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<br />INSTRUCTION SHEET
<br />FOR AJA DOCUMENT G"02
<br />
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<br />A. GENERAL INFORMATION
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<br />1" Purpose and Related Documents
<br />.\11\ Docuinent G702, Application and Cerrit1(',ltC for Payment, is In he used in coniuncrion with Ai'\. DoclIrnem G(0), Continuation Sheet. These
<br />ch:JCUmClltS,are designed to be llsed em a Project where a CrJ!1tGlctor b,IS a direct Agreement with the Owner. Pn)(:edures [or their use are covered
<br />in i\1/\ Document A201, Genera] Conditions of the C(}ntracr for Contitll.lCtion. 1987 Edition.
<br />
<br />2. Use of Current Documents
<br />
<br />Prior to using any A10\. doclIIllcm, the user should consult the AlA, ,111 AIi'. component chapter or a current AlA Documents List to determine tbe
<br />current edition of each documcnt
<br />
<br />3. Limited License for Reproduction
<br />
<br />AlA I)oClJJTlent G'02 is a cop~1ightcd work aod may not be reproduced or exccrpted from in substantial part without the express written permis-
<br />siun of tbe AL\. The docume11l is intended to be used as a comumahle-rhat is, the original document purchased by the mer is intended ro be
<br />consumed in the course of being used. There is no implied permission to reproduce this document, nor does membership in The ."\merican
<br />Inst.itute of Arcbitects confer any further rights to reproduce ((702, A limited license is hereby grant.ed to retail purcha.;ers to reproduce:1 maxi-
<br />mum of tcn copies of a completed or executed G702, but only for use in connection with a panicuJar project. Further reproductions are probibited
<br />\vithout tbe express written permission of the AIr"..
<br />
<br />B. COMPLETING THE G702 FORM:
<br />
<br />Al'tcr the CommOOt. has completed Ai'\. Document G703, Continuation Sheet, summary information shoulJ be transferred to AL\ Document G702,
<br />Application and Certificate for Payment.
<br />
<br />The Contranor should sign G702, have it notarized, and submit it, together ",:jth G703, r.o t.heArchit.ect,
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<br />The Architect should review G702 and G703 and, if they are acceptable, complete {he Architect's Cerrificate for Payment on G702, The .A.rchitcct
<br />may ccrrifr a different amount than that applied for, pursuant to Panlgraphs 9,5 and 9.6 of A20I. 111e Architect should then initial all figure:; on
<br />G702 and G703 that have been changed to conform to the amount ccrtified and ;(In;(Jch an explan~ltion, The completed G702 and G703 shOllld be
<br />forv"ard~d to the O,-vner.
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<br />The joiiowing is an e.'l::ample of an Application for Pay,nent for ll'ork in progress, Please note thaI doffar amounts shown below are for ilfustl'(/-
<br />tim pwposes onl:v, and are not intended to reflect actual construction costs.
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<br />CONTRACTOR'S APPLICATION FOR PAYMENT
<br />AllpliCJtion io m:lde t{)r rJlymem, ~,~ shc.v.-n below_ in connection Wilh rhe COOU~([
<br />Com;nu;Hion Sheet, AiA Documenr G7(l,~, is altadKo
<br />
<br />ORIGINAL CONTRACT SUM
<br />Nel change by Change Orders
<br />CONTRACT SUM TO DATE (Line I '" 2)
<br />TOTAL COMPLETED & STORED TO DATE
<br />IC<)lumn (i <lI1 G70:l)
<br />
<br />,
<br />
<br />~~,ooo. 00
<br />?,~,"~
<br />IO?,a:::t?....
<br />40,000. ""
<br />
<br />The und~'rsigned Comr~ctor certifies [MallO lhe best of th<.: COlllr:Klor'~ knowledge, ;nl(lr e
<br />rn~lion and belief the Work covered by this Application for Paymenr has been cumpleted
<br />in aecord~rl(e wilh the Contr3ct Docuffit'ms, lha~ all amounts h<lw:' been p'J.id b)' the
<br />Comr~C1or for Work fm which previous Certificateo for Payment were iS5Ut'J "nd P:lY
<br />menrs receJ\ed from rht' O...ner an<1 thar eurrent payment ohawn herem lS no", due
<br />
<br />{ONTRACTOR ~fnu~
<br />5, Jl<?1!>~ Mr-i.f;,-~U;)15t-Ir ",," ^~ I, i"t'if..
<br />
<br />Stale or VI~INtA
<br />Cmmr? of: r"If~..rN
<br />Sllbscribed and SW(l<n to before
<br />on"h"fl~:l-
<br />
<br />7'lot~ry Public
<br />My Commission expires' J?e?. ~t, 1.di1~
<br />ARCHITECT'S CERTIFICATE FOR PAYMENT
<br />
<br />".$
<br />
<br />'i , RETAINAGE:
<br />_''1, of Completed Wl~rk
<br />(Columr15 D -; Eon G7(J3)
<br />___ ':'/~ of Sturnl Materbl
<br />(Column f on (;70_'\)
<br />-j,)1all.:cr~inJg<o jLine 53 '5b or
<br />TrJtal ;,1 Column I otG70,'I]
<br />
<br />t ~,~.tJP
<br />'::00. ..."
<br />
<br />() TOTAL EARNED LESS RETAINAGE ,
<br />(l_ille'ilcosUm>Sl;)ral)
<br />, ~~I~(;~~~I~~(~r 7~~~:f~~~T,E~ .F~R PAY~ENT $_15,t10~ ,~
<br />
<br />. ~t;OO.-
<br />. ~{;.?tJO.'"
<br />
<br />18.:.,Q?"'"
<br />
<br />J
<br />
<br />In JCCQrdatl,'c withlh~--ConrrJCI ])cx\lmem~, based on Dn,sire observ::ltion" ~nd the data
<br />comprising [his 3pplicati(>,\, tIle Architen cenific" 10 rhe Owner thai to the be,t of the
<br />Architects knowlnlgt:, mfmmation and belie! the Work ha" progn:s,ed as indicalt'l1, the
<br />quality of tIll" Work is in a('('ordance With [he C()mr~cr Documen[o, ~nJ the Contractor
<br />is nllitkd to pa~'rw'::llt of (he AMOUNT CfRTTFlED
<br />
<br />fJ CURRENT PAYMENT DUE
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<br />~~~.~~'~s~n~'~)ISH, INCLUDING RETA~NAG~.?_a?,N
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<br />Clil\NGE ORDER St'MMAR';"
<br />Tutal dl,mgc'" "ppf<)v~'d in
<br />_ prt;\'iuu,' llIomh, by Owner
<br />!iilaI3pp[()\'Cdt!li,,:,'11J11tll
<br />- rrJ'IAI.S
<br />~::~5~HANGI-:~ by Cf;~ng<: (~I':.r!
<br />
<br />AMOUNT CERTIFIED
<br />(,~lIu('h (!Xphmalhm if amuunt cl"'li{ied dlj{,'r.< .flU'" We (jtnOllnl appli(-d jm: Imliat
<br />alt figu~l'1i 'm IN.> ,.I/Jpiia,/iml and Oil Ih<, ComimUllion Sht!l'1 lI'a! (I"e ('}Hmgrd ro
<br />(,m{orm to tbe amollnt n'~tlfied.)
<br />"'''CHITECT
<br />Hy Dale;
<br />I'his Cenitiure b nor n,'gOl;Jhlc rh... ^~MOUNT CERTiFIED is p"y:tb!e only to ,ht, Con
<br />lr;lcto[" named herdn, Issuance, p;l\,ment ~nd -accqltance of p;rymem lre wi!hil\ll
<br />prcilldice (() :my rigilb OJ tlK O.,,-ner or Contr~c!Or WIller this C()m!"~<'l
<br />
<br />A.j)"Im"s~. i OED.' CT10"~~
<br />
<br />1<2c~-~"""".",,::::::=-
<br />lO,~ ,&1# rs &JtXJ.4P
<br />..~. ':!,~.""~. ,
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<br />C. MAKING PAYMENT
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<br />The Owner should make payment directly to the Cuntractor based on the amollnt certified by the ArchLtecr on AlA Document G702, Applicat.ion
<br />;tod Certificate for Payment. Thc completed form contains the mime and address of the Contractor. Payment should not be made to any othcr
<br />party unless specifically inclic.lteu on (;702.
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<br />D.
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<br />EXECUTION OF THE DOCUMENT
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<br />E,l(h pcrson executing the Agrecn"tcnt should indicate the c~1p;lcity in 'Ivhich they ;lrc acting (Le" presideot, secretary, partner; etc.) and the author-
<br />ity under v,-hich they :Ire executing the Agreemenl. W'bcre appropriate, ,1 copy of the resolution aUlhorizing the indi\idual tu act on behalf of the
<br />firm or entity should he att<!Ched.
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<br />8/92
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<br />fmtmc/irm sheet revised 6/9':1 U'it/)ollt proceclumi change
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