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~'LIi~ItIENV f~ID CFRfIFlCATE Fl1R PAYM~NT ~E <br />~ ~ <br />~u ~~n~: IqFiltlt~l L:WNTY <br />10~ HIGH Si. I~ <br />5F1LEM, IlR 9731~ <br />5F~tl~, OR 97310 <br />PERIOD T0: @8/04197 <br />ARCHITECT'S <br />FRl~4 iGONTRACTOA) : STAT~I L't~VSTRIICTIDM, INC. VIA tARCHITECT? : PRO,IECT N0: <br />~D, ~~~ I~VTRACT DATE: <br />Eugene,~740t~ <br />Pt~IE ~k: ~~41 } ~3~3 C~ITRACT FOR: <br />~~ - ~'~~.? <br />Ct~Y~ DRDER St~tARY ORIGII~ CDNTIi~T SLM4 518, 579. ~ -- <br />Ct~,'t Ott1~1~ f~ROUED IN <br />PHEUl[~1S M[~t1H:i BY ~,N~R <br />~H[1VED TH1S N~1NTH <br />I AI?DITItX+lS I. DEDl~TIO~IS I <br />1 I I <br />1 I I <br />i 1 I <br />I I ~ <br />I I I <br />pG.IMbEk 1 DATE t~PkUVED 1 I I <br />i I i I <br />I 1 I I <br />1 1 i I <br />t I 1 I <br />I f I i <br />1 I I 1 <br />{ i I 1 <br />I I I i <br />rur~.s i i i <br />I I i <br />t~T CHAt+~E f I i <br />BY G'NNNGE UkDERS I I I <br />' ' I <br />The undersigned Contractar certifies that to the best of the <br />Cantractor's knowledge, infor~ation and belief the Nurk <br />covered by this Application for Pay~ent has beea ro~pleted <br />in accordance Nith the Contrart Docu~ents, that all a~ounts <br />haae been paid by the Cantractor for aark for ~ich previous <br />Certificates for Pay~ent were issued and pay~ents received <br />fro~ the OMner, and that current pay~ent sharm herein is noa <br />dur. <br />CL~Vl ki~;TUH: <br />i,t~ ;~~.~. <br />ay,~~~i ---~~~_ Date: ~_~r~ ~ <br />~T t~lAtd6E BY CfWN6E DRDER5 <br />[~NTRACT 5t~1 TU DATE 518, 579. 8~- <br />TOTF~ t~'LETED AI~ STORED TO DATE 482,8~@.~ <br />f~TpIN~E: <br />5.0% of Cu~pleted Work 482,820.~ <br />5.0X of Stored Material <br />Total Retainage P4,I41.~ <br />TOTt~. fAt~D LE55 AETAIt~E 458, 679. ~ ~ <br />~ <br />a <br /> c <br />i~<E <br />LE5S PREVIDLIS CERTIFICATES UF PAYP~NT 332 988. 77 <br />, ~"~ ~' ;~ <br />~~ ~ --~ <br />~~ 'r <br />~ <br /> <br /> <br />CUkRENT Si~.E5 TAX: ~ <br />, <br />~~~~?~. <br />~ ~~ = ' "~ '` <br />~ <br />:~ ~ <br />' <br /> U <br />• <br />.. : <br />lL %~, "U'i /[ <br />ll ~ ^- C,.~ i1 <br />@. ~X af Taxabl e A~ount ° ~~' ~~ ~ "' <br />~Y_1 , <br /> ~.~ CGi ~: <br />~~ <br /> <br />Current Sales Tax i~ <br /> ~ <br />CURHENT PAYP~NT DLIE 1P5, b9~.23 a G ~~ <br />_ <br />{ <br /> ,, ,.~ <br />, <br />~~,,•_;; ~ <br />Bi~~~jO,FINISH, II~.~N6/_-~II~IGE ^~59,9~.0@ ~`i~~ ' <br />. ~/ rf ~ ~ . s ~ n . ~'_ _._~ <br />State of: ~~Q(~~/v County of: ~-.~/~ <br />5ubscribed and swdrn to befare ~e this y~ day afQll~~1997 <br />My Couisaion expires: ~_~~C~ <br />At~iiTE~T'S CERTiFtI',taTE FUR PAYI~NT <br />!n accordance with the Con#ract Oocu~ents, based on on-site <br />observations and the data co~pri5ing the above application <br />the Architect certifies to the Uwner that ta the best of the <br />Architect's knowledge, infor~atian and belief the liork ha5 <br />progressed as indicated, the quality of the Work is in <br />eccarr~ance with the Cantract Dotu~ents, and the Contractor <br />is entitled to pay~ent of the ~IOL1dT CERTIFIED. <br />PRDJECT: I~ARIUN CO/SALEM/DEM~ <br />2~ HIGH 5T. <br />AM~t1NT GERTIFIED <br />ARt;H1TECT: ~~i~.cn..t~ (,(',p~ ~ . <br />aY' _ ~~~.1~"`_"U°` Date: _ ~ -- <br />This Certification is not negotiable. The ~LMT RTIFIED is <br />payable only to the Cantractor na~ed herein. Issuance, pay~ent <br />and ecceptance of pay~ent are Nithout prejudice ta any rights <br />of the tb~ner or Contractor under this Contract. <br />~ ~.~.~ ~. r~2.v ~ ~.t.._.~.J~ ~~-~.a <br />`` ~~ q ~ , i,' -~."l..t~ <br />f '~",i~~ ~"~"+U~ Q. ~ ~} i ~ <br />~ .. ~ ~~ Y ~" ~~ ~ <br />~~r~~ ~1~~ /~ ~ <br />t~PLICATIOM NQ: 6 DATE 08JQ~4/97 <br />