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 5 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 #084 (30,681.00) (30,681.00) (30,681.00) 100%
Change Order #088 130,000.00 130,000.00 130,000.00 100%
Change Order #091 6,000.00 6,000.00 6,000.00 100%
Change Order #092 380.00 380.00 380.00 100%
Change Order #093 4,892.00 4,892.00 4,892.00 100%
Change Order #095 1,046.00 1,046.00 1,046.00 100%
Change Order #096 10,255.00 10,255.00 10,255.00 100%
Change Order #097 4,560.00 4,560.00 4,560.00 100%
Change Order #098 8,800.00 8,800.00 8,800.00 100%
Change Order #099 2,033.00 2,033.00 2,033.00 100%
Change Order #100 20,625.00 20,625.00 20,625.00 100%
Change Order #102 3,854.00 3,854.00 3,854.00 100%
Change Order #103 73,987.00 73,987.00 73,987.00 100%
Change Order #104 50,000.00 50,000.00 50,000.00 100%
Change Order #105 136,001.00 136,001.00 136,001.00 100%
Change Order #106 3,568.00 3,568.00 3,568.00 100%
Change Order #107 650.00 650.00 650.00 100%
Change Order #108 4,258.00 4,258.00 4,258.00 100%
Change Order #109 4,482.00 4,482.00 4,482.00 100%
Change Order #110 2,461.00 2,461.00 2,461.00 100%
Change Order #111 17,466.00 17,466.00 17,466.00 100%
Change Order #112 2,266.00 2,266.00 2,266.00 100%
Change Order #113 3,253.00 3,253.00 3,253.00 100%
Letter dated 11/16/00 1,221.00 1,221.00 1,221.00 100%
Letter dated 12/6/00 39,264.00 39,264.00 39,264.00 100%
TOTALS 12,858,182.00 12,817,697.00 40,485.00 12,858,182.00
NYC-WTC_000171428
OCR can misread numbers and units. Confirm readings against the page image before using them.