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APPLICATION AND CERTIFICATE FOR PAYilrr~iv"~' AIA DOCUMENT G702 (tns~ruceions on reverse side) race oNe oF YA~Es TO OWNER: ~ PROJECT: APPLICATION NO.: 0z Dis[ribution ro: Marion County Risk Management S31P1R CAUI'thOll52 SCjIlaT2 Pr'Oj 2Ct YERIOD TO: 4-Z~-9~ ~~WNER 100 High Street, N.E. Asbestos Abatement & Deno PROJECT NOS.: NOne ^ ARCHITECT Salem, Oregon 97301 ^ CoNTx,~CTOR FROM CONTRACTOR: VIA ARCHITECT: N/A CONTRACT DATE: 4-21-97 ^ Precision Industrial Constructors, Inc. ^ 1395-D Downriver Drive CCNT~, WA 98674 COlVTRACTOR'S APPLICATION FO~i PAYMENT Applica[ion is made for paymenc, as shown below, in wnnection wi[h che Con[racc. Concinuacion Sheec, AIA Doeumene G703, is atnehed. ORIGINAL CONTRACT SUM ..................5 232,175.00 2. Net change by Change Orders . . . . . . . . . . . . . . . ~_ --- 3. CONTRACT SUM TO DATE (Line 1 t 2)........$ 232~175.00 4. TOTAL COMPLETED & STORED TO DATE ... ...8 82~419.60 (Column G on G703) 5. RETAiNAGE a. ~% of Compleeed Work $ 2.970.98 (Columns D + E on G703) b. % of Scored Maeerial 8 (Column F on G703) Torai Retainage (Line Sa + 56 or $ Z~g70.98 Tora1 in Column I of G703) . . . . . . . . . . . . . . . 6.TOTAL EARNED LESS RETAINAGE............~ ~9,448.62 (Line 4 less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 23~000.00 (Line 6 from prior Cerei£cate) . . . . . . . . . . . . . . . . . S 8. CURRENT PAYMENT DUE ................. 8 56,448.62 9. BALANCE TO FINISH, INCLUDlNG RETAINAGE (Line 3 less Line 6) ~ 149,755.40 CHANGE ORDER SUMMP.RY ADDITIONS DEDUCTIONS Toral changes approved in previous monchs by Owner Total approved this Mon[h ~ TOTALS NET CHANGES by Change Order The undersigned Con[ne~or certiFies [hat eo the besc of the Con[racror's knowledge, infoo- mation and belief [he Work covered by chis Applicacion for Paymen[ has been completed in accordance wich [he Contrxec Documents, chat aIl arnounts have been paid by che Concractor for Work for which pre.vious Cenificates for Paymen~ were issued and pay- menes received from the Owner, and tha[ currene payment shown herein is now due. CONTRACTOR: BY -Dare: 4-28-97 o ey / u z Scace of~ ti'ashi,pL99ton county of: ~wiirz Subscribed and swom eo before me chis a~''`'~~ day of ~P¢~'/ / 997 No~:try Publi . ~ My Commis ' ex res: // 9 99 ARCHITECT'S CERTIFICATE FOR PAYMENT In accordance with che Contrac[ Documents, based on on-site observaeions and [he data comprising [his appHcation, the Archi[ect cer[ifies to the Owner chat [o che bes[ of the Architect's knowledge, informacion and belief the Work has progressed as indicaced~ che quality of [he Work is in accordance with [he Con[racc Documenes, and che Coneraceor is en~itled [o payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED ............................... (AZtach ezplanation if amounz certified diJfers Jrom the amount appLied for. Initial all figures on this Application and on the Continuation Sbeet that are cl~anged to confornz to tbe amount certified.). ARCHITECT: BY~ Da[e: This Certificare is noc negoaable. Tlie .^.T~IOUNT CERTIFIED is payable only ro~he Con- [ractor named herein. Issuance, paymene and acceprance of paymen[ are wichou~ prejudice co any rights of [he Owner or Con[ractor under this Contracc. ~ AIA DOCUMENT G702 • qPPi,lCq'[[ON AND CEFTIFICATE FOR PAYMENT • 199? EDCf10N • AIAm • OO 199? • THE AMERICAN INSI'ITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W, WPSHRVGTON, D.G 2000Ca5z9? • WARNING: Unlicensed photocopying vlolates U.S. copyright laws entl will subject the violatot ro Iegal prosecution. G702-1992 ~~?~' CAUTION: You should use an original AIA documenY which has this caution printed in red. An origEnal assures that changes wilt not be ohseured as may occur when doeuments are reproduced