) FINISH !lf�nriuFl�; rn�) (1) F,) (N.,u 0-F,/ T()U, \T F; fc G 1 MOBILIZATION 5,000 5,000 0 0 5,000 10c 0 2 5TUMP REMOVAL 5,000 5,000 0 0 5.000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10.000 0 5,000 0 5,000 50 5,000 5 CURBS d MISC. CONC. 5,000 0 0 0 0 0 5,000 6 PAVING, UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING, LOWER DRIVE 20,c0c C 0 0 0 0 20,000 B PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 17 GRAND TOTAL 105,000 20,000 10,000 10,000 40,000 65, 00 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 AIO 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.1 ERMCO Contract ;'f 2695 -4320 1� TM 124070 Do- cu meet G703_ 1- 992 Continuation Sheet AIA Document G702TM, Application and Certification for Payment, APPLICATION NO: 6/11/2010 containing Contractor's- signed certification is attached. APPLICATION DATE: 6/30/2010 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: ARCHITECT'S PROJECT NO: A B C D E f G H 1 WORK COM PLETED TOTAL MATERIALS BALANCE SCHEDULED FROM PREVIOUS PRE5ENTLY COMPLETED TO RETAINAGE ITEM DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED (G +C) FINISH (If variable rate) NO. TO DATE (D +E) (Not i,aDorE) (D +E� +F) (c G) 0(.22 1,5 0(.229 CHANGE ORDER #3 0(.230 RCP 4 (58,852.00) (58,852.00) (58,852.00) 100 0(,231 CHANGE ORDER #004 NO COAT: 0 232 CHANGE ORDER 005 0 .233 ASI-037, RCP -006 23,177.00 19,500.00 19,500.00 84 3,677.00 01 234 C HANGE ORDER 0(_235 RCP- 1 (7,554.00) (7,554.00) (7,554.00) 100 0(-236 HANGE ORDER #007 0(.237 AS17038 18,732.00 16,500.00 16,500.00 88 2,232.00 0( .238 C HANGE ORDER 008 0(.239 ALLOWANCE 4320A ELEC GENEF (350,000.00) (350,000.00) (350,000.00) 100 0( .240 A LLOWANCE 4330A FIRE ALARM (75,000.00) (75,000.00) (75,000.00) 100 0(,241 ALLOWANCE 4330B FIRE /SECUR (5,000.00) (5,000.00) (5,000.00) 100 0(.242 ALLOWANCE 4320D ELECTRICAL (10,000.00) (10,000.00) (10 100 0(.243 E OND REDUCTION FOR ALLOW 1 (2,715.00) (2,715.00) (2,715.00) 100 0(.244 C HANGE ORDER 009 01245 WORK DIRECTIVE 4320 -001 NEW 0(.246 C HANGE ORDER 010 0 .247 SI -PAC-104 WATER HEATER AD 17,090.00 12,000.00 12,000.00 70 5,090.00 0(.248 E 3.03 0(.249 LIGHTING R -M 30,000.00 29,200.00 800.00 30,000 00 100 00.25o LIGHTING R L 35,000.00 31,000.00 4,000.00 315,000.00 100 GRAND TOTAL 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, 1987, 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 G703"— 1992 Instructions �i Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AfA Document G702TM, Application and Certificate for Payment, is to be used in conjunction with A[A 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 TM 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 A IA 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 ct aia.org. COMPLETING G703 -1992 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 ofcolumns 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 1. 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 6703 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 he 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 helow are for illustrative put poses oni�v, and are not intended to reflect actual construction costs. A U C U E E' C II I N' TIPLETED AL '10'I'AL LI MA'I'f;Rl. \I.S BALANCE I No. SC FROM 1' A11014 YHESFR.L1' C'OMPLHTEll NI Kh;TAINAG I: R'O DESCRIPTION OF WORK VALUE APPCATION THIS PERIOD STOKEIi I? AND STORED +C) FINISH (lJ.'u.'in r.i0 hle (1) E) (V II in OeuP7 TO DATE (1) E F) 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5000 5 CURBS d MISC. CONC. 5,000 0 0 0 0 0 5,000 5 PAVING, UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING, LOWER DRIVE 20,000 0 0 0 0 0 20,000 S PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 ;RAND TOTAL 105,000 20000 10,000 10000 40,000 65,000 AIA Document G703TI 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 AM" 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. ERMCO Contract 2695 4320 TM 124070 vl vv. AIA. _Document G703 1.99.2 Continuation Sheet AIA Document G702 TM, Application and Certification for Payment, APPLICATION'NO`. 6/i 1 /2010 containing Contractor s signed,certification is attached. APPLICATION DATE: In tabulations below amounts are stated to the nearest dollar. 6/30/2010 Use Column I on Contracts where variable retainage for line items may apply. P.:ERIOD TO: ARCHITECT'S PROJECT NO: A B C D E F' G Il WORK COMPLETED TOTAL MATERIALS BALANCE SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED TO RETAINAGE ITEM DESCRIPTION OF WORK AND STORED NO. VALUE APPLICATION THIS PERIOD STORED (G C) FINISH (Ifvariable rate) (D +E) (Not inDorE) TO DATE (C —G) (D +E +F) 00251 LIGHTING F -M 350,000.00 340 340,678.00 97 9,3227 00 252 LIGHTING F L 22,000.00 8,500.00 4,500.00 13,000.00 59 9,000.00 00 253 C IANGE ORDER 11 00 254 A LOWANCE FROM 43208 ALLOT {100,000.00) (100,000.00) (100,000.00) 140 00 255 ALLOWANCE TO 4320A ALLOW 1 100,000.00 100,000.00 100,000 00 100 00 256 A LOW REDUCTION 43208 ALLO (30,000.00) (30,000.00) (30,000.00) 100 00 257 B ND REDUCTION (186.40) (186.00) (1.86 00) 100 7,037,1.92.00 6 137,602.51 6,585,898.78 94 451,293.22 GRAND TOTAL CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not be ob AIA Document G703TI 1992. Copyright 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA 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. =Document G703"- 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702TM, 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 A20ITM, 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 chi aia.org. COMPLETING G703 -1992 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 he 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 L 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 foliowing is an example ofa Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illustrative purposes wily, and are not intended to reflect actual construction costs. A B C D E C, H WORK COMPLETED TOTAL \I� \Tr:RIA I.ti IIA LANCE: l'4*1`1 ?TF.I) ITF.AA SCHEDULED FROM PREVIOUS I'R1:5 F.NTL1' °!o TO RC'rAINA(ii: NO- nBSCRIPTION OF WORK VALUE API'LICATION THIS PERIOD S'I'Uk 1; 1) AND STORM] (C C) FINISH (If vurlabfe m"I (1) (X mD_E) C T() DATE (c- G) 01 E +F) 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 C 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 C 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 D 5,000 50 5,000 5 CURBS d MISC. CONC. 5,000 0 0 0 0 0 5,000 6 PAVING, UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING, LOWER DRIVE 20,000 0 0 0 0 0 20,000 8 PAVERS 20,00c 0 0 10,000 10,000 50 10,000 9 BRICKWORK 5,000 0 0 0 0 0 5,000 i i l0 11 G1lAN U'r07 AI. 105 000 20,000 10,000 10,000 40,000 65,000 AIA Document G703- 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. AFFIDAVIT AND WAIVER OF LIEN STATE OF INDIANA Final Partial X )SS: COUNTY OF MARION Rod Burton being duly sworn states that he is the Controller of ERMCO, INC. having contracted with City of Carmel (124070.026) to furnish certain materials and /or labor as follows: Electrical Installation for a project known as Parcel 7A Regional Performing Arts Center Interior Rough Construction Package P4 located in Carmel, IN and does further state: PARTIAL WAIVER: That the balance due from the owner is the sum of ONE HUNDRED THIRTY SEVEN THOUSAND SIX HUNDRED TWO DOLLARS AND 51/100($137,602.51) the receipt of which is hereby acknowledged: or X the payment of which has been promised as the sole consideration for this Affidavit and Partial Waiver of Lien which is given to and for said amount, effective upon receipt of such payment: FINAL WAIVER: That the final balance due from the owner is the sum of receipt of which is hereby acknowledged: or the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which is given to and for said amount, effective upon receipt of such payment: THEREFORE, the undersigned waives and releases unto Owner of said premises any and all lien and claim whatsoever on the above described property and improvements thereon on account of labor or material or both, furnished by the undersigned thereto, and further certifies that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. ERMCO, IN by Rod Burton Controller Witness my hand and notarial seal, this 1 I day of June 2010 Q� Notary Public My Commission Expires 12/19//2015 Lou Anne Puckett Notary Public- Printed Signature County of Residence: Marion AFFIDAVIT AND WAIVER OF LIEN STATE OF INDIANA Final Partial X )SS: COUNTY OF MARION Rod Burton being duly sworn states that he is the Controller of ERMCO, INC. having contracted with City of Carmel (124070.023) to furnish certain materials and /or labor as follows: Electrical. Installation for a project known as Parcel 7A Regional Performing Arts Center Interior Rough Construction Package P4 located in Carmel, IN and does further state: PARTIAL WAIVER: That the balance due from the owner is the sum of THREE HUNDRED NINE THOUSAND THIRTY SIX DOLLARS AND 40/100($309,036.40) X the receipt of which is hereby acknowledged: or the payment of which has been promised as the sole consideration for this Affidavit and Partial Waiver of Lien which is given to and for said amount, effective upon receipt of such payment: FINAL WAIVER: That the final balance due from the owner is the sum of receipt of which is hereby acknowledged: or the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which is given to and for said amount, effective upon receipt of such payment: THEREFORE, the undersigned waives and releases unto Owner of said premises any and all lien and claim whatsoever on the above described property and improvements thereon on account of labor or material or both, furnished by the undersigned thereto, and further certifies that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. ERMCO, IN by J Rod Burton Controller Witness my hand and notarial seal, this l I day of June 201-0 Notary Public My Commission Expires 12/19/2015 Lou Anne Puckett Notary Public- Printed Signature County of Residence: Marion Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. 1 13dX <5T7 Terms L &IIo'e"oa h, "'V Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Total /3702.5/ I hereby certify that the attached invoice(s), or bili(s), is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF ✓�O Gx /,SG l:3 6 02 S/ ON ACCOUNT OF APPROPRIATION FOR Board Members Po# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 90 2. 26 I Y' 137602 bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 20 io ignature D(rectar of Redevelopment Title Cost distribution ledger classification if claim paid motor vehicle highway fund