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APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 (Instructions on reverse side) pA~F o~~ ~>F ~~A~t:, '1'o O~ti'NEK: Marion Co. & Salem Area Transit Attn: John Whittineton 3140 Del Webb Ave NE Salem_ OR 97303-4165 FROD9 CONTRAC7'OR Pence/Kelly Construction, Inc. PO Box 4109 CONTRACT FOR: Salem, OR 97302-8109 363 State Stteet Salem, OR 97301-3533 APPLICATION NO.: 9900600004 Distribution to: PERIOD TO: 6/30/99 ~ OWNER PROJECT NOS.: 99-006 ^ ARCHITECT ~ CONTRACTOR CONTRACT DATE: 2/17/99 ~ P/I{ - DH 6~ P/K - MS CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor:s knowledge, infor- macion and belief the Work covered by this Application for Payment has been completed Application is made for payment, as shown below, in connection wi~h the Contract. in accordance with the Contract Documents, chat a]l amounts have been paid by the Cc~ntinuation Sheet. ,41A Document G703, is attached. Co ror for Wo fo which previous Certificaces for Paymenc were issued and pay- m ts re ~ved fr m th Owner, and that current payment shown herein is now due. 1. ORIGINAL CONTRACT SUM . . . . . . . . . . . . . . . . . . ~ 18,459,484.00 , _ . Net change by Change Orders . . . . . . . . . . . . . . . .~ 325,899.00 CO TR TO : ~. CONTRACT SUM TO DATE (Line 1 f 2) ........~ 18,785.383.00 By: Date: 6/28/99 -+ . TOTAL COMPLETED & STORED TO DATE . . . . . . ~ 1,820,314.00 (C~~lumn G on G'0?~) ~ RETAINAGE: ;i. 5.00~~, ~>f Completed Work ~ 91,019.00 (Columns D + E on G?03) b. ~•~'/,~ of titorcd Material ~ 0.00 (Column F bn G703) ~ Total Rctainage (Line ~a + Sb or Tc~ta] in Cc~lumn 1 of G703) . . . . . . . . . . . . . . . . . 8 91,019.00 State of: Qregon County of: Mazjon Subscribed and s~vorn ro before me this 28th day f Jun Notary Public: ~ My Commission expires: July 14, 2001 OFFIClAL SEA!_ ~~~~ kiAFTHE~IF ~ 5~i974i IdOTARY PUBLIC -• 0l~EG~P~ CtJMMISSIQP•J PlC. 303C13 MY COA4MISSI4h+ FKpIRES JULY 14, FOZt ; b. TOTAL EARNED LESS RETAINAGE. ...........~ 1.729,295.00 ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 less Line 5 Total) ~. LESS PREVIOUS CERTIFICATES FOR PAYMENT (Linr 6 from prior Certificare) . . . . . . . . . . . . . . . . . S 1,034,839.00 ~ . CURRENT PAYMENT DUE . . . . . . . . . . . . . . . . . ~ 694,456.00 9. BALANCE TO FINISH, INCLUDING RETAINAGF~~ 056,088.4Q \ (Line ~ less Line 6) ~ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Tot.if rhanges approved in ~ E~re~°ious months bv Ow•ner ~ T<~tal approved this Month TOTALS ;~ET CHANGES b~~ Change Order • In accordance wi~h the Contract Documents, based on on-site observations and [he data comprising this application, the Architect cer[ifies to the Owner that to the best of the Archicect's knowledge, information and belief the Wor a p o ressed as indicated, the quality of the Work is in accordance with the C n r ts, and the Contractor is entitled ro payment of the AMOUNT CE AMOUNT CERTIFIED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S~, .~o. ae~ (Attach e.xplanation if a»zount certified differs from the amount applied for. /nitia/ all figures on tbis pplication and on t/~e Continuation Sheet that are changed to con~orm to the a~ u cerfified.) ARCHIT T: By: Date: This e' ~s not negociable. The AMOliNT CERTIFIED is payabl only r~he Con- tractor named herein. Issuance, payment and acceptance of pacment ~ rc~ ~v°ithou~~ prejudice to any rights of ~he On~ner or Con~rac~or under this Con~ract. ~ ~ AIA DOCUMENT G702 • APPLICATION AND CERTIFIG~TE FOR PAY'M6NT • 1992 EDITION • AIA~ •~01992 • THE AMERIC,4N INtiT]TUTE OF AKCHITF.CTti, I'35 tiE\Y' pORK ~~~'j1'~~j .~~'t!~['E, v,~~~. ~r:~St~l1~GTON, DC 'ootib-5?9? • WARNING: Unlicensed photocopying vfolates U.S. copyright laws and wil~ subject the violator to legal prosecution. ~ 2 .°'/. t;~%~ V CA ION: You shouid use an original AIA document which has this caution printed in red. An original assures that changes will not be obscured as may occur when documents are reproduced. PROJECT: Courthouse SQUare V 1 A A RC H I T E CT: ~lrbuckle Costic Architects