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APPLI~ ~TION AND CERTIFICATE FOR PAYMEI` ' AIA DOCUMENT G702 (Instructions on reverse side) ancE o~. r PAGES TO OWNER: Marion Co. Bt Salem Area Transit Attn: John WhittinQton 3140 Del Webb Ave NE Salem.OR 97303-4165 FROM CONTRACTOR: Pence/Kelly Construction, Inc. PO Box 41(?9 Salem, OR 47302-8109 CONTRACT FOR: PROJECT: Courthouse Sauare Court ~ High Streets Salem, OR 97301 VIA ARCHITECT: Arbuckle Costic Architects 363 State Street Salem, OR 97301-3533 APPLICATION NO.: 9900600007 PERIOD TO: 8/31/99 PROJECT NOS.: 99-006 CONTRACT DATE: 2/]'7/99 Distribution to: ~ OWNER ^ ARCHITECT ~ CONTRACTOR ~ P/K - DH ~ P/K - MS CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. Continuation Shee[, AIA Document G703, is attached. i. ORIGINAL CONTRACT SUM . . . . . . . . . . . . . . . . . . ~ 18,459,484.00 2 . Net change by Change Orders . . . . . . . . . . . . . . . ~ 699,062.00 3. CONTRACT SUM TO DATE (Line 1 t 2) ........ 8 19,158,546.00 4. TOTAL COMPLETED & STORED TO DATE ...... 8 4,486,064.00 (Column G on G703) . 5. RETAINAGE: a. 5•~ % of Completed Work 8 224,306.65 (Columns D + E on G703) b. 0.00 ~~o of Srored Material ~ 4.~ (Column F on G703) Total Retainage (Line Sa + Sb or Total in Column I of G703) . . . . . . . . . . . . . . . . . 8 224,306.65 6 . TOTAL EARNED LESS RETAINAGE . . . . . : . . . . . . ~ 4,261,757.35 (Line 4 less Line 5 Total) The undersigned Contractor certifies chat ro the best of the Contractor's knowledge, infor- mation and belief the Worl; covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by che Contractor for Work for which previous Certificates for Payment were issued and pay- ments received fro~i ihe Ow~ner, and that current payment shown herein is now due. C By: \~ ~" " ~ ~ Scate of: Q~gon County of: M&rion Subscribed and sworn to before me this 27th day f Au -99 Notary Public: . My Commission expires: July 14, 2001 Inc. Date: 8/27/99 ~ p OFFICIAL SEAL P~ia~TTFIE~hf ~. SaROT4i 1h MQTARY PUBLIC - QREGOAI COMMISSIGN P!•9. 3030V3 MY COt~MISSION EXP!RES JUL'~' 14, 2C01 ARCHITECT'S CERTIFICATE FOR PAYMENT 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT In accordance with the Contract Documents, based on on-site observations anc~data Line 6 frorim rior Certificate $ 3 326 85U.00 comprising this application, the Architect certifies to the Owner that to the best of the ~ P ~ ) ................. , , Architect's knowledge, information and belief the Work has progressed as indicated, the 8. CURRENT PAYMENT DUE ................. ~ 934,907.35 quality of the Work is in accordance with the Contract Documents, and the Contractor 's entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH, INCLUDING RETAINAGE14 896 '788.65 (Line 3 less Line 6) ffi ~ ~ AMOUNT CERTIFIED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ ~'~ 'T,~D.~_~ (Attach explanation if amount certified diff'ers from the amount applied for Initia! CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner 473,002.00 Total approved this Month ~ • TOTALS ' ' NET CHANGES by Change Order ' ' all figures on this plication nd on the Continuatipn Sheet that are changed to conform to the ount erti ed.) ' ARC~I Arbu e stic cMtects ~ B : Date: erti icate is not negotiable. The AMOUNT CERTIFIED is payabie o y to the Co - tracror named herein. Issuance, payment and acceptance of payment are wi out prejudice to any rights of the Owner or Contracror under this Cor~~t. = AIA DOCUMENT G702 • APPLICATION AND CER'CIFICATE FOR PAYMENT • 1992 EDITiON • AIA~ •~01992 • THE AMERICAN INS"CITUTE OF ARCHITECTS, 1735 NEW YORK ~/~ ~~'/~ AvENUE, N.W., WpSHING'fON, D:C. 20006-5292 • WARNING: Unilcensed photocopying violates U.S. copyright laws and will subject the vlolator to Iegai prosecutlon. ~\ G702-1992 i:.i:C~ C ION: You shouid use an original AIA document which has thfs caution printed In red. An original assures that changes will not be obscured as may occur whe d ents are reproduced.