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APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 (Instructions on reverse side) PnGE orre oF PAGES TO OWNER: Marion Co. & Salem Area Transit Attn: John Whittineton 3140 Del Webb Ave NE Salem.OR 97303-4165 FxOM CONTRACTOR: Pence/Kelly Construction, Inc PO Box 4109 Salem, OR 97302-8109 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.: 9900600019 Distribution to: PERIOD TO: 7/31/00 ~~WNER PROJECT NOS.: 99-006 G~ ARCHITECT C~CONTRACTOR CONTRACT DATE: 2/17/99 ~ P/K - DH ~ P/K - MS The undersigned Contractor certifies that to the best of the Contractor's knowledge, infor- CONTRACTOR'S APPLICATION FOR PAYMENT mation and belief the Work covered by this Application for Payment has been completed 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 che Continuation Sheet, AIA Document G703, is attached. Cont tor for Wor hich previous Certificates for Payment were issued and pay- nts rec d fro the wner, and that current payment shown herein is now due. 1. ORIGINAL CONTRACT SUM . . . . . . . . . . . . . . . . . . ~ 18,459,484.00 C NTRA TOR: Penc elly Co truction, Inc. 2 . Net change by Change Orclers . . . . . . . . . . . . . . . S 2,?00,266.00 3. CONTRACT SUM TO DATE (Line 1 t 2) ..•••.•. 8 20,659 750.00 BY~ Date: ?!28/~10 ~ 4. TOTAL COMPLETED & STORED TO DATE .,.... f 1$,~,227.00 (Column G on G703) • 5. RETAINAGE: a. 0.00% of Completed Work ~ 0.00 (Columns D + E on G703) b. 0.00% of Stored Material t 0.00 (Column F on G703) Total Retainage (Line Sa + Sb or . TotalinColumnIofG703)..••••••'••••••••~~ 0.00 6 . TOTAL EARNED LESS RETAINAGE . . . . . . . . . . . . ~ 18 973 227.00 (Line 4 less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 froin prior Certificate) . . . . . . . . . . . • • • • . • E 18,054,861.00 8. CURRENT PAYMENT DUE . . . . . . . . . . . . . . . . . ~ 918,366.00 9. BALANCE TO FINISH, INCLUDING RETAINAGE 1,686,523.00 , (Line 3 less Line 6) t t~ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner 2,081,986.00 -14,806. Total approved this Month ~ • TOTALS ' ' ' ' ' NET CHANGES by Change Order ~ ~ ' State of: Oregon County of: Marion Subscribed and sworn to before OFFICIAL SEAL me this 2$th da o J y- ilAATTttEi-iY L SMITH 1~07ANY PUBLIC - OREGON COMMiSSI~ia PlO. 303013 ~RY C054"."lSSION EriPiRES JULY 14, 2001 Notary Public: ~ ~ My Commission expires: July 14, 2001 ARCHITECT'S CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on-site observations and the data comprising this application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 °~I b. 3 6~ , oe (Attach explanation i amount certified differs Jrom the amount applied for. Initial all figures on this pplication and on the Continuation Sheet that are changed to confor o e o t certified.) ARCHITEC ~buckle Costic Architects gy; Date: erti icate is not negotiable. The AMOUNT CERTIFIED is paya le onl to the Con- ractor n med herein. Issuance, payment and acceptance of payment ar~t~t prejudice to any rights of the Owner or Contractor under this Contract. ~~ AIA DOCUMENT G702 • APPLICATION AND CERTIFICATE FOR PAYMENT • 1992 EDITION • A[A~ • OO 1992 • THE AMERIGN INSTITUTE OF ARCHITEG75, 1735 NEW YORK Gi7~IL°79JL ~~ AvENUE, N W., WASHtNGTON, D.C. 2000Cr5292 • WARNING: Uniicen~ed photocopying violetea U.S. copyrlght lews and wlll subJect the vlolator to legal prosecutlon. i~.~'h CAUTION: l~bu should use an orlglnal AIA document which has thls cautlon printed in red. An originel assures that changes will not be obscured es may occur when documents are reproduced.