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Sheet 1: SofV
CONTINUATION SHEET FOR AIA DOCUMENT G702 | ||||||||||
APPLICATION AND CERTIFICATE FOR PAYMENT | PAGE 2 OF 2 | |||||||||
APPLICATION NUMBER: | 1 | |||||||||
PROJECT NAME: | APPLICATION DATE: | |||||||||
CONTRACTOR'S PROJECT NO.: | PERIOD FROM: | |||||||||
TO: | ||||||||||
ITEM | ORIGINAL | REVISED | PREVIOUS | WORK IN PLACE | STORED | PERCENT | BALANCE | |||
NO. | DESCRIPTION OF WORK | VALUE | VALUE | APPLICATIONS | THIS MONTH | MATERIALS | TOTAL TO DATE | COMPLETE | TO FINISH | RETAINAGE |
1 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
2 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
3 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
4 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
5 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
6 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
7 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
8 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
9 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
10 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
11 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
12 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
13 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
14 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
15 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | |||
TOTALS | 0 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | 0 | 0 |
CONTINUATION SHEET FOR AIA DOCUMENT G702 | ||||||||||
APPLICATION AND CERTIFICATE FOR PAYMENT | PAGE 2 OF 2 | |||||||||
APPLICATION NUMBER: | 1 | |||||||||
PROJECT NAME: | APPLICATION DATE: | |||||||||
CONTRACTOR'S PROJECT NO.: | PERIOD FROM: | |||||||||
CT Project | TO: | |||||||||
ITEM | ORIGINAL | REVISED | PREVIOUS | WORK IN PLACE | STORED | PERCENT | BALANCE | |||
NO. | DESCRIPTION OF WORK | VALUE | VALUE | APPLICATIONS | THIS MONTH | MATERIALS | TOTAL TO DATE | COMPLETE | TO FINISH | RETAINAGE |
1 | Tenant Painting | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | |
2 | Labor | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | |
3 | Material | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | |
4 | CO # 1 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | |
5 | Labor | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | |
6 | Material | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | |
7 | CO # 2 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | |
8 | Labor | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | |
9 | Material | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | |
10 | CO # 3 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | |
11 | Labor | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | |
12 | Material | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | |
13 | CO # 4 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | |
14 | Labor | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | |
15 | Material | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | |
Tax on Labor | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
Tax on Materials | 0 | 0 | 0 | 0 | 0 | #DIV/0! | - | - | ||
TOTALS | 0 | 0 | 0 | 0 | 0 | 0 | #DIV/0! | 0 | 0 |
APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 PAGE ONE | |||||||||||
TO OWNER : | Erland Construction, Inc. | PROJECT: | APPLICATION NO: | ||||||||
71 Third Avenue | Job No. | ||||||||||
Burlington MA 01803 | |||||||||||
PERIOD TO: | |||||||||||
FROM CONTRACTOR | VIA ARCHITECT: | ARCHITECT'S | |||||||||
PROJECT NO: | |||||||||||
CONTRACT DATE: | |||||||||||
CONTRACTOR'S APPLICATION FOR PAYMENT | Application is made for payment , as shown below, in connection with the Contract. | ||||||||||
Continuation sheet, AIA Document G703, is attached. | |||||||||||
CHANGE ORDER SUMMARY | 1. ORIGINAL CONTRACT SUM | 0 | |||||||||
2. NET CHANGE BY CHANGE ORDERS | 0 | ||||||||||
Change Orders Approved in | 3. CONTRACT SUM TO DATE (LINE 1 & 2) | 0 | |||||||||
Previous months by Owner | ADDITIONS | DEDUCTIONS | 4. TOTAL COMPLETED & STORED TO DATE | 0 | |||||||
TOTAL | 0 | ||||||||||
Approved this month | 5. RETAINAGE | ||||||||||
Number | Date Approved | a. % of completed work | 0 | ||||||||
b. % of stored material | |||||||||||
Total retainage | 0 | ||||||||||
TOTAL | 0 | 0 | 6. TOTAL EARNED LESS RETAINAGE | 0 | |||||||
Net Change by Change Orders | 0 | (Line 4 less Line 5 Total) | |||||||||
The undersigned Contractor certifies that to the best of the Contractor's Knowledge, | 7. LESS PREVIOUS CERTIFICATES FOR | ||||||||||
information and belief the Work covered by the Application for Payment has been | PAYMENT (Line 6 from prior Certificate) | 0 | |||||||||
completed in accordance with the Contract Documents, that all amounts have been | |||||||||||
paid by the Contractor for Work for which previous Certificates for Payment were | 8. CURRENT PAYMENT DUE | 0 | |||||||||
issued and payments received from the Owner, and that current payment shown | 9. BALANCE TO FINISH, PLUS RETAINAGE | 0 | |||||||||
herein is now due. | (Line 3 less Line 6) | ||||||||||
CONTRACTOR: | Commonwealth of Massachusetts | County of: | |||||||||
Subscribed and sworn to before me the | day of | ||||||||||
Notary Public: | |||||||||||
By: | Date: | My Commission Expires: | |||||||||
, Project Manager | |||||||||||
ARCHITECT'S CERTIFICATE FOR PAYMENT | AMOUNT CERTIFIED | ||||||||||
In accordance with the Contract Documents, based on on-site observations and the | (Attach explanation if amount certified differs from the amount applied for.) | ||||||||||
data comprising the above application, the Architect certifies to the Owner that to the | ARCHITECT: | ||||||||||
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 | By: | Date: | |||||||||
the Contractor is entitled to payment of the AMOUNT CERTIFIED. | This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the | ||||||||||
Contractor named herein. Issuance, payment and acceptance of payment are without | |||||||||||
prejudice to any rights of the Owner or Contractor under this Contract. | |||||||||||
AIA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT MAY 1983 EDITION AIA @1983 | |||||||||||
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE,N.W. WASHINGTON D.C. 20006 |
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