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APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 (Instructlons on reverse side) PecE oxE oF P~cEs TO OWNER: Marion Co. & Salem Area Transit Attn: John Whittineton 314U Del Webb Ave NE Salem OR 97303-4165 FROM CONTRACTOR: Pence/Kelly Construction, Inc PO Box 4109 Salem, OR 97302-8109 CONTRACT FOR: PROJECT: Courthouse Sauare Conrt & High Streets Salem, OR 97301 VIA ARCHITECT: Arbuckle Costic Architects 363 State Street Salem, OR 97301-3533 APPLICATION NO.: qqpp600009 Distribution to: PERIOD TO: 10/31/99 ~ OWNER PROJECT NOS.: 99-006 ~ ARCHITECT ~ CONTRACTOR CONTRACT DATE: 2/1~/99 ~ P~ - DH ~L7 P/K - MS CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document G703, is attached. 1. ORIGINAL CONTRACT SUM . . . . . . . . . . . . . . . . . . ~ 18.459,484.00 2 . Net change by Change Orders . . . . . . . . . . . . . . . ~ 8642P6-~4 3 . CONTRACT SUM TO DATE (Line i t 2) • • • • • • • • ~ 19.320,390.00 4 . TOTAL COMPLETED & STORED TO DATE . . . . . . ~ 6.395,245.00 (Column G on G703) • 5. RETAINAGE: a. ~•~ % of Completed Work ~ 0.00 (Columns D + E on G703) b, 0.00 0~0 of Stored Material ~ 0.00 (Column F on G703) Toral Retainage (Line 5a + Sb or TotalinColumnIofG703)•.•••••••••••••••~ 0.00 6 . TOTAL EARNED LESS RETAINAGE . . . . . . . . . . . . ~ 6 395 245_00 (Line 4 less Llne 5 Total) The undersigned Contractor certifies that to the best of the Contractor's knowiedge, infor- mation and belief the Work covered by this Application for Payment has been compleced in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and pay- ments received from the Owner, and that current payment shown herein is now due. ay: Construction, Inc. Stace ofd pregon County~of: ~rion Subscribed and sworn to before me this 26th day Octo Notary Public: / My Commission expires: Ju1y 14, 2001 Date: 10/26/99 OFFICIAL SEAL AAA7'TIiEW L SRl90~'~i NOTARY PUBLIC - OREGON COMMISSION N0. 303013 A4Y COMMISSION EXPIRES JULY 14, 200i ARCHITECT'S CERTIFICATE FOR PAYMENT 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT In accordance with the Contract Documents, based on on-site observations and the data Line 6 froin rior Certificate t 5,191,970.00 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 ................. t 1,203,2'75.00~ quality of the Work is in accordance with the Contract Documents, and the Contractor i entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Llne 6) g 12,925,145.00 AMOUNT CERTIFIED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .E ( .~~. Z7~ (Attach exp[anation if amount certified diJfers from the amount applted jor. Initia[ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Toral changes approved in previous months by Owner 761,924.00 Total approved this Month ~ • ~ ~ • TOTALS ' ' ' ' NET CHANGES by Change Order ~ ' all figures on this Application and on the Continuation Sheet that are changed to conform to the ount c/er~:fied.) ARCH C ~ ~Costic Architects B ; Date: This C i icate is not negotiable. The AMOUNT CERTIFIED is payable o ly to the Con- tractor named herein. Issuance, payment and acceptance of payment are with c prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G~02 • APPLICATION AND CERTIFICATE FOR PAYMENT • 1992 EDITION • AIA~ •~01992 • THE AMERICAN INSTITUTE OF ARCHITEC7'S, 1735 NEW YORK 4 ~~ pvENUE, N.W., WnSHtNGTON, D.C. 20006-5292 • WARNING: Unlicensed photocopying violetes U.S. copyri9ht laws and witt subject the violator to legal prosecution. ~ 2-1992 i~ i O• CAUTION: lbu should use an oHginel AIA document which has thla caution printed in red. An orlginal assures that changes wili not be obscured as may occur when docu ents reproduced.