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APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 (Instructions on reverse side) PncE oxe oF PAGES
<br />TO OWNER: Marion Co. & Salem Area Transit
<br />Attn: John Whittin2ton
<br />3140 Del Webb Ave NE
<br />Salem.OR 97303-4165
<br />FROM CONTRACTOR: Pence/Kelly Construction, Inc.
<br />PO Box 4109
<br />Salem, OR 97302-8109
<br />CONTRACT FOR:
<br />PROJECT: Courthouse Sauare
<br />Court & High Streets
<br />Salem, OR 97301
<br />VIA ARCHITECT: ~buckle Costic Architects
<br />APPLICATION NO.: 9900600014 Distribution to:
<br />PERIOD TO: 3/31/00 ~ OWNER
<br />PROJECT NOS.: 99-006 ^ ARCHITECT
<br /> Q CONTRACTOR
<br />CONTRACT DATE: 2/17/99 ~7 p/I{ _ DH
<br /> ~ P/K - MS
<br />CONTRACTOR'S APPLICATION FOR PAYMENT
<br />Application is made for payment, as shown below, in connection with the Contract.
<br />Continuation Sheet, AIA Document G703, is attached.
<br />1. ORIGINAL CONTRACT SUM . . . . . . . . . . . . . . . . . . E
<br />2 . Net change by Change Orders . . . . . . . . . . . . . . . ~
<br />3 . CONTRACT SUM TO DATE (Line 1 t 2) . . . . . . . . ~
<br />4 . TOTAL COMPLETED & STORED TO DATE . . . . . . ~
<br />(Column G on G703)
<br />5. RETA~E:
<br />a, % of Completed Work ~
<br />(Columns D + E on G703)
<br />b O.OOo~o of Stored Material t
<br />(Column F on G703)
<br />Total Retainage (Line 5a + Sb or
<br />18,459,484.00
<br />1,763,802.00
<br />20,223,286.00
<br />363 State Street
<br />Salem, OR 97301-3533
<br />The undersigned Contractor certifies that to the best of the Contcactor's knowledge, infor-
<br />mation and belief the Work covered by this Application for Payment has been completed
<br />in accordance with the Contract Documents, that all amounts have been paid by the
<br />Contractor for Work for which previous Certificates for Payment were issued and pay-
<br />m ts received fro e Owner, and that current payment shown herein is now due.
<br />C~NTRA OR: Pe c lly Construction, Inc.
<br />By; v v Date:
<br />14,073,874.00 State of: Oregon
<br />County of: Marion
<br />~' Subscribed and sworn to before
<br />0.00 N 7a ~ me this 4th day of P, •
<br />0.00
<br />Notary Public:
<br />0.00 My Commission expires: July 14 :
<br />,
<br />OFfICiAL SEaI
<br />MATTHEW L SMITH
<br />PiOTARY PUBLIC - OREGON
<br />COMM~SSION N0. 303013
<br />MY COMMISSIOR~ EXPIRES JULY 14, 2001
<br />TotalinColumnIofG703)••••~•~••••••••~•~ -
<br />6. TOTAL EARNED LESS RETAINAGE.. ..........E 14,073,874.00 ARCHITECT'S CERTIFICATE FOR PAYMENT ~~~
<br />(Line 4 less Line 5 Total)
<br />7. LESS PREVIOUS CERTIFICATES FOR PAYMENT In accordance with the Contract Documents, based on on-site observations and the data
<br />Line 6 froin nor Certificate ,~ 12,307,186.00 comprising this application, the Architect certifies to the Owner that to the best of the
<br />~ p ~ ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' Architect's knowledge, information and belief the Work has progressed as indicated, the
<br />8. CURRENT PAYMENT DUE ................ S 1,766,688.00 quality of the Work is in accordance with the Contract Documents, and the Contracto~~~C
<br />\is entitled to payment of the AMOUNT CERTIFIED.
<br />9. BALANCE TO FINISH, INCLUDING RETAINAGE 6,149,412.00 `~
<br />(Line 3 less Line 6) $ AMOUNT CERTIFIED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E ~ _ 7~ ~ _ ~i~
<br />(Attach explanation ij amount certified differs from tbe amount applied jor. Initial
<br />CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS
<br />Total changes approved in
<br />previous months by Owner 1,747,879.00 -14,806.00
<br />Total approved this Month ' '
<br />TOTALS ' ' ~ ~
<br />NET CHANGES by Change Order ' ' ~
<br />all jigures on this A plication and on tbe Continuation Sheet that are changed to
<br />conform to the am unt rtif~d.)
<br />ARCHIT ~b le Costic Architects
<br />gy. Date: ~
<br />This ~s not negotiable. The AMOUNT CERTIFIED is payable only to he Con-
<br />tractor named herein. Issuance, payment and acceptance of payment are wi~hout
<br />prejudice to any rights of the Owner or Contracror under this Contract.
<br />A` LLL AIA DOCUMENT G702 • APPLICATION AND CERTIFICATE FOR PAYMENT • 1992 EDITION • AIA~ •~01992 • THE AMERIGN INSTITUTE OF ARCHITECTS, 1735 NEW YORK
<br />~` ~ AVENUE, N.W., WASHINGTON, D.C. 2000G5292 • WARNING: Unlicensed photocopying violates U.S. copyrlght laws and will aubJect the violator to legal prosecutfon. G702-1992
<br />~,~ ~i
<br />C ION: You shouid use an original AIA document which has this cautfon printed in red. An or(ginal assures that changes wlll not be obscured as may occur when documents are reproduced.
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