NYC 9/11 Public Portal Document
Mayor's Office of Emergency Management
7 World Trade Center
1st, 7th & 23rd Floors
CONTINUATION SHEET EQUIVALENT TO G703 PAGE 2 OF 5 PAGES
APPLICATION AND CERTIFICATE FOR PAYMENT, CONTAINING APPLICATION NO. 11
CONTRACTOR'S SIGNED CERTIFICATION IS ATTACHED DATE 3/20/01
AMB. JOB S57-5175
USE COLUMN I ON CONTRACTS WHERE VARIABLE RETAINAGE FOR LINE
ITEMS MAY ITEMS MAY APPLY.
A B C D E F G H I
ITEM DESCRIPTION OF SCHEDULED FROM THIS PERIOD MATERIALS TOTAL % G-C BALANCE TO RETAINAGE
COMPLETED
PREVIOUS
AND STORED
NO WORK VALUE APPLICATION TO DATE FINISH
Base Contract 11,533,019.00 11,533,019.00 11,533,019.00 100%
Change Order #001 7,000.00 7,000.00 7,000.00 100%
Change Order #003 3,704.00 3,704.00 3,704.00 100%
Change Order #004 388,804.00 388,804.00 388,804.00 100%
Change Order #005 117,684.00 117,684.00 117,684.00 100%
Change Order #006 406.00 406.00 406.00 100%
Change Order #007 (289,803.00) (289,803.00) (289,803.00) 100%
Change Order #008 11,688.00 11,688.00 11,688.00 100%
Change Order #009 11,707.00 11,707.00 11,707.00 100%
Change Order #010 2,666.00 2,666.00 2,666.00 100%
Change Order #011 2,898.00 2,898.00 2,898.00 100%
Change Order #012 7,766.00 7,766.00 7,766.00 100%
Change Order #013 985.00 985.00 985.00 100%
Change Order #014 (5,216.00) (5,216.00) (5,216.00) 100%
Change Order #015 21,234.00 21,234.00 21,234.00 100%
Change Order #016 18,500.00 18,500.00 18,500.00 100%
Change Order #017 5,042.00 5,042.00 5,042.00 100%
Change Order #019 4,636.00 4,636.00 4,636.00 100%
Change Order #020 11,000.00 11,000.00 11,000.00 100%
Change Order #021 18,500.00 18,500.00 18,500.00 100%
Change Order #022 6,728.00 6,728.00 6,728.00 100%
Change Order #023 5,800.00 5,800.00 5,800.00 100%
TOTALS 11,884,748.00 11,884,748.00 11,884,748.00
NYC-WTC_000171425
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