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ent by: STATON CONSTRUCTIDN
<br />~'~LICAT1lNi A~~iD CERTI~iCAiE ht1R F~IYMEN~'
<br />~CI EOW~E€fii : P4HAItltd ~~7kf~TY
<br />1~V~ ii! 6H ST. IvE
<br />SAE.~t~, ElR 9731~i
<br />~iUR i~:~1NT~tALfUHi: SI'Aft~l COt~1'RE~GTTOt~, IHC.
<br />29a~4-p Rirpar'~ Fnad
<br />~ugene„ t~'t 9740.',-"i59~4
<br />PF![N~lE i: t~Ql} k61-0~43
<br />EQl~TkACT FE3k:
<br />CF3tiTRACT t}ATE:
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<br />~HN6E U({DEk SEJ~iI~t{If{Y pRf~I13A1 CCtNTkACT Slii'7 ~~.oJ~,7`:.OD --
<br />....._,....r._.._.,,._~._, .,....,..,.~m. _-pDA~Ti[thS t I?EL~t~;TIAnlS 1
<br />iANGE tNtp~l7S R~'~ROVkA IN 1 1 f
<br />iEVIL~lIS A3GDITH'a BY OW~R I i I
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<br />RI~~R(:{VEQ THIS MCd~li}i i
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<br />NElt~B~k 1 DRTE FINPHaVkD I i i
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<br />~ Bl, i~16. a~a i a
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<br />~e arrdersig~,ed Gontra~tar cert~tzes that ta the tiest of the
<br />Fntractar's knawiedge, infor~atinn and beltiff the werk
<br />~~rered t~y this Applicati~n fur Payment has ~een rflnpleted
<br />~ ac.-cordanre with the ~:ontra~t Aacurenta, that all arounts
<br />ive uEen paid by tt~e Cnntractnr f~~^ wc~rk for wttict~ previaus
<br />~rtifitates fpr F+ayaent ~uere issaed and payoents recei~ed
<br />~aa the Owner, ar~d that current payment shown herein is noa
<br />1e.
<br />N~TRA~. Ffik:
<br />, ., - , ~
<br />`~ f i-. ~ i ~- Late: ~-
<br />G, . ~~~',.r,~ ~,.l~ °~~.~-~_~`~----- ~'y-r--~ ----~
<br />!E~II TEGT° 6 CERT If I G'pTE FUft GAYP~7
<br />~ ac~rdance aith the Contract Docurents, GaseC an on~site
<br />~~ervatians and the data caaprising the above applicatz~n
<br />e Ar:hitect certifiES t6 the t}wr~er•that ta the best af the
<br />c~hitect's k~oaledge, it~far~atian and belief the Work ha~
<br />rogre~sed as indicated, the qu~lity of ~he 4iorh is in
<br />~~o1"li3~I~R Htth th@ ~;oAtl"dC~ DOCUke11~5~ and the Eontractar
<br />Er,tit;ed tn pzysent of the ~t0E1hiT GERTIFiEA,
<br />1 541 4B1 0545; iQ/0B/97 4:52PM;~X #76; Page 213
<br />..,~, ~
<br />Pf~E 1
<br />PROJ~CT: ~ftifkd C01SA~~ItDEtsO ~~. RPR~ICATION N0: 8 pRT~ 0911~t57
<br />E20 EfI~sH 9T.
<br />PERIDD T0: t~5llc/°.7
<br />SALEht, OR 973I~
<br />AR~~tTTEC7' S
<br />UiA {ARC1fITE~Tf: P~DJ~ET NG:
<br />NET CHAiV6E BY Cl~t~ O~DER~ ~31.o1~.oa
<br />C[)tdTRACI 5UM TU DA1£ ~99,59~.8@
<br />70TAL COMPLETED AM17 SFORED T4 ~TE 599,595.5~
<br />RETAINAGE:
<br />:.0x af Caupleted Work 4C~~it.~.~cJ
<br />I
<br />5.~',~ af ~tared F4aterial
<br />7nta! Retainage ~ ~9,979.75
<br />"fQTRI. ERi~I} ~ESS RETAINAGE 5b9,b1~.25
<br />LES5 PR~UIDt15 EER7IFICATES DF pYmct~il 492,6St~.0a
<br />ELEkRFtdT SALES TA7t:
<br />0.007: of Taxable Aanunt
<br />Gurrent Sales Tax
<br />Ct#RRENT PAYMENT DIiE ~ 76, 9E5. ~Qf
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<br />2 _ $
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<br />SALAi~# FINISH, I 1~ TRINAC,E 24,579.75
<br />;si~
<br />5tet~ of: ~ ~~ uanty af: LQ~(~- -.,,..,.-._~._.
<br />5uGSCriGed dhd swa~^n io hefore ne Lhis~~ day of~~'~,194 ~'
<br />f~y Can~iSSion expires, (~rt, ~/~
<br />Ai40l3NT CER7IFIED ; 4
<br />Afs'CWITELI': ~,e~c~l1~ U ~C~-r ~~CJ < <... r
<br />I
<br />By. Date:
<br />~~ _ y..~~~ ~7
<br />This ertification is not nega iabie. 'fhe AMC~JNT CEki'IFTm is
<br />payabie c,nly to the Contractor na~ed herein. Is~uanck, p~y~ent
<br />and acceptance ut payaent are ~`ithout Frejudice to any r~ght5
<br />af the Owner or Cnntractor und ir tt~is Cantrafit. ` ;.i t> N,
<br />i,., ,t,,ct,,,•~R',. r -~.v ,`~-A.. ~... ~~J. -tJ~^-. -~ ~v J
<br />G. ~- •~. : ~' '~~' 1Y ~`-~v'''r -~-~+ 1.~.- c.s y- „--e.~7T' •
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