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APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 (Inscructions on reverse side) PAGE ONE OF PAGES <br />TO OWNER: Marion Co. & Salem Area Transit <br />Attn: John Whittineton <br />3140 Del Webb Ave NE <br />Salem.OR 97303-4165 <br />FROM CONTRACTOR: Pence/Kelly Construction, Inc. <br />PO Box 4109 <br />Salem, OR 97302-8109 <br />CONTRACT FOR: <br />PROJECT: Courthouse Sauare <br />Court & High Streets <br />Salem, OR 97301 <br />VIA ARCHITECT: Arbuckle Costic Architects <br />363 State Street <br />Salem, OR 97301-3533 <br />APPLICATION NO.: 9900600018 Distribution to: <br />PERIOD TO: 6/30/00 ~] OWNER <br />PROJECT NOS.: 99-006 ~1 ARCHITECT <br /> $] CONTRACTOR <br />CONTRACT DATE: 2/17/99 ~'7 P/K - DH <br /> ~7 P/K - MS <br />-_ _ <br />The undersigned Contractor certifies that to the best of the Contractor's knowledge, in or- <br />CONTRACTOR'S APPLICATION FOR PAYMENT mation and belief the Work covered by this Application for Payment has been completed <br />Application is made for payment, as shown below, in connection wlth the Contract. in accordance with the Contract Documents, that all amounts have been paid by the <br />Continuation Sheet, AIA Document G703, is attached. Contractor for Work for which previous Certificates for Payment were issued and pay- <br />18,459.484.00 ments received from he~Owner, and that current payment shown herein is now due. <br />t . ORIGINAL CONTRAG? SUM . . . . . . . . . . . . . . . . . . t Pen~ elly Construction, Inc. <br />2,067,180.00 ~ TRA OR: <br />z . Net change by Change Orclers . . . . . . . . . . . . . . . E <br />3. CONTRACT SUM TO DATE (Line 1 t 2) •••••••• E 20,526,664.00 By: Date: 6/26/00 <br />4. TOTAL COMPLETED & STORED TO DATE ...... E 18,054,861.00 <br />(Column G on G703) • <br />5. RETAINAGE: <br />a. ~Q~ of Completed Work t 0.00 <br />(Columns D + E on G703) <br />b. ~.Q06 of Stored Material ~ 0.00 <br />(Column F on G703) <br />Total Retainage (Line 5a + Sb or <br />TotalinColumnlofG703)••.•~•• •~•••••••~ 0.00 <br />6 . TOTAL EARNED LESS RETAINAGE . . . . . . . . . . . . t 18,054,861.00 <br />(Line 4 less Line 5 Total) <br />?. LESS PREVIOUS CERTIFICATES FOR PAYMENT <br />(Line 6 from prior Certificate) . . . . . . . . . . . . . . . . . E 17,019,329.00 <br />8. CURRENT PAYMENT DUE . . . . . . . . . . . . . . . . . E 1,035,532.0 <br />9. BALANCE TO FINISH, INCLUDING RETAINAGE 2~471,803.00 <br />(Line 3 less Line 6) ~ <br />CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS <br />Total changes approved in <br />previous months by Owner 1,969,068.0 -14,806.0 <br />Toral approved this Month + • <br /> <br />TOTALS <br />' ' ' _ <br />' ~ <br />NET CHANGES by Change Order ~ ~ ' <br />State of: Oregon <br />County of: Marion <br />Subscribed and sworn to before ~ <br />me this 26~ da of Ju _ OFFICIAL SEAL ~, <br />~~"`'' '<=_ PA~±TT'liEW L SMITtI' <br />~ ~~" ~07ARY PU6LiC - OREGQN <br />Notar Public: . C0~".kISSlON N0, 303013 <br />y ti'f COk~E~iISS10W [YPIRES JULY 14, 2001 <br />My Commission expires: July 14, 2001 _ <br />ARCHITECT'S CERTIFICATE FOR PAYMENT ~'~ <br />In accordance with the Contract Documents, based on on-site observations and the data <br />comprising this application, the Architect certifies to the Owner that to the best of the <br />Architect's knowledge, information and belief the Work has progressed as indicated, the <br />quality of the Work is in accordance with the Contract Documents, and the Contractor <br />is entitled to payment of the AMOUNT CERTIFIED. • <br />AMOUNT CERTIFIED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . t I . D?~5 . 53Z. eo <br />(Attach explanation if amount certified dijfers from the amount applied for. Initiai <br />all figures on this A plication and on the Continuation Sheet that are changed to <br />conform to the am nt certifi .) <br />ARCH Arb 1 stic Architects <br />By; Date: ~ <br />This erti icate is not negotiable. The AM CERTIFIED is paya le on to the Con- <br />tractor named herein. Issuance, payment and acceptance of payment are withoul~( <br />prejudice to any rights of the Owner or Contractor under this Contract. <br />AIA DOCUMENT G702 • APPLiGTION AND CERTIFICATE FOR PAYMENT • 1992 EDITION • AIA~ • 01992 • THE AMERtCAN iNSTITU'fE OF ARCHITECTS, 1735 NEW YORK \? <br />AVENUE, N W., WASHINGTON, D.C. 2000Cr5292 • WARNING: Unlicensed photocopying violates U.S. copy~ight Iaws and witl sub~ect the vtoletor to legel prosecution. <br />s~ .ia <br />CA If1N~ rF+u nh~utd u!ea nn eriolnnl AIA documwnt which hps this cnutlon prMted In red. An oriqinel nssurea thet c henqes w i i l no t be o bscure d ns mey oc c u r w h e n d o c u m e n t s e r e <br />