Permit to Occupy or Use for 7 WTC OEM project,

NYC 9/11 Public Portal Document

APPLICATION AND CERTIFICATE FOR PAYMENT EQUIVALENT TO G702 PAGE 1 OF 5 PAGES

TO (OWNER): SILVERSTEIN PROPERTIES PROJECT: Mayor's Office of Emergency Mgt APPLICATION #11 7 WORLD TRADE CENTER 7 Wor|Id Trade Center NEW YORK, NEW YORK 1st, 7; PERIOD TO 3/20/01

FROM: AMBASSADOR CONSTRUCTION 317 MADISON AVENUE MAH 2 2 T O] NEW YORK, NEW YORK 10017 AMB. JOB #857-5175 L/ SPI Proj#890094-0300 CONTRACT FOR; GENERAL CONSTRUCTION

APPLICATION IS MADE FOR PAYMENT AS SHOWN BELOW, IN CONTRACTOR'S APPLICATION FOR PAYMENT CONNECTION WITH THE CONTRACT. CONTINUATION SHEET IS ATTACHED.

CHANGE ORDER SUMMARY 1. ORIGINAL CONTRACT $ 11,533,019.00 CHANGE ORDERS APPROVED IN ADDITIONS DEDUCTION 2. NET CHANGE BY C/O'S 1,325,163.00 PREVIOUS MONTHS BY OWNER 1,610,378.00 (325,700.00) 3. CONTRACT SUM TO DATE $ 12,858,182.00 APPROVED THIS MONTH 4. TOTAL COMPLETED (COL G) $ 12,858,182.00 # [DATE APPROVED 5. RETAINAGE 40,485.00 TOTAL 1,650,863.00 (325,700.00) 6. TOTAL EARNED LESS RETAINAGE $ 12,858,182.00 7. LESS PREVIOUS THE UNDERSIGNED CONTRACTOR CERTIFIES THAT TO THE BEST OF THE PAYMENT 12,342,444.00 CONTRACTOR'S KNOWLEDGE, INFORMATION AND BELIEF THE WORK 8. CURRENT PAYMENT DUE $ 515,738.00 COVERED BY THIS APPLICATION FOR PAYMENT HAS BEEN COMPLETED IN 9. BALANCE DUE ACCORDANCE WITH THE CONTRACT DOCUMENTS, THAT ALL AMOUNTS HAVE BEEN PAID BY THE CONTRACTOR FOR WORK FOR WHICH PREVIOUS CERTIFICATES FOR CURRENT PAYMENT SHOWN HEREIN IS NOW DUE. AMBA^D^ COf^RUCTION CO., INC. STATE OF: NEW YORK COUNTY OF: NEW YORK SUBSCRIBED AND SWORN TO BEFORE 2001 NOTARY PUBLIC. p^j,lic, Stateof New York 4 No. 41-4998601

ARCHITECTS CERTIFICATE FOR PAYMENT IN ACCORDANCE WITH THE AMOUNT CERTIFIEQ^............................ $ CONTRACT DOCUMENTS, BASED ON ONSITE OBSERVATIONS AND THE (ATTACH EXPLANATION IF AMOUNT CERTIFIED DIFFERS FROM THE DATA COMPRISING THE ABOVE APPLICATION, THE ARCHITECT AMOUNT APPLIED FOR) CERTIFIES TO THE OWNER THAT TO THE BEST OF THE ARCHITECT'S BY:______________ _ DATE: KNOWLEDGE, INFORMATION AND BELIEF THE WORK HAS THIS CERTIFICATE IS NOT NEGOTIABLE. THE AMOUNT CERTIFIED IS PROGRESSED AS INDICATED, THE QUALITY OF THE WORK IS IN ACCORDANCE PAYABLE ONLY TO THE CONTRACTOR NAMED HEREIN. ISSUANCE, WITH THE CONTRACT DOCUMENTS, AND THE CONTRACTOR IS ENTITLED TO PAYMENT AND ACCEPTANCE OF PAYMENT ARE WITHOUT PREJUDICE PAYMENT OF THE AMOUNT CERTIFIED. TO ANY RIGHTS OF THE OWNER OR CONTRACTOR UNDER THIS CONTRACT.

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