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<br />~ <br /> <br />I <br />lQ <br />..- <br />~ <br />~ <br />, <br />~ <br /> <br />H <br />::1 <br />.... <br />:r <br />~ <br />LL. <br /> <br />2i <br />..- <br />.... <br />2i <br />I <br />~ <br />~ <br />.., <br /> <br /> <br />...--.----".----...- ... <br /> <br />By: <br /> <br />CONTRACTOR: <br />HiIIlwd & Sons Con <br /> <br /> <br />Inc. <br /> <br />__...-.....-...-=-"T_-=~ <br /> <br />Dale: <br /> <br />t""_---:-'.~.s&.... <br /> <br />~ l-rtr <br /> <br />0.1.: <br /> <br />I <br />In accordance with the Contract Documents, btIsed on an-sle observation. <br />and the data comprising the abOVll appaoltlon. !he Consultant certlfitls .to the <br />Owner that lhe Work ha. progressecSto lhe point indicattld; that to the best <br />of his knowledge, infCllmalion and beller. lie qlnllity of tlw Work. is In lICCord- <br />anoe with Conlract Documenls; and that thB Connc:tor 1& .ntilled \0 payment <br />of U1. CURRENT PAYMENT DUE. <br /> <br />The undersigned Conlracb CBrtllle. that to '" be,t of hi. knowledge. inlcrmltiDn and <br />belief the Wotk COVe{t!d b~ ttu. Application for payment h.. bean eompleled in aa;or. <br />dllnCe willlhe Contract documents, that all anlOunts heve been pAId by him for Work <br />10r which PlevJoUIl Certncales for PlIyITlerrt W1Ilelssued and pa~I"e/lts IPCeived (lellll <br />Iha OWI.r, aud thai CIIlIlll1t !'t"ynl..1l shown h,rein is now dut'. <br /> <br />CURRENT PAYMENT DUE <br /> <br />s <br /> <br /> <br />.00 <br /> <br />Net ChanQe <br /> <br /> <br />LESS PREVIOUS CERTIFICATES FOR PAYMENT <br /> <br />RETAlNAGE <br /> <br />'M. <br /> <br />$ <br /> <br /> <br />L55 <br /> <br />Bn <br /> <br />Totals: I 2. <br /> <br />TOTAL COMPLETED & STORED TO DATE <br /> <br />r- <br />~ <br />~ <br />r- <br />~ <br />0' <br />u <br />o <br />.... <br /> <br />Approved this month <br /> <br />CONTRACT SUM TO DATE <br /> <br />$ <br /> <br />73 <br /> <br />'0 <br /> <br />.00 <br /> <br />Change Orders approved In <br />previous months by Owner <br />Totals: <br /> <br />\ '!ob.Q) ., <br /> <br />ORIGiNAl CONTRACT SUM <br />Nel change <br /> <br />by Changll Onl.... <br /> <br />. <br /> <br />"Z _ \'3~ .00 <br /> <br />$ <br /> <br />171.000.00 <br /> <br />...-.--...--.......---.---...--.-..... <br />Change Order Summlry <br />.-- -. -- ..--.-----... .,-.---.. .-..--\.....---... .-.. <br />AddIIons Ded'ldlons <br /> <br />The present <br /> <br />51alus 01 .. IlCCDUrIt <br /> <br />ror U\1s Conlracl is all follow!>: <br /> <br /> <br />n <br />RI <br />, <br />.., <br />IE <br />.. <br /> <br />I <br /> <br />Application for Payment <br /> <br />Attn: M.rk H. Spencer <br /> <br />OWner: City of Paris <br />Contra~t Tim': 120 Days <br />Contract O.te: May 12, 2003 <br />Begin ConstrucUon: July 11, 2003 <br />Completto.!' ~at!: _N,!!.ve.!flpe!... 8,_2I!O~ <br /> <br />AppflC.'ion is made lor Payment <br /> <br />~ <br /> <br />as shown beloW In c:onntCtion will t/,. Conlract <br /> <br /> <br />Project '02-008 <br /> <br />_.:='. .._._.:=;:::-.:::.-:-r-::-=- ~__ I_-::-==:'-~=-=-:;'~-::~:;-:':::""-:-:-=::-:':.~~ ..... "=r. -_.-:-":.~ <br /> <br />To: MH S Project: Paris Sports Complex - <br />. . Contract 16 Conerete Flatwork & Park <br />AmenItIes <br /> <br />Pl.anln n <br /> <br /> <br />'...ClIrI...... 14.' <br />~I_ >JIll <br />Ch..'........ <br />... Itlll1."'lO.. <br /> <br />.':"l""...~""':"":':'.. <br /> <br />'~,;":r.~. <br /> <br />From: <br /> <br />-=~...':".~~'...:.-::- - <br /> <br />To <br /> <br />Application" <br /> <br />.- . <br /> <br />~/1Q <br /> <br />-, <br />ft:,. At <br /> <br />...... <br /> <br />4t- <br /> <br />be. <br /> <br />I <br />I <br />t <br />I <br /> <br />I <br /> <br /> <br />I <br />I <br />. <br />