shelco, inc....1,293.54 l\iewline products inc 1,901.40 1,901.40 overhead door co of the high...
TRANSCRIPT
Shelco Inc
Eblien School - Payables
As of June 24 2013
A B A+B
Unpaid Held Accounts Total Due
Subcontractor Retainage Payable Amt VendorsSubs
AOA Signs Inc
Air-Vent Exteriors Inc
Andrews amp Hamilton Co Inc 369000 369000
Blue Ridge Glass 3694880 3694880
Carolina Interiors Flooring Outlet Inc 712680 712680
Concrete Connection Inc
Cook amp Boardman Inc 3048662 3048662
Custom Wood Products of Rural Hall Inc
Doggett Concrete Inc
Grindstaff Fence Co Inc 675241 675241
Hamilton Stephens Steele amp Martin 114591 114591
Haynes Electric Construction Company
KONE Inc
Learning Environments Inc
L amp L Contracting Inc
Manning Brothers Food Equipment Co Inc
Morrow Brick Contractors Inc
MT Waterproofing Co Inc 129354 129354
lIewline Products Inc 190140 190140
Overhead Door Co of the High Country Inc 174650 174650
Patton Construction Group Inc
Peach State Roofing Inc
Perfect Polish Inc
Rug Busters Inc
Southern Energy Management Inc 565500 565500
Southern Flooring Inc 150990 150990
Southern Mechanical of the Carolinas
Southend Painting Contractors
Southern States Sprinkler Company LLC
Spur Construction LLC
Tate Steel Inc
Butch Thompson amp Company
TP Howards Plumbing Co Inc 2508155 2508155
Warco Construction Inc
12219252 114591 12333843
R01 LEGAL01 Suits and claims0903002 Buncombe Co SchoolSchool Supt Issue2013 06 25 Retain payable
info 6252013
------------------------------------------------
PAGE OF 8 PAGESAPPLICATION AND CERTIFICATE FOR PAYMENT TO OWNER Buncombe County Schools PROJECT West Buncombe Intermediate School AlA Document G702
175 Bingham Rd 59 Lees Creek Rd Asheville NC APPLICATION No26 Distribution to Asheville NC
28806 28806 PERIOD TO 25-JUN-13 D OWNER
PROJECT Nos 0903002 o ARCHITECTFROM CONTRACTOR Shelco Inc ARCHITECT Architectural Design Studio 30 Patewood Drive 90 Church Street INVOICE No090300229 o CONTRACTOR
Suite 151 Asheville NC o Greenville SC 29615 US 28801 CONTRACT DATE 08-DEC-09 o
CONTRACT FOR West Buncombe Intermediate School
CONTRACTORS APPLICATION FOR PAYMENT Application is made for payment as shown below in connection with the Contract Continuation sheet is attached
1 ORIGINAL CONTRACT SUM $ 2 Net change by change orders $
3 CONTRACT SUM TO DATE ( Line1 +- 2 ) $ 4 TOTAL COMPLETED amp STORED TO DATE $
(Column G on G703) 5 RETAINAGE
Total retainage Column I of G703) bullbullbullbullbullbullbullbullbullbullbull $
6 TOTAL EARNED LESS RET AINAGE $ (Line 4 less Line 5 Total)
7 LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) bullbullbullbullbullbullbullbullbullbullbull $
8 CURRENT PAYMENT DUE $1
9 BALANCE TO FINISH INCLUDING RETAINAGE (Line 3 less Line 6 ) $
(A)
1547935900
20120100
1568056000
1568056000
000
1568056000
1489107458
789485421
000
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS I
Change Order approved in previous months by Owner
22954700 -2834600 I
APPROVED THIS MONTH
Number Date Approved I
(A) Excll ding any aI ~ounts that may be SUrr( 3R Owner Change (unding CCD dela) damages relatedclaims or SyStE m
resolved rder 14 and any
I
to the me chamfc a ~ I
I~ I
CURRENT TOTAL
Net Change by Change Orders
000 000
20120100 I
AlA DOCUMENT G702 bull APPLICATION AND CERTIFICATE FOR PAYMENT THE AMERICAN INSTITUE OF ARCHITECTS 1735 NEW YORK AVENUE NW WASHINGTON DC 20006
The undersigned Contractor certifies that to the best of the Contractors knowledge information and belief the work covered by this Application for Payment has been 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 issued and payments received from the Owner and that current payment shown herein is now due
~yO~ Date hal3 StaU no- C-amp GshyCounty of NecK( Y 6u(5 Subscribed and sworn to before
day of
EVA H HINKEL NOTARY PUBLIC
cklsnburg County North Carolina me this a 5 Notary Public My Commission ExplreaJII~ ZOl3
My Commission expires Ji 1 a ClJI3 l
ARCHITECTS CERTIFICATE FOR PAYMENT In accordance with the Contract Documents based on on-site observations and the data comprising the above application the Architect certifies to the Owner that to the best of the Architects knowledge information and belief the Work has progressed as indicated the quality of Work is in accordance with the Contract Documents and the Contractor is entitled to the payment of the AMOUNT CERTIFIED
AMOUNT CERTIFIED $
(Attach explanation If amount certified differs from the amount applied for Initial figures on this Application certified)
and on the Continuation Sheet that are changed to conform to the amount
ARCHITECT Architectural Design Studio
By Date
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
2
I
Shelco Inc
CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply PROJECT NO 0903002
A B D EC F HG
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO FROM
PREVIOUS VALUE
THIS APPLICATION PERIOD
MATERIAL PRESENTLY
STORED
TOTAL COMPLETED AND STORED PER- BALANCE
TO DATE (G C) TO FINISH RETAINAGE
00
0101
0102
01 03
0104
01 05
0106
0107
0108
0201
0202
0203
0204
0205
0206
0207
0208
0301
0302
0303
0304
0305
0306
Original Contract
General Conditions
Final Cleanup
Discovery amp Change Allowance
Permanent Sign Allowance
PerformancePayment Bond
Builders Risk
Building Permit
Owners Protective Liability
SiteworkiSite Utilities
Survey amp Layout
Termite Treatment
SidewalksSitewalls
Dumpster Pad
Stained Sidewalks
FencesGates
Bike Loops
Continous Footing
Wall Concrete
Isolated Footings
Slab on Grade
Suspended Slab
Expansion Joint
851 70500
2650000
2000000
800000
8931200
27 60000
3150000
713900
199412000
1108400
1544900
280321 00
553900
951300
17154400
2554 00
76869300
29466200
2048400
43085500
5014700
2331 00
84596035
2650000
2000000
8000 00
89312 00
2760000
3150000
713900
199412000
1108400
1544900
28032100
553900
951300
171 54400
255400
76869300
294662 00
2048400
43085500
5014700
2331 00
574465
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
0 00
000
000
000
000
000
000
000
000
000
85170500
2650000
2000000
800000
8931200
2760000
31 50000
713900
199412000
1108400
1544900
28032100
553900
951300
17154400
255400
76869300
29466200
2048400
43085500
5014700
2331 00
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
1
I
I
3 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B
ITEM DESCRIPTION OF WORK NO
00 Original Contract
0401 Masonry
0501 Structural Steel
0502 Miscellaneous Steel
0503 Expansion Joints
0601 Wood Blocking
07 01 FireproofingSafing
07 02 Roof System
0703 Caulk amp Sealant
0704 WaterproofingDam p-Proof
0801 Doors Frames Hardware
0802 Fiberglass Sandwich Panel
0803 Overhead Door
0804 Access Doors
0806 WindowsStorefront
0901 DrywallFraming
0902 Drywall Acoustical
0903 Acoustical Wall Ceiling
0904 Ceramic
0905 VCTResilient
0906 Carpet
0907 Wood Flooring
0908 Painting
C
SCHEDULED VALUE
180000000
856 51400
1942500
4553 00
44311 00
330500
97195200
1200000
3500000
28277500
46632 00
1519000
269400
30017800
34500000
12925700
3831700
61 37500
7176600
4019300
988900
8562500
0 E
WORK COMPLETED (D+E)
FROM PREVIOUS
APPLICATION
180000000
85651400
1942500
455300
44 31100
330500
971 952 00
1200000
3500000
28277500
46 63200
1519000
269400
30017800
34500000
12925700
38 31700
61 37500
7176600
4019300
988900
8562500
THIS PERIOD
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F
MATERIAL PRESENTLY
STORED
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
G
TOTAL COMPLETED AND STORED
TO DATE
180000000
85651400
1942500
455300
4431100
330500
971 95200
1200000
3500000
28277500
46632 00
1519000
2694 00
30017800
34500000
12925700
3831700
6137500
7176600
4019300
988900
8562500
PER- (G C)
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
4 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26 Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E F G H I
ITEM NO
DESCRIPTION OF WORK SCHEDULED VALUE
WORK COMPLETED (D+E)
FROM PREVIOUS THIS
APPLICATION PERIOD
MATERIAL PRESENTLY
STORED
TOTAL COMPLETED AND STORED
TO DATE PER- (G 1C)
BALANCE TO FINISH RETAINAGE
00
1001
1002
1003
1004
Original Contract
Toilet Partitions
Toilet Accessories
Aluminum Louvers
Flagpoles
391000
1686300
312300
213500
391000
1686300
312300
213500
000
000
000
000
000
000
000
000
391000
1686300
312300
213500
10000
10000
10000
10000
000
000
000
000
I 000 I
I
000 I
000 I
000 I
1005
1006
1007
1008
ChalkTackMarker Boards
Signage
Lockers
Fire Extinguishers
3800000
6979000
4070000
255600
3800000
6979000
40700 00
255600
000
000
000
000
000
000
000
000
38000 00
6979000
4070000
2556 00
10000
10000
10000
10000
000
000
000
000
000 I
I
000 I
000 I
000 I
1009
1101
Fire Dept Knox Box
Stage Curtains
41100
773600
411 00
773600
000
000
000
000
411 00
773600
10000
10000
000
000
000 I
000 I
1102 Projection Screen 695600 6956 00 000 000 6956 00 10000 000 000
11 03 Dock Equipment 124800 124800 000 000 124800 10000 000 000
1104 Food Service Equipment 307446 00 30744600 000 000 30744600 10000 000 000
1105 Ressidential Appliances 361500 361500 000 000 361500 10000 000 000
1106 Shop EquipmentPottery Klin 2423 00 242300 000 000 242300 10000 000 000
11 07 Athletic Equipment 34631 00 34631 00 000 000 34 631 00 10000 000 000
1201 Blinds 1002000 1002000 000 000 10020 00 10000 000 000
1202 Entrance Mats 3511 00 3511 00 000 000 3511 00 10000 000 000
1203 Manufactured Casework 35894500 35894500 000 000 35894500 10000 000 000
1204 Telescoping Bleachers 2020000 2020000 000 000 2020000 10000 000 000
1301 Trellis 2463700 2463700 000 000 2463700 10000 000 000
1401 Elevators 5850000 5850000 000 000 5850000 10000 000 000
5 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
00 Original Contract
1501 Sprinkler 107671 00 107671 00 000
1502 Plumbing 557901 00 55790100 000
1503 HVAC 181314100 1813141 00 000
1601 Electrical 168828700 168828700 000
000 000 000
Original Contract Total 1547935900 1547361435 5 74465
01 Change Order 1
6003 Unforseen Conditions removal of 132700 132700 000
dead animal from project sit
6004 Unforseen Condition- rock removal 149300 149300 000
6005 Unforseen Condition- stone 784400 784400 000
beddingon 36 pipe due to exsit
6006 Regulatory Review Comments 2037600 2037600 000
6008 Earthwork- Rock Removal 202 00 202 00 000
Change Order 1 Total 3124200 3124200 000
02 Change Order2
6010 Take Down existing playground 651900 651900 000
equipment
Change Order2 Total 651900 651900 000
03 Change Order 3
6012 Stie Changes - Owner chanage G-3 1430800 1430800 000
6013 Revised structural steel bracing 69600 69600 000
- - -shy -shy -shy - -shy -shy -shy -
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1C)
000 107671 00 10000
000 557901 00 10000
000 1813141 00 10000
000 168828700 10000
000 000
--shy000 1547935900 10000
000 132700 10000
000 149300 10000
000 784400 10000
000 20 37600 10000
000 20200 10000
--shy000 3124200 10000
000 651900 10000
--shy000 651900 10000
000 1430800 10000
000 69600 10000
- - - - -
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
- -shy
6 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NOIn tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICA TION PERIOD
03 Change Order 3
6014 Playground installation 11018000 11018000
6015 Change rigid insulationldelete -2012300 -2012300
sidewalk
Change Order 3 Total 10506100 10506100
04 Change Order 4
6016 Delete playground add form OCO3 -6 51900 -651900
Change Order 4 Total -651900 -651900
05 Change Order 5
6027 Adverse weather days 000 000
Change Order 5 Total 000 000
06 Change Order 6
6017 Delete quantity of concrete sidewalks -2158700 -21 58700
6018 Waterline Relocation 1064700 1064700
6019 Add asphalt paving and concrete pad 1655000 1655000
at dumpster
6020 Delete seeding at existing building -51500 -51500
6021 Change grade at parking area 327000 327000
existing elementary school
6022 Remove unsuitable soil at entrance 1056000 1056000
drive
6023 Add waterproofing at retaining wall 262700 262700
6024 Delete dashboard Allowance -10 50000 -1050000
6025 Change roofing from fully applied to -1926200 -19262 00
mechanially fastened
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1C)
000 11018000 10000
000 -2012300 10000
--shy000 10506100 10000
000 -651900 10000
--shy000 -651900 10000
000 000
--shy000 000
000 -2158700 10000
000 10647 00 10000
000 1655000 10000
000 -51500 10000
000 3270 00 10000
000 1056000 10000
000 262700 10000
000 -1050000 10000
000 -1926200 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
7 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
06 Change Order 6
6026 LEED Changes 13617 00 1361700
Change Order 6 Total 540700 540700
07 Change Order 7
6034 Hardware Change 564400 564400
6035 Food Service Equiment Change 62B00 62B00
6036 Change Door Frame at Electric Room 465 00 46500
6037 Extend Electrical Boxes for LEED 973 00 973 00
Changes
6038 Delete Allowacne for Sign -B56000 -B 56000
6039 Add Sanitary Drain at Dumpster 2B0300 2B0300
6040 Add Hot Water at Toilets 1936700 1936700
6041 Electrical for Media Equipment 735500 7355 00
6042 Deduct Electrical Outlets at front -61500 -61500
Entry
Change Order 7 Total 2806000 2806000
10 Change Order 10
6043 Relocate outdoor freezerlcppoler 155500 155500
units 40 North
6044 Make electrical changes to kitchen 319200 319200
equipment item 37 amp 45
6045 Make electrical change to kitchen 95400 95400
equipment item 8
6046 Extend freezerlcooler units 40 North 64200 64200
Change Order 10 Total 634300 634300
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1 C)
000 1361700 10000
--shy000 540700 10000
000 564400 10000
000 62B00 10000
000 46500 10000
000 97300 10000
000 -B 56000 10000
000 2B0300 10000
000 1936700 10000
000 735500 10000
000 -61500 10000
--shy000 2806000 10000
000 155500 10000
000 319200 10000
000 954 00 10000
000 64200 10000
--shy000 634300 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000 -shy -
I
I
I
I
I
I
I
I
8 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
11 Change Order 11
6047 Site changes related to entry drive 837800 837800 000
6048 Credit to delete 111 sq yrds of heavy -355700 -355700 000
duty asphalt
Change Order 11 Total 482100 482100 000
12 Change Order 12
6049 Electrical changes to provide amp install 947000 947000 000
new data cabinets FB
Change Order 12 Total 947000 947000 000
13 Change Order 13
6051 Change EM Fixtures 1079700 1079700 000
Change Order 13 Total 1079700 1079700 000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G C)
000 837800 10000
000 -355700 10000
--shy000 482100 10000
000 947000 10000
--shy000 947000 10000
000 1079700 10000
--shy000 1079700 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
1568056000 1567481535 574465 000 1568056000 000 000 PROJECT TOTAL
AlA DOCUMENT G703 bull APPLICATION AND CERTIFICATE FOR PAYMENT THE AMERICAN INSTITUE OF ARCHITECTS 1735 NEW YORK AVENUE NW WASHINGTON DC 20006
------------------------------------------------
PAGE OF 8 PAGESAPPLICATION AND CERTIFICATE FOR PAYMENT TO OWNER Buncombe County Schools PROJECT West Buncombe Intermediate School AlA Document G702
175 Bingham Rd 59 Lees Creek Rd Asheville NC APPLICATION No26 Distribution to Asheville NC
28806 28806 PERIOD TO 25-JUN-13 D OWNER
PROJECT Nos 0903002 o ARCHITECTFROM CONTRACTOR Shelco Inc ARCHITECT Architectural Design Studio 30 Patewood Drive 90 Church Street INVOICE No090300229 o CONTRACTOR
Suite 151 Asheville NC o Greenville SC 29615 US 28801 CONTRACT DATE 08-DEC-09 o
CONTRACT FOR West Buncombe Intermediate School
CONTRACTORS APPLICATION FOR PAYMENT Application is made for payment as shown below in connection with the Contract Continuation sheet is attached
1 ORIGINAL CONTRACT SUM $ 2 Net change by change orders $
3 CONTRACT SUM TO DATE ( Line1 +- 2 ) $ 4 TOTAL COMPLETED amp STORED TO DATE $
(Column G on G703) 5 RETAINAGE
Total retainage Column I of G703) bullbullbullbullbullbullbullbullbullbullbull $
6 TOTAL EARNED LESS RET AINAGE $ (Line 4 less Line 5 Total)
7 LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) bullbullbullbullbullbullbullbullbullbullbull $
8 CURRENT PAYMENT DUE $1
9 BALANCE TO FINISH INCLUDING RETAINAGE (Line 3 less Line 6 ) $
(A)
1547935900
20120100
1568056000
1568056000
000
1568056000
1489107458
789485421
000
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS I
Change Order approved in previous months by Owner
22954700 -2834600 I
APPROVED THIS MONTH
Number Date Approved I
(A) Excll ding any aI ~ounts that may be SUrr( 3R Owner Change (unding CCD dela) damages relatedclaims or SyStE m
resolved rder 14 and any
I
to the me chamfc a ~ I
I~ I
CURRENT TOTAL
Net Change by Change Orders
000 000
20120100 I
AlA DOCUMENT G702 bull APPLICATION AND CERTIFICATE FOR PAYMENT THE AMERICAN INSTITUE OF ARCHITECTS 1735 NEW YORK AVENUE NW WASHINGTON DC 20006
The undersigned Contractor certifies that to the best of the Contractors knowledge information and belief the work covered by this Application for Payment has been 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 issued and payments received from the Owner and that current payment shown herein is now due
~yO~ Date hal3 StaU no- C-amp GshyCounty of NecK( Y 6u(5 Subscribed and sworn to before
day of
EVA H HINKEL NOTARY PUBLIC
cklsnburg County North Carolina me this a 5 Notary Public My Commission ExplreaJII~ ZOl3
My Commission expires Ji 1 a ClJI3 l
ARCHITECTS CERTIFICATE FOR PAYMENT In accordance with the Contract Documents based on on-site observations and the data comprising the above application the Architect certifies to the Owner that to the best of the Architects knowledge information and belief the Work has progressed as indicated the quality of Work is in accordance with the Contract Documents and the Contractor is entitled to the payment of the AMOUNT CERTIFIED
AMOUNT CERTIFIED $
(Attach explanation If amount certified differs from the amount applied for Initial figures on this Application certified)
and on the Continuation Sheet that are changed to conform to the amount
ARCHITECT Architectural Design Studio
By Date
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
2
I
Shelco Inc
CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply PROJECT NO 0903002
A B D EC F HG
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO FROM
PREVIOUS VALUE
THIS APPLICATION PERIOD
MATERIAL PRESENTLY
STORED
TOTAL COMPLETED AND STORED PER- BALANCE
TO DATE (G C) TO FINISH RETAINAGE
00
0101
0102
01 03
0104
01 05
0106
0107
0108
0201
0202
0203
0204
0205
0206
0207
0208
0301
0302
0303
0304
0305
0306
Original Contract
General Conditions
Final Cleanup
Discovery amp Change Allowance
Permanent Sign Allowance
PerformancePayment Bond
Builders Risk
Building Permit
Owners Protective Liability
SiteworkiSite Utilities
Survey amp Layout
Termite Treatment
SidewalksSitewalls
Dumpster Pad
Stained Sidewalks
FencesGates
Bike Loops
Continous Footing
Wall Concrete
Isolated Footings
Slab on Grade
Suspended Slab
Expansion Joint
851 70500
2650000
2000000
800000
8931200
27 60000
3150000
713900
199412000
1108400
1544900
280321 00
553900
951300
17154400
2554 00
76869300
29466200
2048400
43085500
5014700
2331 00
84596035
2650000
2000000
8000 00
89312 00
2760000
3150000
713900
199412000
1108400
1544900
28032100
553900
951300
171 54400
255400
76869300
294662 00
2048400
43085500
5014700
2331 00
574465
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
0 00
000
000
000
000
000
000
000
000
000
85170500
2650000
2000000
800000
8931200
2760000
31 50000
713900
199412000
1108400
1544900
28032100
553900
951300
17154400
255400
76869300
29466200
2048400
43085500
5014700
2331 00
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
1
I
I
3 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B
ITEM DESCRIPTION OF WORK NO
00 Original Contract
0401 Masonry
0501 Structural Steel
0502 Miscellaneous Steel
0503 Expansion Joints
0601 Wood Blocking
07 01 FireproofingSafing
07 02 Roof System
0703 Caulk amp Sealant
0704 WaterproofingDam p-Proof
0801 Doors Frames Hardware
0802 Fiberglass Sandwich Panel
0803 Overhead Door
0804 Access Doors
0806 WindowsStorefront
0901 DrywallFraming
0902 Drywall Acoustical
0903 Acoustical Wall Ceiling
0904 Ceramic
0905 VCTResilient
0906 Carpet
0907 Wood Flooring
0908 Painting
C
SCHEDULED VALUE
180000000
856 51400
1942500
4553 00
44311 00
330500
97195200
1200000
3500000
28277500
46632 00
1519000
269400
30017800
34500000
12925700
3831700
61 37500
7176600
4019300
988900
8562500
0 E
WORK COMPLETED (D+E)
FROM PREVIOUS
APPLICATION
180000000
85651400
1942500
455300
44 31100
330500
971 952 00
1200000
3500000
28277500
46 63200
1519000
269400
30017800
34500000
12925700
38 31700
61 37500
7176600
4019300
988900
8562500
THIS PERIOD
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F
MATERIAL PRESENTLY
STORED
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
G
TOTAL COMPLETED AND STORED
TO DATE
180000000
85651400
1942500
455300
4431100
330500
971 95200
1200000
3500000
28277500
46632 00
1519000
2694 00
30017800
34500000
12925700
3831700
6137500
7176600
4019300
988900
8562500
PER- (G C)
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
4 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26 Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E F G H I
ITEM NO
DESCRIPTION OF WORK SCHEDULED VALUE
WORK COMPLETED (D+E)
FROM PREVIOUS THIS
APPLICATION PERIOD
MATERIAL PRESENTLY
STORED
TOTAL COMPLETED AND STORED
TO DATE PER- (G 1C)
BALANCE TO FINISH RETAINAGE
00
1001
1002
1003
1004
Original Contract
Toilet Partitions
Toilet Accessories
Aluminum Louvers
Flagpoles
391000
1686300
312300
213500
391000
1686300
312300
213500
000
000
000
000
000
000
000
000
391000
1686300
312300
213500
10000
10000
10000
10000
000
000
000
000
I 000 I
I
000 I
000 I
000 I
1005
1006
1007
1008
ChalkTackMarker Boards
Signage
Lockers
Fire Extinguishers
3800000
6979000
4070000
255600
3800000
6979000
40700 00
255600
000
000
000
000
000
000
000
000
38000 00
6979000
4070000
2556 00
10000
10000
10000
10000
000
000
000
000
000 I
I
000 I
000 I
000 I
1009
1101
Fire Dept Knox Box
Stage Curtains
41100
773600
411 00
773600
000
000
000
000
411 00
773600
10000
10000
000
000
000 I
000 I
1102 Projection Screen 695600 6956 00 000 000 6956 00 10000 000 000
11 03 Dock Equipment 124800 124800 000 000 124800 10000 000 000
1104 Food Service Equipment 307446 00 30744600 000 000 30744600 10000 000 000
1105 Ressidential Appliances 361500 361500 000 000 361500 10000 000 000
1106 Shop EquipmentPottery Klin 2423 00 242300 000 000 242300 10000 000 000
11 07 Athletic Equipment 34631 00 34631 00 000 000 34 631 00 10000 000 000
1201 Blinds 1002000 1002000 000 000 10020 00 10000 000 000
1202 Entrance Mats 3511 00 3511 00 000 000 3511 00 10000 000 000
1203 Manufactured Casework 35894500 35894500 000 000 35894500 10000 000 000
1204 Telescoping Bleachers 2020000 2020000 000 000 2020000 10000 000 000
1301 Trellis 2463700 2463700 000 000 2463700 10000 000 000
1401 Elevators 5850000 5850000 000 000 5850000 10000 000 000
5 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
00 Original Contract
1501 Sprinkler 107671 00 107671 00 000
1502 Plumbing 557901 00 55790100 000
1503 HVAC 181314100 1813141 00 000
1601 Electrical 168828700 168828700 000
000 000 000
Original Contract Total 1547935900 1547361435 5 74465
01 Change Order 1
6003 Unforseen Conditions removal of 132700 132700 000
dead animal from project sit
6004 Unforseen Condition- rock removal 149300 149300 000
6005 Unforseen Condition- stone 784400 784400 000
beddingon 36 pipe due to exsit
6006 Regulatory Review Comments 2037600 2037600 000
6008 Earthwork- Rock Removal 202 00 202 00 000
Change Order 1 Total 3124200 3124200 000
02 Change Order2
6010 Take Down existing playground 651900 651900 000
equipment
Change Order2 Total 651900 651900 000
03 Change Order 3
6012 Stie Changes - Owner chanage G-3 1430800 1430800 000
6013 Revised structural steel bracing 69600 69600 000
- - -shy -shy -shy - -shy -shy -shy -
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1C)
000 107671 00 10000
000 557901 00 10000
000 1813141 00 10000
000 168828700 10000
000 000
--shy000 1547935900 10000
000 132700 10000
000 149300 10000
000 784400 10000
000 20 37600 10000
000 20200 10000
--shy000 3124200 10000
000 651900 10000
--shy000 651900 10000
000 1430800 10000
000 69600 10000
- - - - -
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
- -shy
6 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NOIn tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICA TION PERIOD
03 Change Order 3
6014 Playground installation 11018000 11018000
6015 Change rigid insulationldelete -2012300 -2012300
sidewalk
Change Order 3 Total 10506100 10506100
04 Change Order 4
6016 Delete playground add form OCO3 -6 51900 -651900
Change Order 4 Total -651900 -651900
05 Change Order 5
6027 Adverse weather days 000 000
Change Order 5 Total 000 000
06 Change Order 6
6017 Delete quantity of concrete sidewalks -2158700 -21 58700
6018 Waterline Relocation 1064700 1064700
6019 Add asphalt paving and concrete pad 1655000 1655000
at dumpster
6020 Delete seeding at existing building -51500 -51500
6021 Change grade at parking area 327000 327000
existing elementary school
6022 Remove unsuitable soil at entrance 1056000 1056000
drive
6023 Add waterproofing at retaining wall 262700 262700
6024 Delete dashboard Allowance -10 50000 -1050000
6025 Change roofing from fully applied to -1926200 -19262 00
mechanially fastened
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1C)
000 11018000 10000
000 -2012300 10000
--shy000 10506100 10000
000 -651900 10000
--shy000 -651900 10000
000 000
--shy000 000
000 -2158700 10000
000 10647 00 10000
000 1655000 10000
000 -51500 10000
000 3270 00 10000
000 1056000 10000
000 262700 10000
000 -1050000 10000
000 -1926200 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
7 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
06 Change Order 6
6026 LEED Changes 13617 00 1361700
Change Order 6 Total 540700 540700
07 Change Order 7
6034 Hardware Change 564400 564400
6035 Food Service Equiment Change 62B00 62B00
6036 Change Door Frame at Electric Room 465 00 46500
6037 Extend Electrical Boxes for LEED 973 00 973 00
Changes
6038 Delete Allowacne for Sign -B56000 -B 56000
6039 Add Sanitary Drain at Dumpster 2B0300 2B0300
6040 Add Hot Water at Toilets 1936700 1936700
6041 Electrical for Media Equipment 735500 7355 00
6042 Deduct Electrical Outlets at front -61500 -61500
Entry
Change Order 7 Total 2806000 2806000
10 Change Order 10
6043 Relocate outdoor freezerlcppoler 155500 155500
units 40 North
6044 Make electrical changes to kitchen 319200 319200
equipment item 37 amp 45
6045 Make electrical change to kitchen 95400 95400
equipment item 8
6046 Extend freezerlcooler units 40 North 64200 64200
Change Order 10 Total 634300 634300
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1 C)
000 1361700 10000
--shy000 540700 10000
000 564400 10000
000 62B00 10000
000 46500 10000
000 97300 10000
000 -B 56000 10000
000 2B0300 10000
000 1936700 10000
000 735500 10000
000 -61500 10000
--shy000 2806000 10000
000 155500 10000
000 319200 10000
000 954 00 10000
000 64200 10000
--shy000 634300 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000 -shy -
I
I
I
I
I
I
I
I
8 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
11 Change Order 11
6047 Site changes related to entry drive 837800 837800 000
6048 Credit to delete 111 sq yrds of heavy -355700 -355700 000
duty asphalt
Change Order 11 Total 482100 482100 000
12 Change Order 12
6049 Electrical changes to provide amp install 947000 947000 000
new data cabinets FB
Change Order 12 Total 947000 947000 000
13 Change Order 13
6051 Change EM Fixtures 1079700 1079700 000
Change Order 13 Total 1079700 1079700 000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G C)
000 837800 10000
000 -355700 10000
--shy000 482100 10000
000 947000 10000
--shy000 947000 10000
000 1079700 10000
--shy000 1079700 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
1568056000 1567481535 574465 000 1568056000 000 000 PROJECT TOTAL
AlA DOCUMENT G703 bull APPLICATION AND CERTIFICATE FOR PAYMENT THE AMERICAN INSTITUE OF ARCHITECTS 1735 NEW YORK AVENUE NW WASHINGTON DC 20006
2
I
Shelco Inc
CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply PROJECT NO 0903002
A B D EC F HG
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO FROM
PREVIOUS VALUE
THIS APPLICATION PERIOD
MATERIAL PRESENTLY
STORED
TOTAL COMPLETED AND STORED PER- BALANCE
TO DATE (G C) TO FINISH RETAINAGE
00
0101
0102
01 03
0104
01 05
0106
0107
0108
0201
0202
0203
0204
0205
0206
0207
0208
0301
0302
0303
0304
0305
0306
Original Contract
General Conditions
Final Cleanup
Discovery amp Change Allowance
Permanent Sign Allowance
PerformancePayment Bond
Builders Risk
Building Permit
Owners Protective Liability
SiteworkiSite Utilities
Survey amp Layout
Termite Treatment
SidewalksSitewalls
Dumpster Pad
Stained Sidewalks
FencesGates
Bike Loops
Continous Footing
Wall Concrete
Isolated Footings
Slab on Grade
Suspended Slab
Expansion Joint
851 70500
2650000
2000000
800000
8931200
27 60000
3150000
713900
199412000
1108400
1544900
280321 00
553900
951300
17154400
2554 00
76869300
29466200
2048400
43085500
5014700
2331 00
84596035
2650000
2000000
8000 00
89312 00
2760000
3150000
713900
199412000
1108400
1544900
28032100
553900
951300
171 54400
255400
76869300
294662 00
2048400
43085500
5014700
2331 00
574465
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
0 00
000
000
000
000
000
000
000
000
000
85170500
2650000
2000000
800000
8931200
2760000
31 50000
713900
199412000
1108400
1544900
28032100
553900
951300
17154400
255400
76869300
29466200
2048400
43085500
5014700
2331 00
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
1
I
I
3 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B
ITEM DESCRIPTION OF WORK NO
00 Original Contract
0401 Masonry
0501 Structural Steel
0502 Miscellaneous Steel
0503 Expansion Joints
0601 Wood Blocking
07 01 FireproofingSafing
07 02 Roof System
0703 Caulk amp Sealant
0704 WaterproofingDam p-Proof
0801 Doors Frames Hardware
0802 Fiberglass Sandwich Panel
0803 Overhead Door
0804 Access Doors
0806 WindowsStorefront
0901 DrywallFraming
0902 Drywall Acoustical
0903 Acoustical Wall Ceiling
0904 Ceramic
0905 VCTResilient
0906 Carpet
0907 Wood Flooring
0908 Painting
C
SCHEDULED VALUE
180000000
856 51400
1942500
4553 00
44311 00
330500
97195200
1200000
3500000
28277500
46632 00
1519000
269400
30017800
34500000
12925700
3831700
61 37500
7176600
4019300
988900
8562500
0 E
WORK COMPLETED (D+E)
FROM PREVIOUS
APPLICATION
180000000
85651400
1942500
455300
44 31100
330500
971 952 00
1200000
3500000
28277500
46 63200
1519000
269400
30017800
34500000
12925700
38 31700
61 37500
7176600
4019300
988900
8562500
THIS PERIOD
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F
MATERIAL PRESENTLY
STORED
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
G
TOTAL COMPLETED AND STORED
TO DATE
180000000
85651400
1942500
455300
4431100
330500
971 95200
1200000
3500000
28277500
46632 00
1519000
2694 00
30017800
34500000
12925700
3831700
6137500
7176600
4019300
988900
8562500
PER- (G C)
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
4 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26 Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E F G H I
ITEM NO
DESCRIPTION OF WORK SCHEDULED VALUE
WORK COMPLETED (D+E)
FROM PREVIOUS THIS
APPLICATION PERIOD
MATERIAL PRESENTLY
STORED
TOTAL COMPLETED AND STORED
TO DATE PER- (G 1C)
BALANCE TO FINISH RETAINAGE
00
1001
1002
1003
1004
Original Contract
Toilet Partitions
Toilet Accessories
Aluminum Louvers
Flagpoles
391000
1686300
312300
213500
391000
1686300
312300
213500
000
000
000
000
000
000
000
000
391000
1686300
312300
213500
10000
10000
10000
10000
000
000
000
000
I 000 I
I
000 I
000 I
000 I
1005
1006
1007
1008
ChalkTackMarker Boards
Signage
Lockers
Fire Extinguishers
3800000
6979000
4070000
255600
3800000
6979000
40700 00
255600
000
000
000
000
000
000
000
000
38000 00
6979000
4070000
2556 00
10000
10000
10000
10000
000
000
000
000
000 I
I
000 I
000 I
000 I
1009
1101
Fire Dept Knox Box
Stage Curtains
41100
773600
411 00
773600
000
000
000
000
411 00
773600
10000
10000
000
000
000 I
000 I
1102 Projection Screen 695600 6956 00 000 000 6956 00 10000 000 000
11 03 Dock Equipment 124800 124800 000 000 124800 10000 000 000
1104 Food Service Equipment 307446 00 30744600 000 000 30744600 10000 000 000
1105 Ressidential Appliances 361500 361500 000 000 361500 10000 000 000
1106 Shop EquipmentPottery Klin 2423 00 242300 000 000 242300 10000 000 000
11 07 Athletic Equipment 34631 00 34631 00 000 000 34 631 00 10000 000 000
1201 Blinds 1002000 1002000 000 000 10020 00 10000 000 000
1202 Entrance Mats 3511 00 3511 00 000 000 3511 00 10000 000 000
1203 Manufactured Casework 35894500 35894500 000 000 35894500 10000 000 000
1204 Telescoping Bleachers 2020000 2020000 000 000 2020000 10000 000 000
1301 Trellis 2463700 2463700 000 000 2463700 10000 000 000
1401 Elevators 5850000 5850000 000 000 5850000 10000 000 000
5 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
00 Original Contract
1501 Sprinkler 107671 00 107671 00 000
1502 Plumbing 557901 00 55790100 000
1503 HVAC 181314100 1813141 00 000
1601 Electrical 168828700 168828700 000
000 000 000
Original Contract Total 1547935900 1547361435 5 74465
01 Change Order 1
6003 Unforseen Conditions removal of 132700 132700 000
dead animal from project sit
6004 Unforseen Condition- rock removal 149300 149300 000
6005 Unforseen Condition- stone 784400 784400 000
beddingon 36 pipe due to exsit
6006 Regulatory Review Comments 2037600 2037600 000
6008 Earthwork- Rock Removal 202 00 202 00 000
Change Order 1 Total 3124200 3124200 000
02 Change Order2
6010 Take Down existing playground 651900 651900 000
equipment
Change Order2 Total 651900 651900 000
03 Change Order 3
6012 Stie Changes - Owner chanage G-3 1430800 1430800 000
6013 Revised structural steel bracing 69600 69600 000
- - -shy -shy -shy - -shy -shy -shy -
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1C)
000 107671 00 10000
000 557901 00 10000
000 1813141 00 10000
000 168828700 10000
000 000
--shy000 1547935900 10000
000 132700 10000
000 149300 10000
000 784400 10000
000 20 37600 10000
000 20200 10000
--shy000 3124200 10000
000 651900 10000
--shy000 651900 10000
000 1430800 10000
000 69600 10000
- - - - -
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
- -shy
6 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NOIn tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICA TION PERIOD
03 Change Order 3
6014 Playground installation 11018000 11018000
6015 Change rigid insulationldelete -2012300 -2012300
sidewalk
Change Order 3 Total 10506100 10506100
04 Change Order 4
6016 Delete playground add form OCO3 -6 51900 -651900
Change Order 4 Total -651900 -651900
05 Change Order 5
6027 Adverse weather days 000 000
Change Order 5 Total 000 000
06 Change Order 6
6017 Delete quantity of concrete sidewalks -2158700 -21 58700
6018 Waterline Relocation 1064700 1064700
6019 Add asphalt paving and concrete pad 1655000 1655000
at dumpster
6020 Delete seeding at existing building -51500 -51500
6021 Change grade at parking area 327000 327000
existing elementary school
6022 Remove unsuitable soil at entrance 1056000 1056000
drive
6023 Add waterproofing at retaining wall 262700 262700
6024 Delete dashboard Allowance -10 50000 -1050000
6025 Change roofing from fully applied to -1926200 -19262 00
mechanially fastened
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1C)
000 11018000 10000
000 -2012300 10000
--shy000 10506100 10000
000 -651900 10000
--shy000 -651900 10000
000 000
--shy000 000
000 -2158700 10000
000 10647 00 10000
000 1655000 10000
000 -51500 10000
000 3270 00 10000
000 1056000 10000
000 262700 10000
000 -1050000 10000
000 -1926200 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
7 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
06 Change Order 6
6026 LEED Changes 13617 00 1361700
Change Order 6 Total 540700 540700
07 Change Order 7
6034 Hardware Change 564400 564400
6035 Food Service Equiment Change 62B00 62B00
6036 Change Door Frame at Electric Room 465 00 46500
6037 Extend Electrical Boxes for LEED 973 00 973 00
Changes
6038 Delete Allowacne for Sign -B56000 -B 56000
6039 Add Sanitary Drain at Dumpster 2B0300 2B0300
6040 Add Hot Water at Toilets 1936700 1936700
6041 Electrical for Media Equipment 735500 7355 00
6042 Deduct Electrical Outlets at front -61500 -61500
Entry
Change Order 7 Total 2806000 2806000
10 Change Order 10
6043 Relocate outdoor freezerlcppoler 155500 155500
units 40 North
6044 Make electrical changes to kitchen 319200 319200
equipment item 37 amp 45
6045 Make electrical change to kitchen 95400 95400
equipment item 8
6046 Extend freezerlcooler units 40 North 64200 64200
Change Order 10 Total 634300 634300
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1 C)
000 1361700 10000
--shy000 540700 10000
000 564400 10000
000 62B00 10000
000 46500 10000
000 97300 10000
000 -B 56000 10000
000 2B0300 10000
000 1936700 10000
000 735500 10000
000 -61500 10000
--shy000 2806000 10000
000 155500 10000
000 319200 10000
000 954 00 10000
000 64200 10000
--shy000 634300 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000 -shy -
I
I
I
I
I
I
I
I
8 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
11 Change Order 11
6047 Site changes related to entry drive 837800 837800 000
6048 Credit to delete 111 sq yrds of heavy -355700 -355700 000
duty asphalt
Change Order 11 Total 482100 482100 000
12 Change Order 12
6049 Electrical changes to provide amp install 947000 947000 000
new data cabinets FB
Change Order 12 Total 947000 947000 000
13 Change Order 13
6051 Change EM Fixtures 1079700 1079700 000
Change Order 13 Total 1079700 1079700 000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G C)
000 837800 10000
000 -355700 10000
--shy000 482100 10000
000 947000 10000
--shy000 947000 10000
000 1079700 10000
--shy000 1079700 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
1568056000 1567481535 574465 000 1568056000 000 000 PROJECT TOTAL
AlA DOCUMENT G703 bull APPLICATION AND CERTIFICATE FOR PAYMENT THE AMERICAN INSTITUE OF ARCHITECTS 1735 NEW YORK AVENUE NW WASHINGTON DC 20006
3 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B
ITEM DESCRIPTION OF WORK NO
00 Original Contract
0401 Masonry
0501 Structural Steel
0502 Miscellaneous Steel
0503 Expansion Joints
0601 Wood Blocking
07 01 FireproofingSafing
07 02 Roof System
0703 Caulk amp Sealant
0704 WaterproofingDam p-Proof
0801 Doors Frames Hardware
0802 Fiberglass Sandwich Panel
0803 Overhead Door
0804 Access Doors
0806 WindowsStorefront
0901 DrywallFraming
0902 Drywall Acoustical
0903 Acoustical Wall Ceiling
0904 Ceramic
0905 VCTResilient
0906 Carpet
0907 Wood Flooring
0908 Painting
C
SCHEDULED VALUE
180000000
856 51400
1942500
4553 00
44311 00
330500
97195200
1200000
3500000
28277500
46632 00
1519000
269400
30017800
34500000
12925700
3831700
61 37500
7176600
4019300
988900
8562500
0 E
WORK COMPLETED (D+E)
FROM PREVIOUS
APPLICATION
180000000
85651400
1942500
455300
44 31100
330500
971 952 00
1200000
3500000
28277500
46 63200
1519000
269400
30017800
34500000
12925700
38 31700
61 37500
7176600
4019300
988900
8562500
THIS PERIOD
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F
MATERIAL PRESENTLY
STORED
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
G
TOTAL COMPLETED AND STORED
TO DATE
180000000
85651400
1942500
455300
4431100
330500
971 95200
1200000
3500000
28277500
46632 00
1519000
2694 00
30017800
34500000
12925700
3831700
6137500
7176600
4019300
988900
8562500
PER- (G C)
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
4 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26 Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E F G H I
ITEM NO
DESCRIPTION OF WORK SCHEDULED VALUE
WORK COMPLETED (D+E)
FROM PREVIOUS THIS
APPLICATION PERIOD
MATERIAL PRESENTLY
STORED
TOTAL COMPLETED AND STORED
TO DATE PER- (G 1C)
BALANCE TO FINISH RETAINAGE
00
1001
1002
1003
1004
Original Contract
Toilet Partitions
Toilet Accessories
Aluminum Louvers
Flagpoles
391000
1686300
312300
213500
391000
1686300
312300
213500
000
000
000
000
000
000
000
000
391000
1686300
312300
213500
10000
10000
10000
10000
000
000
000
000
I 000 I
I
000 I
000 I
000 I
1005
1006
1007
1008
ChalkTackMarker Boards
Signage
Lockers
Fire Extinguishers
3800000
6979000
4070000
255600
3800000
6979000
40700 00
255600
000
000
000
000
000
000
000
000
38000 00
6979000
4070000
2556 00
10000
10000
10000
10000
000
000
000
000
000 I
I
000 I
000 I
000 I
1009
1101
Fire Dept Knox Box
Stage Curtains
41100
773600
411 00
773600
000
000
000
000
411 00
773600
10000
10000
000
000
000 I
000 I
1102 Projection Screen 695600 6956 00 000 000 6956 00 10000 000 000
11 03 Dock Equipment 124800 124800 000 000 124800 10000 000 000
1104 Food Service Equipment 307446 00 30744600 000 000 30744600 10000 000 000
1105 Ressidential Appliances 361500 361500 000 000 361500 10000 000 000
1106 Shop EquipmentPottery Klin 2423 00 242300 000 000 242300 10000 000 000
11 07 Athletic Equipment 34631 00 34631 00 000 000 34 631 00 10000 000 000
1201 Blinds 1002000 1002000 000 000 10020 00 10000 000 000
1202 Entrance Mats 3511 00 3511 00 000 000 3511 00 10000 000 000
1203 Manufactured Casework 35894500 35894500 000 000 35894500 10000 000 000
1204 Telescoping Bleachers 2020000 2020000 000 000 2020000 10000 000 000
1301 Trellis 2463700 2463700 000 000 2463700 10000 000 000
1401 Elevators 5850000 5850000 000 000 5850000 10000 000 000
5 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
00 Original Contract
1501 Sprinkler 107671 00 107671 00 000
1502 Plumbing 557901 00 55790100 000
1503 HVAC 181314100 1813141 00 000
1601 Electrical 168828700 168828700 000
000 000 000
Original Contract Total 1547935900 1547361435 5 74465
01 Change Order 1
6003 Unforseen Conditions removal of 132700 132700 000
dead animal from project sit
6004 Unforseen Condition- rock removal 149300 149300 000
6005 Unforseen Condition- stone 784400 784400 000
beddingon 36 pipe due to exsit
6006 Regulatory Review Comments 2037600 2037600 000
6008 Earthwork- Rock Removal 202 00 202 00 000
Change Order 1 Total 3124200 3124200 000
02 Change Order2
6010 Take Down existing playground 651900 651900 000
equipment
Change Order2 Total 651900 651900 000
03 Change Order 3
6012 Stie Changes - Owner chanage G-3 1430800 1430800 000
6013 Revised structural steel bracing 69600 69600 000
- - -shy -shy -shy - -shy -shy -shy -
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1C)
000 107671 00 10000
000 557901 00 10000
000 1813141 00 10000
000 168828700 10000
000 000
--shy000 1547935900 10000
000 132700 10000
000 149300 10000
000 784400 10000
000 20 37600 10000
000 20200 10000
--shy000 3124200 10000
000 651900 10000
--shy000 651900 10000
000 1430800 10000
000 69600 10000
- - - - -
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
- -shy
6 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NOIn tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICA TION PERIOD
03 Change Order 3
6014 Playground installation 11018000 11018000
6015 Change rigid insulationldelete -2012300 -2012300
sidewalk
Change Order 3 Total 10506100 10506100
04 Change Order 4
6016 Delete playground add form OCO3 -6 51900 -651900
Change Order 4 Total -651900 -651900
05 Change Order 5
6027 Adverse weather days 000 000
Change Order 5 Total 000 000
06 Change Order 6
6017 Delete quantity of concrete sidewalks -2158700 -21 58700
6018 Waterline Relocation 1064700 1064700
6019 Add asphalt paving and concrete pad 1655000 1655000
at dumpster
6020 Delete seeding at existing building -51500 -51500
6021 Change grade at parking area 327000 327000
existing elementary school
6022 Remove unsuitable soil at entrance 1056000 1056000
drive
6023 Add waterproofing at retaining wall 262700 262700
6024 Delete dashboard Allowance -10 50000 -1050000
6025 Change roofing from fully applied to -1926200 -19262 00
mechanially fastened
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1C)
000 11018000 10000
000 -2012300 10000
--shy000 10506100 10000
000 -651900 10000
--shy000 -651900 10000
000 000
--shy000 000
000 -2158700 10000
000 10647 00 10000
000 1655000 10000
000 -51500 10000
000 3270 00 10000
000 1056000 10000
000 262700 10000
000 -1050000 10000
000 -1926200 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
7 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
06 Change Order 6
6026 LEED Changes 13617 00 1361700
Change Order 6 Total 540700 540700
07 Change Order 7
6034 Hardware Change 564400 564400
6035 Food Service Equiment Change 62B00 62B00
6036 Change Door Frame at Electric Room 465 00 46500
6037 Extend Electrical Boxes for LEED 973 00 973 00
Changes
6038 Delete Allowacne for Sign -B56000 -B 56000
6039 Add Sanitary Drain at Dumpster 2B0300 2B0300
6040 Add Hot Water at Toilets 1936700 1936700
6041 Electrical for Media Equipment 735500 7355 00
6042 Deduct Electrical Outlets at front -61500 -61500
Entry
Change Order 7 Total 2806000 2806000
10 Change Order 10
6043 Relocate outdoor freezerlcppoler 155500 155500
units 40 North
6044 Make electrical changes to kitchen 319200 319200
equipment item 37 amp 45
6045 Make electrical change to kitchen 95400 95400
equipment item 8
6046 Extend freezerlcooler units 40 North 64200 64200
Change Order 10 Total 634300 634300
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1 C)
000 1361700 10000
--shy000 540700 10000
000 564400 10000
000 62B00 10000
000 46500 10000
000 97300 10000
000 -B 56000 10000
000 2B0300 10000
000 1936700 10000
000 735500 10000
000 -61500 10000
--shy000 2806000 10000
000 155500 10000
000 319200 10000
000 954 00 10000
000 64200 10000
--shy000 634300 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000 -shy -
I
I
I
I
I
I
I
I
8 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
11 Change Order 11
6047 Site changes related to entry drive 837800 837800 000
6048 Credit to delete 111 sq yrds of heavy -355700 -355700 000
duty asphalt
Change Order 11 Total 482100 482100 000
12 Change Order 12
6049 Electrical changes to provide amp install 947000 947000 000
new data cabinets FB
Change Order 12 Total 947000 947000 000
13 Change Order 13
6051 Change EM Fixtures 1079700 1079700 000
Change Order 13 Total 1079700 1079700 000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G C)
000 837800 10000
000 -355700 10000
--shy000 482100 10000
000 947000 10000
--shy000 947000 10000
000 1079700 10000
--shy000 1079700 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
1568056000 1567481535 574465 000 1568056000 000 000 PROJECT TOTAL
AlA DOCUMENT G703 bull APPLICATION AND CERTIFICATE FOR PAYMENT THE AMERICAN INSTITUE OF ARCHITECTS 1735 NEW YORK AVENUE NW WASHINGTON DC 20006
4 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26 Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E F G H I
ITEM NO
DESCRIPTION OF WORK SCHEDULED VALUE
WORK COMPLETED (D+E)
FROM PREVIOUS THIS
APPLICATION PERIOD
MATERIAL PRESENTLY
STORED
TOTAL COMPLETED AND STORED
TO DATE PER- (G 1C)
BALANCE TO FINISH RETAINAGE
00
1001
1002
1003
1004
Original Contract
Toilet Partitions
Toilet Accessories
Aluminum Louvers
Flagpoles
391000
1686300
312300
213500
391000
1686300
312300
213500
000
000
000
000
000
000
000
000
391000
1686300
312300
213500
10000
10000
10000
10000
000
000
000
000
I 000 I
I
000 I
000 I
000 I
1005
1006
1007
1008
ChalkTackMarker Boards
Signage
Lockers
Fire Extinguishers
3800000
6979000
4070000
255600
3800000
6979000
40700 00
255600
000
000
000
000
000
000
000
000
38000 00
6979000
4070000
2556 00
10000
10000
10000
10000
000
000
000
000
000 I
I
000 I
000 I
000 I
1009
1101
Fire Dept Knox Box
Stage Curtains
41100
773600
411 00
773600
000
000
000
000
411 00
773600
10000
10000
000
000
000 I
000 I
1102 Projection Screen 695600 6956 00 000 000 6956 00 10000 000 000
11 03 Dock Equipment 124800 124800 000 000 124800 10000 000 000
1104 Food Service Equipment 307446 00 30744600 000 000 30744600 10000 000 000
1105 Ressidential Appliances 361500 361500 000 000 361500 10000 000 000
1106 Shop EquipmentPottery Klin 2423 00 242300 000 000 242300 10000 000 000
11 07 Athletic Equipment 34631 00 34631 00 000 000 34 631 00 10000 000 000
1201 Blinds 1002000 1002000 000 000 10020 00 10000 000 000
1202 Entrance Mats 3511 00 3511 00 000 000 3511 00 10000 000 000
1203 Manufactured Casework 35894500 35894500 000 000 35894500 10000 000 000
1204 Telescoping Bleachers 2020000 2020000 000 000 2020000 10000 000 000
1301 Trellis 2463700 2463700 000 000 2463700 10000 000 000
1401 Elevators 5850000 5850000 000 000 5850000 10000 000 000
5 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
00 Original Contract
1501 Sprinkler 107671 00 107671 00 000
1502 Plumbing 557901 00 55790100 000
1503 HVAC 181314100 1813141 00 000
1601 Electrical 168828700 168828700 000
000 000 000
Original Contract Total 1547935900 1547361435 5 74465
01 Change Order 1
6003 Unforseen Conditions removal of 132700 132700 000
dead animal from project sit
6004 Unforseen Condition- rock removal 149300 149300 000
6005 Unforseen Condition- stone 784400 784400 000
beddingon 36 pipe due to exsit
6006 Regulatory Review Comments 2037600 2037600 000
6008 Earthwork- Rock Removal 202 00 202 00 000
Change Order 1 Total 3124200 3124200 000
02 Change Order2
6010 Take Down existing playground 651900 651900 000
equipment
Change Order2 Total 651900 651900 000
03 Change Order 3
6012 Stie Changes - Owner chanage G-3 1430800 1430800 000
6013 Revised structural steel bracing 69600 69600 000
- - -shy -shy -shy - -shy -shy -shy -
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1C)
000 107671 00 10000
000 557901 00 10000
000 1813141 00 10000
000 168828700 10000
000 000
--shy000 1547935900 10000
000 132700 10000
000 149300 10000
000 784400 10000
000 20 37600 10000
000 20200 10000
--shy000 3124200 10000
000 651900 10000
--shy000 651900 10000
000 1430800 10000
000 69600 10000
- - - - -
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
- -shy
6 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NOIn tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICA TION PERIOD
03 Change Order 3
6014 Playground installation 11018000 11018000
6015 Change rigid insulationldelete -2012300 -2012300
sidewalk
Change Order 3 Total 10506100 10506100
04 Change Order 4
6016 Delete playground add form OCO3 -6 51900 -651900
Change Order 4 Total -651900 -651900
05 Change Order 5
6027 Adverse weather days 000 000
Change Order 5 Total 000 000
06 Change Order 6
6017 Delete quantity of concrete sidewalks -2158700 -21 58700
6018 Waterline Relocation 1064700 1064700
6019 Add asphalt paving and concrete pad 1655000 1655000
at dumpster
6020 Delete seeding at existing building -51500 -51500
6021 Change grade at parking area 327000 327000
existing elementary school
6022 Remove unsuitable soil at entrance 1056000 1056000
drive
6023 Add waterproofing at retaining wall 262700 262700
6024 Delete dashboard Allowance -10 50000 -1050000
6025 Change roofing from fully applied to -1926200 -19262 00
mechanially fastened
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1C)
000 11018000 10000
000 -2012300 10000
--shy000 10506100 10000
000 -651900 10000
--shy000 -651900 10000
000 000
--shy000 000
000 -2158700 10000
000 10647 00 10000
000 1655000 10000
000 -51500 10000
000 3270 00 10000
000 1056000 10000
000 262700 10000
000 -1050000 10000
000 -1926200 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
7 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
06 Change Order 6
6026 LEED Changes 13617 00 1361700
Change Order 6 Total 540700 540700
07 Change Order 7
6034 Hardware Change 564400 564400
6035 Food Service Equiment Change 62B00 62B00
6036 Change Door Frame at Electric Room 465 00 46500
6037 Extend Electrical Boxes for LEED 973 00 973 00
Changes
6038 Delete Allowacne for Sign -B56000 -B 56000
6039 Add Sanitary Drain at Dumpster 2B0300 2B0300
6040 Add Hot Water at Toilets 1936700 1936700
6041 Electrical for Media Equipment 735500 7355 00
6042 Deduct Electrical Outlets at front -61500 -61500
Entry
Change Order 7 Total 2806000 2806000
10 Change Order 10
6043 Relocate outdoor freezerlcppoler 155500 155500
units 40 North
6044 Make electrical changes to kitchen 319200 319200
equipment item 37 amp 45
6045 Make electrical change to kitchen 95400 95400
equipment item 8
6046 Extend freezerlcooler units 40 North 64200 64200
Change Order 10 Total 634300 634300
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1 C)
000 1361700 10000
--shy000 540700 10000
000 564400 10000
000 62B00 10000
000 46500 10000
000 97300 10000
000 -B 56000 10000
000 2B0300 10000
000 1936700 10000
000 735500 10000
000 -61500 10000
--shy000 2806000 10000
000 155500 10000
000 319200 10000
000 954 00 10000
000 64200 10000
--shy000 634300 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000 -shy -
I
I
I
I
I
I
I
I
8 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
11 Change Order 11
6047 Site changes related to entry drive 837800 837800 000
6048 Credit to delete 111 sq yrds of heavy -355700 -355700 000
duty asphalt
Change Order 11 Total 482100 482100 000
12 Change Order 12
6049 Electrical changes to provide amp install 947000 947000 000
new data cabinets FB
Change Order 12 Total 947000 947000 000
13 Change Order 13
6051 Change EM Fixtures 1079700 1079700 000
Change Order 13 Total 1079700 1079700 000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G C)
000 837800 10000
000 -355700 10000
--shy000 482100 10000
000 947000 10000
--shy000 947000 10000
000 1079700 10000
--shy000 1079700 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
1568056000 1567481535 574465 000 1568056000 000 000 PROJECT TOTAL
AlA DOCUMENT G703 bull APPLICATION AND CERTIFICATE FOR PAYMENT THE AMERICAN INSTITUE OF ARCHITECTS 1735 NEW YORK AVENUE NW WASHINGTON DC 20006
5 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
00 Original Contract
1501 Sprinkler 107671 00 107671 00 000
1502 Plumbing 557901 00 55790100 000
1503 HVAC 181314100 1813141 00 000
1601 Electrical 168828700 168828700 000
000 000 000
Original Contract Total 1547935900 1547361435 5 74465
01 Change Order 1
6003 Unforseen Conditions removal of 132700 132700 000
dead animal from project sit
6004 Unforseen Condition- rock removal 149300 149300 000
6005 Unforseen Condition- stone 784400 784400 000
beddingon 36 pipe due to exsit
6006 Regulatory Review Comments 2037600 2037600 000
6008 Earthwork- Rock Removal 202 00 202 00 000
Change Order 1 Total 3124200 3124200 000
02 Change Order2
6010 Take Down existing playground 651900 651900 000
equipment
Change Order2 Total 651900 651900 000
03 Change Order 3
6012 Stie Changes - Owner chanage G-3 1430800 1430800 000
6013 Revised structural steel bracing 69600 69600 000
- - -shy -shy -shy - -shy -shy -shy -
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1C)
000 107671 00 10000
000 557901 00 10000
000 1813141 00 10000
000 168828700 10000
000 000
--shy000 1547935900 10000
000 132700 10000
000 149300 10000
000 784400 10000
000 20 37600 10000
000 20200 10000
--shy000 3124200 10000
000 651900 10000
--shy000 651900 10000
000 1430800 10000
000 69600 10000
- - - - -
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
- -shy
6 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NOIn tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICA TION PERIOD
03 Change Order 3
6014 Playground installation 11018000 11018000
6015 Change rigid insulationldelete -2012300 -2012300
sidewalk
Change Order 3 Total 10506100 10506100
04 Change Order 4
6016 Delete playground add form OCO3 -6 51900 -651900
Change Order 4 Total -651900 -651900
05 Change Order 5
6027 Adverse weather days 000 000
Change Order 5 Total 000 000
06 Change Order 6
6017 Delete quantity of concrete sidewalks -2158700 -21 58700
6018 Waterline Relocation 1064700 1064700
6019 Add asphalt paving and concrete pad 1655000 1655000
at dumpster
6020 Delete seeding at existing building -51500 -51500
6021 Change grade at parking area 327000 327000
existing elementary school
6022 Remove unsuitable soil at entrance 1056000 1056000
drive
6023 Add waterproofing at retaining wall 262700 262700
6024 Delete dashboard Allowance -10 50000 -1050000
6025 Change roofing from fully applied to -1926200 -19262 00
mechanially fastened
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1C)
000 11018000 10000
000 -2012300 10000
--shy000 10506100 10000
000 -651900 10000
--shy000 -651900 10000
000 000
--shy000 000
000 -2158700 10000
000 10647 00 10000
000 1655000 10000
000 -51500 10000
000 3270 00 10000
000 1056000 10000
000 262700 10000
000 -1050000 10000
000 -1926200 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
7 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
06 Change Order 6
6026 LEED Changes 13617 00 1361700
Change Order 6 Total 540700 540700
07 Change Order 7
6034 Hardware Change 564400 564400
6035 Food Service Equiment Change 62B00 62B00
6036 Change Door Frame at Electric Room 465 00 46500
6037 Extend Electrical Boxes for LEED 973 00 973 00
Changes
6038 Delete Allowacne for Sign -B56000 -B 56000
6039 Add Sanitary Drain at Dumpster 2B0300 2B0300
6040 Add Hot Water at Toilets 1936700 1936700
6041 Electrical for Media Equipment 735500 7355 00
6042 Deduct Electrical Outlets at front -61500 -61500
Entry
Change Order 7 Total 2806000 2806000
10 Change Order 10
6043 Relocate outdoor freezerlcppoler 155500 155500
units 40 North
6044 Make electrical changes to kitchen 319200 319200
equipment item 37 amp 45
6045 Make electrical change to kitchen 95400 95400
equipment item 8
6046 Extend freezerlcooler units 40 North 64200 64200
Change Order 10 Total 634300 634300
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1 C)
000 1361700 10000
--shy000 540700 10000
000 564400 10000
000 62B00 10000
000 46500 10000
000 97300 10000
000 -B 56000 10000
000 2B0300 10000
000 1936700 10000
000 735500 10000
000 -61500 10000
--shy000 2806000 10000
000 155500 10000
000 319200 10000
000 954 00 10000
000 64200 10000
--shy000 634300 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000 -shy -
I
I
I
I
I
I
I
I
8 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
11 Change Order 11
6047 Site changes related to entry drive 837800 837800 000
6048 Credit to delete 111 sq yrds of heavy -355700 -355700 000
duty asphalt
Change Order 11 Total 482100 482100 000
12 Change Order 12
6049 Electrical changes to provide amp install 947000 947000 000
new data cabinets FB
Change Order 12 Total 947000 947000 000
13 Change Order 13
6051 Change EM Fixtures 1079700 1079700 000
Change Order 13 Total 1079700 1079700 000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G C)
000 837800 10000
000 -355700 10000
--shy000 482100 10000
000 947000 10000
--shy000 947000 10000
000 1079700 10000
--shy000 1079700 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
1568056000 1567481535 574465 000 1568056000 000 000 PROJECT TOTAL
AlA DOCUMENT G703 bull APPLICATION AND CERTIFICATE FOR PAYMENT THE AMERICAN INSTITUE OF ARCHITECTS 1735 NEW YORK AVENUE NW WASHINGTON DC 20006
6 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NOIn tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICA TION PERIOD
03 Change Order 3
6014 Playground installation 11018000 11018000
6015 Change rigid insulationldelete -2012300 -2012300
sidewalk
Change Order 3 Total 10506100 10506100
04 Change Order 4
6016 Delete playground add form OCO3 -6 51900 -651900
Change Order 4 Total -651900 -651900
05 Change Order 5
6027 Adverse weather days 000 000
Change Order 5 Total 000 000
06 Change Order 6
6017 Delete quantity of concrete sidewalks -2158700 -21 58700
6018 Waterline Relocation 1064700 1064700
6019 Add asphalt paving and concrete pad 1655000 1655000
at dumpster
6020 Delete seeding at existing building -51500 -51500
6021 Change grade at parking area 327000 327000
existing elementary school
6022 Remove unsuitable soil at entrance 1056000 1056000
drive
6023 Add waterproofing at retaining wall 262700 262700
6024 Delete dashboard Allowance -10 50000 -1050000
6025 Change roofing from fully applied to -1926200 -19262 00
mechanially fastened
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1C)
000 11018000 10000
000 -2012300 10000
--shy000 10506100 10000
000 -651900 10000
--shy000 -651900 10000
000 000
--shy000 000
000 -2158700 10000
000 10647 00 10000
000 1655000 10000
000 -51500 10000
000 3270 00 10000
000 1056000 10000
000 262700 10000
000 -1050000 10000
000 -1926200 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
7 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
06 Change Order 6
6026 LEED Changes 13617 00 1361700
Change Order 6 Total 540700 540700
07 Change Order 7
6034 Hardware Change 564400 564400
6035 Food Service Equiment Change 62B00 62B00
6036 Change Door Frame at Electric Room 465 00 46500
6037 Extend Electrical Boxes for LEED 973 00 973 00
Changes
6038 Delete Allowacne for Sign -B56000 -B 56000
6039 Add Sanitary Drain at Dumpster 2B0300 2B0300
6040 Add Hot Water at Toilets 1936700 1936700
6041 Electrical for Media Equipment 735500 7355 00
6042 Deduct Electrical Outlets at front -61500 -61500
Entry
Change Order 7 Total 2806000 2806000
10 Change Order 10
6043 Relocate outdoor freezerlcppoler 155500 155500
units 40 North
6044 Make electrical changes to kitchen 319200 319200
equipment item 37 amp 45
6045 Make electrical change to kitchen 95400 95400
equipment item 8
6046 Extend freezerlcooler units 40 North 64200 64200
Change Order 10 Total 634300 634300
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1 C)
000 1361700 10000
--shy000 540700 10000
000 564400 10000
000 62B00 10000
000 46500 10000
000 97300 10000
000 -B 56000 10000
000 2B0300 10000
000 1936700 10000
000 735500 10000
000 -61500 10000
--shy000 2806000 10000
000 155500 10000
000 319200 10000
000 954 00 10000
000 64200 10000
--shy000 634300 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000 -shy -
I
I
I
I
I
I
I
I
8 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
11 Change Order 11
6047 Site changes related to entry drive 837800 837800 000
6048 Credit to delete 111 sq yrds of heavy -355700 -355700 000
duty asphalt
Change Order 11 Total 482100 482100 000
12 Change Order 12
6049 Electrical changes to provide amp install 947000 947000 000
new data cabinets FB
Change Order 12 Total 947000 947000 000
13 Change Order 13
6051 Change EM Fixtures 1079700 1079700 000
Change Order 13 Total 1079700 1079700 000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G C)
000 837800 10000
000 -355700 10000
--shy000 482100 10000
000 947000 10000
--shy000 947000 10000
000 1079700 10000
--shy000 1079700 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
1568056000 1567481535 574465 000 1568056000 000 000 PROJECT TOTAL
AlA DOCUMENT G703 bull APPLICATION AND CERTIFICATE FOR PAYMENT THE AMERICAN INSTITUE OF ARCHITECTS 1735 NEW YORK AVENUE NW WASHINGTON DC 20006
7 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
06 Change Order 6
6026 LEED Changes 13617 00 1361700
Change Order 6 Total 540700 540700
07 Change Order 7
6034 Hardware Change 564400 564400
6035 Food Service Equiment Change 62B00 62B00
6036 Change Door Frame at Electric Room 465 00 46500
6037 Extend Electrical Boxes for LEED 973 00 973 00
Changes
6038 Delete Allowacne for Sign -B56000 -B 56000
6039 Add Sanitary Drain at Dumpster 2B0300 2B0300
6040 Add Hot Water at Toilets 1936700 1936700
6041 Electrical for Media Equipment 735500 7355 00
6042 Deduct Electrical Outlets at front -61500 -61500
Entry
Change Order 7 Total 2806000 2806000
10 Change Order 10
6043 Relocate outdoor freezerlcppoler 155500 155500
units 40 North
6044 Make electrical changes to kitchen 319200 319200
equipment item 37 amp 45
6045 Make electrical change to kitchen 95400 95400
equipment item 8
6046 Extend freezerlcooler units 40 North 64200 64200
Change Order 10 Total 634300 634300
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G 1 C)
000 1361700 10000
--shy000 540700 10000
000 564400 10000
000 62B00 10000
000 46500 10000
000 97300 10000
000 -B 56000 10000
000 2B0300 10000
000 1936700 10000
000 735500 10000
000 -61500 10000
--shy000 2806000 10000
000 155500 10000
000 319200 10000
000 954 00 10000
000 64200 10000
--shy000 634300 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000
000 -shy -
I
I
I
I
I
I
I
I
8 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
11 Change Order 11
6047 Site changes related to entry drive 837800 837800 000
6048 Credit to delete 111 sq yrds of heavy -355700 -355700 000
duty asphalt
Change Order 11 Total 482100 482100 000
12 Change Order 12
6049 Electrical changes to provide amp install 947000 947000 000
new data cabinets FB
Change Order 12 Total 947000 947000 000
13 Change Order 13
6051 Change EM Fixtures 1079700 1079700 000
Change Order 13 Total 1079700 1079700 000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G C)
000 837800 10000
000 -355700 10000
--shy000 482100 10000
000 947000 10000
--shy000 947000 10000
000 1079700 10000
--shy000 1079700 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
1568056000 1567481535 574465 000 1568056000 000 000 PROJECT TOTAL
AlA DOCUMENT G703 bull APPLICATION AND CERTIFICATE FOR PAYMENT THE AMERICAN INSTITUE OF ARCHITECTS 1735 NEW YORK AVENUE NW WASHINGTON DC 20006
8 CONTINUATION SHEET AlA DOCUMENT G703 PAGE AlA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT containing APPLICATION NUMBER 26Contractors signed Certification is attached
APPLICATION DATE 06252013 INVOICE NO In tabulation below amounts are stated to the nearest cent
PERIOD TO 06252013 090300229Use Column I on Contracts where variable retainage for line items may apply
A B C 0 E
WORK COMPLETED (D+E) ITEM DESCRIPTION OF WORK SCHEDULED NO VALUE FROM
PREVIOUS THIS APPLICATION PERIOD
11 Change Order 11
6047 Site changes related to entry drive 837800 837800 000
6048 Credit to delete 111 sq yrds of heavy -355700 -355700 000
duty asphalt
Change Order 11 Total 482100 482100 000
12 Change Order 12
6049 Electrical changes to provide amp install 947000 947000 000
new data cabinets FB
Change Order 12 Total 947000 947000 000
13 Change Order 13
6051 Change EM Fixtures 1079700 1079700 000
Change Order 13 Total 1079700 1079700 000
F G
TOTAL MATERIAL COMPLETED
PRESENTLY AND STORED PER- STORED TO DATE (G C)
000 837800 10000
000 -355700 10000
--shy000 482100 10000
000 947000 10000
--shy000 947000 10000
000 1079700 10000
--shy000 1079700 10000
H
BALANCE TO FINISH
000
000
000
000
000
000
000
I
RETAINAGE
000
000
000
000
000
000
000
1568056000 1567481535 574465 000 1568056000 000 000 PROJECT TOTAL
AlA DOCUMENT G703 bull APPLICATION AND CERTIFICATE FOR PAYMENT THE AMERICAN INSTITUE OF ARCHITECTS 1735 NEW YORK AVENUE NW WASHINGTON DC 20006