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(@  !     #  !     #   "@ @  "     @ !  !    # '  # '   (   %    ( (  '  D &@@ &8@ "@@ "!@ @  ! !@  ,@  ,!@  ! !@  @  !@  (@  @  !@  , ! @  ( & @ & !@  (@     ` G702!_Regression_Int  ;7 ' Print_Area_MI;6 8Print_Titles_MI);Cv;lT _S)APPLICATION AND CERTIFICATION FOR PAYMENTAIA DOCUMENT G702 PAGE ONE OFPAGES TO OWNER:PROJECT:APPLICATION NO:Distribution to:OWNER ARCHITECTX PERIOD TO: CONTRACTORFROM CONTRACTOR:VIA ARCHITECT: PROJECT NOS: CONTRACT FOR:CONTRACT DATE:$CONTRACTOR'S APPLICATION FOR PAYMENTUThe undersigned Contractor certifies that to the best of the Contractor's knowledge, QApplication is made for payment, as shown below, in connection with the Contract.Pinformation and belief the Work covered by this Application for Payment has been3Continuation Sheet, AIA Document G703, is attached.Xcompleted in accordance with the Contract Documents, that all amounts have been paid by Tthe Contractor for Work for which previous Certificates for Payment were issued and Spayments received from the Owner, and that current payment shown herein is now due.1. ORIGINAL CONTRACT SUM  $ 2. Net change by Change Orders CONTRACTOR:N3. CONTRACT SUM TO DATE (Line 1 2) $$4. TOTAL COMPLETED & STORED TO& DATE (Column G on G703)By: Date:5. RETAINAGE:a.%% of Completed Work $ State of: County of:(Column D + E on G703)&Subscribed and sworn to before me this day ofb.(% of Stored Material $Notary Public:(Column F on G703)My Commission expires:, Total Retainage (Lines 5a + 5b orTotal in Column I of G703) #ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE UIn accordance with the Contract Documents, based on on-site observations and the data(Line 4 Less Line 5 Total)Ycomprising the application, the Architect certifies to the Owner that to the best of the"7. LESS PREVIOUS CERTIFICATES FORT Architect's knowledge, information and belief the Work has progressed as indicated,- PAYMENT (Line 6 from prior Certificate) Xthe quality of the Work is in accordance with the Contract Documents, and the Contractor8. CURRENT PAYMENT DUE /is entitled to payment of the AMOUNT CERTIFIED.@9. BALANCE TO FINISH, INCLUDING RETAINAGE $(Line 3 less Line 6)(AMOUNT CERTIFIED . . . . . . . . . . . $CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONSd(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Total changes approved`Application and onthe Continuation Sheet that are changed to conform with the amount certified.) in previous months by Owner ARCHITECT: Total approved this Month TOTALSQThis Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the QContractor named herein. Issuance, payment and acceptance of payment are without NET CHANGES by Change OrderGprejudice to any rights of the Owner or Contractor under this Contract.[AIA DOCUMENT G702 APPLICATION AND CERTIFICATION FOR PAYMENT 1992 EDITION AIA 1992YTHE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006-5292Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee.Z u!0l{ fu  8 +$3  dMbP?_*+%e-&Zd;O?'"~j?(~jtx?)~jt?M\\SCM1\HP LaserJet 8000 Series dLetter.HP LaserJet 8000 Series PCL 5e2"xe.Ai!2b/x ,XB*L&1_/wv#QTNwuVWDlNـ' z7drOeQZX NQ1&76GLPt, cx]mW0{WQ'SR~qGVC!{|@/wT"\hOcIv6L"F2B36,>8f Yqj3}W,D gFC2s6J;enѺn)BQ"_??U} } U} } } } } } } U } } } } } } U}  8w x@<@*@*@ *@  *@  *@ <@h@@@@@@@@@@@@@      "    ! 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