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<br />, .. ~ APPLICATION AND CERTIFICATE FOR PAYMENT AlA DOCUMENT C702 PAGE ONE OF PAGE'
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<br />PROJECT: A City Hall Building for the City ARCHITECT: Doughtie & Porterfield
<br />(name, address) of La Porte, Harris County, Texas
<br />604 \.Jes t Fairmont Parkway ARCHITECT'S PROJECT NO:
<br />La Porte, Texas
<br />TO (Owner) Th C' t f L PH' C CONTRACTOR: P. G. BELL CO.
<br />e ~ y 0 a orte, arr~s ounty,
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<br />Texas CONTRACT FOR: A City Hall Building
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<br />APPLICATION DATE: 1 December 1977 APPLICATION NO: Two (2)
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<br />) ATTN: Mr. Jack Porterfield PERIOD FROM: 1 November 1977 TO 31 November 1977
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<br />CHANGE ORDER SUMMARY Application is made for Payment, as shown below, in connection with the Contract.
<br />Continuation Sheet. AlA Document G702A. is attached,
<br />~ Change Orders approved ADDITIO,\IS S DEDUCTIONS S .
<br />. in previous months by The present status of the account for this Contract is as follows:
<br />Owner -
<br />TOTAL 663 000 00
<br />ORIGINAL CONTRACT SUM "".,.'.,...,..""" $ ,.
<br />Subsequent Change Orders
<br />Number Approved h b 0 00
<br />(date) Net c ange y Change Orders ""'.",..".",,, $ .
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<br />- CONTRACT SUM TO DATE ,.,.,..."",...".,." $ 663,000.00
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<br />TOTAL COMPLETED & STORED TO DATE",.,,". ,$ 173.126.00
<br />(Column G on G702A)
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<br />TOTALS RETAINAGE 10 % ,....,..,............,...$ 17.312.60
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<br />Net change bv Change Orders $ or as noted in Column I on G702A
<br />TOTAL EARNED LESS RETAINAGE ,'.".".'".,'.' ,$ 155,813.40
<br />State of: Texas County of: Harris
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<br />) The undersigned Contractor certifies that the Work LOve red by th,s Appli- LESS PREVIOUS CERTIFICATES FOR PAYMENT, , , . , , . . $ 68,850.00
<br />catIOn for f'Jyment has been completed In accordance with the Contract
<br />e Documents. that all amounts have been paid bv him for Work for which
<br />prevIous Certificates for Payment were ISsued and payments received from CURRENT PAYMENT DUE .",.".""."""."", $ 86 , 963.40
<br />the Owner, and that the current pavment shown herein" now due,
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<br />C P G B 11 C Subscribed and sworn to before mC-lhl.s., 2nd day of December ,1977
<br />ontractor: . . eo, p" ^ ....:--' YJ'l
<br />Notary Public: ~/ L..UCf1 J1. ,/\.;... / / CW
<br />.\1y CommISsion (,xplfes: 2 ~larch 19.yt}
<br />By, Date 2 December 19 77 ~
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<br />and this ApplicatIOn for Payment the Contractor is entitled to payment in the amount shown above. 0 OWNER
<br />o ARCHITECT
<br />~ 0 CONTRACTOR
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<br />By _ /)//1-/7 1 8
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<br />Th" only to the payee named he"'II' and ,t; "suanc!', p.l\m..nt and ,Icceptame are Without prejud,u! to any rlgbt; ot the Owner or Contractor under thplr Contract
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<br />ENT Gi02 . APPLICATION NO CERTIFICATE FOR PAYMENT. MARCH 19i1 E~N' . AIA@ _
<br />,\MFRICt\'-: INSTITUTE OF ARCHITECTS, 1i35 NEW YORK AVE" N W. Wt\~HI'-:C. D. C. 20006 .
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