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<br /> " <br /> 'APPLICATION AND CERTIFICATE FOR PAYJ\1ENT AlA DOCUMENT G702 P,\Gt: ONE m PAtJES <br /> PROJECT: La Porte Public Library ARCHITECr: Reed & Clements, AlA <br /> (name, address) La Porte, Texas <br /> ARCHITECT'S PROJECr NO: 7401 <br /> TO (Owner) City of La Porte, Texas CONTRACTOR: Smith Engineering Company <br /> CONTRACT FOR:Additions & Alterations to the La Porte Public <br /> - Library <br /> APPLICATION DATE: APPLICATION NO: Four <br /> 1- ATTN: PERIOD FROM: Nov. 1, 1975 ToNov. 30, 19J5 <br /> \, e CHANGE ORDER SUMMARY Application is made for Payment, as shown below, in connection with the Contract. <br /> DEDUCTIONS $ Continuation Sheet, AlA Document G702A, is attached. <br /> Change Orders approved ADDITIONS $ The present status of the account for this Con tract is as follows: <br /> in previous months by <br /> Owner - <br /> TOTAL . 70 900 00 <br /> Subsequent Change Orders ORIGINAL CONTRACT SUM ...................... $ , . <br /> Number Approved Net change by Change Orders ................... $ .00 <br /> (date) <br /> CONTRACT SUM TO DATI.......................$ 70.900.00 <br /> TOTAL COMPLETED & STORED TO DATE..........$ 43,170.00 <br /> (Column G on G702A) <br /> TOTALS RETAINAGE 10 % .........................$ 4,317.00 <br /> Net change by' Change Orders $ or as noted in Column I on G702A <br /> e State of: Texas Ha rri s TOTAL EARNED LESS RETAINAGE ..................$ 38,853.00 <br /> County of: <br /> The undersigned Contractor certifies that the Work covered by this Appli- LESS PREVIOUS CERTlFICA TIS FOR PAYMENT. . . . . . . . $ 24.498.00 <br /> cation for Payment has been completed in accordance with the Contract <br /> Documl?nts, that all amounts have been paid by him for Work for which CURRENT PAYMENT DUE .........................$ 14.355.00 <br /> previous Certificates for Payment were issued and payments received from . <br /> the Owner, and that the current payment shown herein is now due. - <br /> Contractor: Smith Engineering Company Subscribed and sworn t~ efore me this '-I- ~ ~f ~~. ,19 7~ .' <br /> Notary Public: ..s . lLttCjI1LLU.... .. <br /> - <br /> ~ <br /> BY:~'" Date: I My Commission expires: 0- ~ ! , <br /> , . <br /> In accordance with the Contract and this Application for Payment the Contractor is entitled to payment in the amount shown above. DOWNER <br /> Architect: ' . o ARCHITECT I <br /> o CONTRACTOR <br /> By: 0 <br /> d acceptant:e are without prejudice to,any rights of the Owner ~ Contractor und.ntract. I <br /> I <br /> This Certifi t negotiable. It is payable only () the payee named herein and its issuance, pay <br /> AlA DOCUMENT G702 . APPLICATION A"D CERTIFICATE FOR PAYMENT. ,'vIARCH 1971 EDITION. AIA@ <br /> ([,1971 · THE AMERICAN '''STlTUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W.. WASHINGTON I), c: -'no(l!', <br />