Application And Certificate For Payment Contractor Page 2

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CONTINUATION SHEET
AIA DOCUMENT G703
PAGE
OF
PAGES
AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing
APPLICATION NUMBER:
Contractor's signed Certification is attached.
APPLICATION DATE:
In tabulation below, amounts are stated to the nearest dollar.
PERIOD TO:
Use Column I on Contracts where variable retainage for the line items may apply
ARCHITECT'S PROJECT NO:
A
B
C
D
E
F
G
H
I
ITEM
DESCRIPTION OF WORK
SCHEDULED
WORK COMPLETED
MATERIALS
TOTAL
%
BALANCE
RETAINAGE
NO.
VALUE
FROM PREVIOUS
THIS PERIOD
PRESENTLY
COMPLETED
(G+C)
TO FINISH
APPLICATION
STORED
AND STORED
(C-G)
(D + E)
(NOT IN
TO DATE
D OR E)
(D+E+F)

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