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APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 (Instructions on reverse side) PnaE oNE oF PAGES
<br />TO OWNER: Marion Co. & Salem Area Transit
<br />Attn: John Whittineton
<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 />PROJECT: Courthouse Sauare
<br />Court & High Streets
<br />Salem, OR 97301
<br />VIA ARCHITECT: Arbuckle Costic Architects
<br />363 State Street
<br />Salem, OR 97301-3533
<br />APPLICATION NO.: 9900600018 Distribution to:
<br />PERIOD TO: 6/30/00 $l OWNER
<br />PROJECT NOS.: 99-006 ~] ARCHITECT
<br /> ~7 CONTRACTOR
<br />CONTRACT DATE: 2/17/99 ~.l P/K - DH
<br /> ~7 P/K - MS
<br />CONTRACT FOR:
<br />CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Concractor certifies that to the best of the Contractor's knowledge, infor-
<br />mation and belief the Work covered by this Application for Payment has been completed
<br />Application is made for payment, as shown below, in connection with the Contract. in accordance with the Contract Documents, that all amounts have been paid by the
<br />Continuation Sheet, AIA Document G703, is attached. Contractor for Work for which previous Certificates for Payment were issued and pay-
<br />ments received from - e Owner, and that current payment shown herein is now due.
<br />1. ORIGINAL CONTRACT SUM . . . . . . . . . . . . . . . . . . ~ 18,459,484.00 ~
<br />C TRAC OR: Penc elly Construction, Inc.
<br />2 . Net change by Change Orders . . . . . . . . . . . . . . . ~ 2,067,180.00
<br />3. CONTRACT SUM TO DATE (Line 1 t 2) ..••.•••~ 20,526,664.00 By: Date: 6/26/00
<br />4 . TOTAL COMPLETED & STORED TO DATE . . . . . . ~ 18,054,861.00
<br />(Column G on G703)
<br />5. RETAINAGE:
<br />a. ~400 of Completed Work ~ 0.00
<br />(Columns D + E on G703)
<br />b. _4.40b of Stored Material $ 0.00
<br />(Column F on G703)
<br />Total Retainage (Line Sa + Sb or
<br />Total in Column I of G703) ~ 0.00
<br />6 . TOTAL EARNED LESS RETAINAGE . . . . . . . . . . . . $ 18,054,861.00
<br />(Line 4 less Line 5 Total)
<br />?. LESS PREVIOUS CERTIFICATES FOR PAYMENT
<br />(Line 6 from prior Certificate) . . . . . . . . . . . . . . . . . ~ 17,019,329.00
<br />8. CURRENT PAYMENT DUE . . . . . . . . . . . . . . . . .I ~ 1,035,532.0
<br />9. BALANCE TO FINISH, INCLUDING RETAINAGE 2~471,803.00
<br />(Line 3 less Line 6) 8
<br />CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS
<br />Total changes approved in
<br />previous months by Owner 1,969,068.0 -14,806.0
<br />Total approved this Month ~ •
<br />TOTALS ~ ° ' ' '
<br />NET CHANGES by Change Order + ~ ~
<br />Scace of: Oregon
<br />Counry of: Marion
<br />Subscribed and sworn to before ~
<br />me this 26~ da of Ju _ OFFICIAL SEAL ~,
<br />,r,.~"°"' `' M9~7TF~~V1i' L SMlTti'
<br />,. ~,_
<br />~;w ~>r hOTARY PU6UC - OREGQN
<br />Notary Pubiic: . CQG":'~ISS!QN N0. 303013
<br />My Commission expires: t., l CO?~ :9l,,SlOP~ [;~PIRES JULY 14, 2001
<br />July 14, 2001
<br />ARCHITECT'S CERTIFICATE FOR PAYMENT ~~
<br />In accordance with the Contract Documents, based on on-site observations and the data
<br />comprising this application, the Architect certifies to the Owner that to the best of the
<br />Architect's knowledge, information and belief the Work has progressed as indicated, the
<br />quality of the Work is in accordance with the Contract Documents, and the Contractor
<br />is entitled to payment of the AMOUNT CERTIFIED. ,
<br />AMOUNT CERTIFIED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 _~ .~~. 53Z, a,,
<br />(Attach explanation iJ amount certified differs from the amount applied for. Initial
<br />all figures on this Application and on the Continuation Sheet that are changed to
<br />conform to the am nt certiji )
<br />ARCH Arb 1 stic Architects
<br />By: Date: ~
<br />This erti icate is not negotiable. The AMOZNT CERTIFIED is paya le on to the Con-
<br />tractor named herein. Issuance, payment and acceptance of payment are withou~
<br />prejudice to any rights of the Owner or Contractor under this Contract~ ~ [l, `
<br />C7
<br />AIA DOCUMENT G702 • APPLICATION AND CERTIFICATE FOR PAYMENT • 1992 EDITION • AIA~ •~01992 • THE AMERICAN INST]TUTE OF ARCHITECTS, 1735 NEW YORK ~/
<br />~~~ AVENUE, N.W., WASHINGTON, D.C. 200oCr5292 • WARNING: Unlicensed photocopying vloletes U.S. copyrlght laws and will subJect the vfolator to legal prosecution. \ Ci ~2-~
<br />:' ~:a
<br />CAUTION: You should use an origfnal AIA document which has this caution printed fn red. An originai assures that changes wlll not be obscured as may occur when documents are reproduced.
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