Find ABCDEFG
APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF TWO PAGES TO OWNER: PROJECT: APPLICATION NO: 5 Distribution to: Vandalay Industries Baton Rouge Mangement Center OWNER 201 Old Forestry Lane 5000 Airline Hwy ARCHITECT Baton Rouge, LA 70811 Baton Rouge, LA 70812 PERIOD TO: 3/31/16 CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: CM CM4221 NA OTHER 3200 Nicholson Dr. PROJECT NO: 58DE-15 Baton Rouge, LA 70803 CONTRACT FOR: GENERAL CONSTRUCTION CONTRACT DATE: 10/17/15 CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge. Application is made for payment. as shown below, in connection with the Contract. information and belief the Work covered by this Application for Payment has been Continuation Sheet, AIA Document G703, is attached. 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. 1. ORIGINAL CONTRACT SUM 2.467.890.00 Net change by Change Orders CONTRACTOR: CONTRACT SUM TO DATE (Line 1 = 2) 2,467,890.00 TOTAL COMPLETED & STORED TO (A) DATE (Column G on G703) By: Date: 3/1/16 5. RETAINAGE: 10 % of Completed Work (B State of Parish of (Column D + E on G703) Subscribed and sworn to before me this day of b. % of Stored Material 1.350.00 Notary Public: (Column F on G703) My Commission expires: Total Retainage(Lines Sa + 56 or total in Column I of G703) (C) ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE In accordance with the Contract Documents, based on on-site observations and the data (Line 4 Less Line 5 Total) (D) comprising the application. the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR 765.996.31 Architect's knowledge, information and belief the Work has progressed as indicated. PAYMENT (Line 6 from prior Certificate) the quality of the Work is in accordance with the Contract Documents, and the Contractor CURRENT PAYMENT DUE (E) is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH. INCLUDING RETAINAGE (Line 3 less Line 6) (F) AMOUNT CERTIFIED . . . (G) CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Arrach explanation of amount certified differs from the amount applied, Ininal all figures on this Total changes approved $0.00 in previous months by Owner 50.00 Application and onthe Continuation Sheer that are changed to conform with the amount certified.) ARCHITECT: Total approved this Month $0.00 $0.00 By: Date TOTALS $0.00 $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under this Contract. NA DOCUMENT G702 . APPLICATION AND CERTIFICATION FOR PAYMENT . 1982 EDITION . AL . $1902 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE, N.W. WASHINGTON, DC 20908-5292 ation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee
