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APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 (Instructions on reverse side) P~GE orrE oF PAGES TO OWNER: Marion Co. & Salem Area Transit Attn: John Whittineton 3140 Del Webb Ave NE Salem_ OR 97303-4165 FROM CONTRACTOR: PenCe/Kelly ConstillCtion, InC. PO Box 4109 Salem, OR 97302-8109 CONTRACT FOR: PROJECT: Courthouse Sauare Courc & High Streets Salem, OR 9'7301 VIA ARCHITECT: Arbuckle Costic Architects 363 State Stteet Salem, OR 97301-3533 APPLICATION NO.: 9g006ppp13 Distribution to: PERIOD TO: 2/28/pp C}~ OWNER PROJECT NOS.: 99-006 ^ ARCHITECT (~ CONTRACTOR CONTRACT DATE: 2/1'7l99 ~ 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 Sheet, AIA Document G703, is atcached. 1. ORIGINAL CONTRACT SUM . . . . . . . . . . . . . . . . . . ~ 18,459,484.00 2 . Net change by Change Orders . . . . . . . . . . . . . . . ~ 1,726,902.00 3 . CONTRACT SUM TO DATE (Line 1 t 2) • . . . . • . • $ 20,186,386.00 4 . TOTAL COMPLETED & STORED TO DATE . . . . . . ~ 12,307,186.00 (Column G on G703) • RETAINAGE: a. Q•~~o of Completed Work $ 0.00 (Columns D + E on G703) b. ~•~/o of Stored Material 8 ~•~ (Column F on G703) Total Retainage (Line 5a + Sb or TotalinColumnIofG703)•• •••••~••••••••~ 0.00 The undersigned Contractor certifies that to the best of the Contractor's knowledge, infor- mation and belief the Work covered by this Application for Payment has been completed in accordance with the act Documents, that all amounts have been paid by the C ctor for Work r whic previous Certificates for Payment were issued and pay- ments r ived fro the Ow r, and that current payment shown herein is now due. By: Srace of: pregon County of: ~rion Subscribed and sworn to before Construction, Inc. me this 25th da of Feb Notary Public: My Commission expires: July 14, 2001 Date: ~~Smn OFFICIAL SEAL RRAT?liE~ L SARIT'H °~07'ARY PUBLfC - OREGON COA9MISSION N0. 303(113 F.9Y COMMISSION EXPiRES JULY 14, 20Q1 6. TOTAL EARNED LESS RETAINAGE.. .. ...... ..~ 12,307,186.00 ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 less Line 5 Total) %. LESS PREVIOUS CERTIFICATES FOR PAYMENT In accordance with the Contract Documents, based on on-site observations a data Line 6 from r~or Certificate ~ 10,835,084.00 comprising this application, the Architect certifies to the Owner that to the best of the ~ p ~ ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' Architect's knowledge, informatlon and belief the Work has progressed as indicated, the 8. CURRENT PAYMENT DUE ................. S 1,472,102.0 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 RETAINAGE ~ g~9,200.00 MOUNT CERTIFIED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . fT_7Z. ) ~ • ~ (Line 3 less Line 6) ~ (Attach explanation ijamount certijied dijjers,/rom the amount applied for. Initial CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in ~ previous months by Owner 1,651,428.00 -14,806. ~ Total approved this Month ~ - TOTALS ' ' ' ' ~ NET CHANGES by Change Order ~ ~ ' all figures on this pplication and on the Continuation Sheet that are changed to conform to the ount ertified.) ARC Arb kle Costic Architects Date: 3 at is not negotiable. The AMOUNT CERTIFIED is paya le onl to the Con- tractor named herein. Issuance, payment and acceptance of payment are withou~ prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702 • APPLICATION AND CERTIFICATE FOR PAYMENT • 1992 EDITION • AfAm •~0t992 • THE AMERICAN INSTITUTE OF ARCHITECT'S, 1735 NEW YORK ~\~~~ ,~vENUE, N.w., WASHINGTON, D.C. 200(K>5292 • WARNING: Unllcensed photocopying vlolates U.S. copyrlght laws and wiil subJect the vlolator to legal prosecution. ~2-1992 i~py .i._ CAUTION: You should use an original AIA document which has this caution printed In red. An original assures thet changes wtll not be obscured as may occur when documents are re duce