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' APFATION AND CERTIFICATION FO' <br />TO OWNER City of Eugene PROJE~ <br />Facility Management Division <br />210 Cheshire Ave. <br />Eugene, Or 97401 <br />FROM CONTRACTOR: VIA ARCHITE~ <br />Colberg Commercial, Inc <br />1310 Coburg Road, Suite 10 <br />Eugene, Or 97401 <br />CONTRACT FOR <br />CONTRACTOR'S APPLICATION FOR PA <br />Application is made for payment, as shown below, in connection with the <br />Continuation Sheet, AIA Document G703, is attached. <br />1. ORIGINAL CONTRACT SUM <br />2. Net change by Change Orders <br />3. CONTRACT SUM TO DATE (Line 1 f 2) <br />4. TOTAL COMPLETED & STORED TO <br />DATE (Column G on G703) <br />5. RETAINAGE: <br />a. 5 % of Completed Work $ 10,; <br />(Column D + E on G703) <br />b. % of Stored Material $ <br />(Column F on G703) <br />Total Retainage (Lines Sa + Sb or <br />Total in Column I of G703) <br />6. TOTAL EARNED LESS RETAINAGE <br />(Line 4 Less Line 5 Total) <br />7. LESS PREVIOUS CERTIFICATES FOR <br />PAYMENT (Line 6 from prior Certificate) <br />8. CURRENT PAYMENT DUE <br />9. BALANCE TO FINISH, INCLUDING RETAINAGE $ <br />(Line 31ess Line 6) <br /> <br />Total changes approved <br />in revious months b Owner <br />Total roved this Month <br />TOTALS $0 <br />NET CHANGES by Change Order $ <br /> <br />~oa~~Obal~ <br />R ~ 3 ~+ ~. $ <br />~ a/s !0 3 dC~' <br />.- ~~- <br />:. ` ~j .r ^ `.ice ; ~C=j. <br /> <br />~ 3$~ <br />C~rJ~~'( <br /> <br />AIA DOCUMENT G702 • APPLICATION AND CERTIFICATION FOR PAYMENT • !6~ EDITION • AU <br />Users may obtain validation of this document by requesting a <br />