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ent by: STATON CONSTRUCTION
<br />~'~LICAr1Qt•: pt~1 CER7FFICAiE r!}R FaYPicNT
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<br />1 541 461 0545; 10!OB!97 d:52PM;~ #7B; Page 2!3
<br />PROJ~~T: 1~Fii0H CD/SA~~t~ LEMO
<br />220 iiIGH ST.
<br />SALE^I, Ok 9,3i~
<br />ViR (ARCtfIIECT):
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<br />AF~?LICAiION rJO; 8 pAT~ ~311~l97
<br />~FI~w ;u: +~5/1~/57
<br />AR~HITE~7'S
<br />~~OJECT NG:
<br />Cdt~TRgET DATE;
<br />CQNFKACT FQk:
<br />AU-?T:[fhS ! AEDL'i:?IGtvS 1
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<br />+e ur+dersigr,ed Gor}tractor certifies tt~at tr, the besi ~f th
<br />~ntractar'S knawle~ge, tnfor~atier~ and hely4P thF wor{~
<br />~~rered ~ry t~~is Fp~Iicativn for F~ay~er,t has been co2plEted
<br />~ u~cordar,ce with the Contrac# Aocuaent~, t!:at all aeount;
<br />~ve oeen Fb:d by tt~e Contractar for wc~~^k fo~ v;hic,*~ previou
<br />~rtificate5 ror uaymant wer•e i~saed and payoents received
<br />°aa the 4w~~er, ar~d that current payaent sho~,n hereir~ is no
<br />~e.
<br />~1TRAC7Qk:
<br />-~~r ~~.-c~~ Lata: ia _
<br />.,-~1,,.iG:/iiC_~ ~c:- /_=' l~
<br />:t~lI IECT+ 5 L~RT I~I CATE FtJ~t PAY~1~17
<br />ac~orGance aith Che Cortract Ducu~ents, 1~sed cn r,n-site
<br />~ervatians and the data caeprising tr,e abuve appltcatzan
<br />e Ar:hiter~t certif~es to the tlwr~er tt~at tu tne hest ~f th
<br />t~h:tect's kr~okledge, ii,far~attor, and belief the Work has
<br />ogresse~ as indicated, t~~e quality of the Work i: in
<br />~oruance with tha Contratt Aocueents, and ;he Cantrcrtor
<br />~*~*it;ed to paynent of the pMpUt4T CERTIFIkA.
<br />CnI5I1~t1.. CCtAfi.4ACT SUM ~1~~, ~,??. UC>- -•. __
<br />NET C~+Ah6E BY C,~h~aE Or"~D~RS a1,o16.oo
<br />CCItdTARC7 SUM Tu DF'iTE J77f J7J. 0~
<br />7aTNL ~AMPLETtD AND STOR~B TQ DATE 559,595.~~~t
<br />RETA INR[iE :
<br />~.en of Cczapleted WU: k ~;.'~~i:.~:`
<br />S.~'r~ G~ ~toi^"rd Mdt~T'1d1
<br />Total ketainage ~9,979.?5
<br />~fQ i RL E~iti~Ep LcSS k~TA i N~~ 5b9, 61 ~. ~
<br />LESS RREUIEI'J5 EEft71FICATES Qr 3AY19~1~iT 49c'~65~.4~5 ~,
<br />CUkRE~tT SF~LES TAX : ~ ~ :~ $
<br />~ ~. •, ~
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<br />3.~7. of 7axaDle Aeaunt }"•"~;
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<br />Current SaIeS Tdx o U n; ~;,,
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<br />CURR`cNT PAYMEIlT DUE '6, 465. ~'fd ~ ~ ~~
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<br />w SALA~! FItlISH~ IM11~bIM1~G ~7RTNAC~ ~4,475.?` ! ,~
<br />~ ~ ~ -=~~.
<br />~~ / ;51.~
<br />State of: ~~'~i~'7 ;ounty af: ~~,/'L.~- _._ . ____
<br />~~ 5uGSCriGed and sworn to befnre ue this~•~-~l day of~`~^~ ,~yQ 7
<br />- ~1y CQ11415510n Pxpll^E5: ,~r~y~~~
<br />A~IOUM1tT ~R7IFIEG y ~ y
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<br />This ertification is not neoa iaGle. The AMDUlJT Cfki'I~IETi -s
<br />payatite ~nly to thE Cantractor na~ed t~erein. Issuanck, p,~ypent
<br />and acceptance ot payAent are uthout ~rejudlce to any r~ght5
<br />PT LhF O+~ner or Cc+ntractor untl ~r tr~~s Cc~ntract.
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