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 3 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
Change Order #024 3,001.00 3,001.00 3,001.00 100%
Change Order #025 34,500.00 34,500.00 34,500.00 100%
Change Order #026 10,800.00 10,800.00 10,800.00 100%
Change Order #028 1,478.00 1,478.00 1,478.00 100%
Change Order #029 464.00 464.00 464.00 100%
Change Order #030 1,391.00 1,391.00 1,391.00 100%
Change Order #031 52,008.00 52,008.00 52,008.00 100%
Change Order #033 5,008.00 5,008.00 5,008.00 100%
Change Order #034 1,391.00 1,391.00 1,391.00 100%
Change Order #035 5,796.00 5,796.00 5,796.00 100%
Change Order #038 7,000.00 7,000.00 7,000.00 100%
Change Order #039 26,391.00 26,391.00 26,391.00 100%
Change Order #040 21,300.00 21,300.00 21,300.00 100%
Change Order #041 14,500.00 14,500.00 14,500.00 100%
Change Order #043 11,000.00 11,000.00 11,000.00 100%
Change Order #045 1,430.00 1,430.00 1,430.00 100%
Change Order #047 3,941.00 3,941.00 3,941.00 100%
Change Order #048 4,679.00 4,679.00 4,679.00 100%
Change Order #049 6,779.00 6,779.00 6,779.00 100%
Change Order #050 1,067.00 1,067.00 1,067.00 100%
Change Order #051 751.00 751.00 751.00 100%
Change Order #052 36,000.00 36,000.00 36,000.00 100%
Change Order #053 2,898.00 2,898.00 2.898.00 100%
TOTALS 12,138,321.00 12,138,321.00 12,138,321.00
NYC-WTC_000171426
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