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^^
7 WORLD TRADE CENTER 7 World Trade Center
NEW YORK, NEW YORK 1st, 7th & 23rd Floors PERIOD TO 1/10/00
FROM; AMBASSADOR CONSTRUCTION
317 MADISON AVENUE
NEW YORK, NEW YORK 10017 AMB. JOB#S57-5175
SPl Proj#890094-0300
CONTRACT FOR: GENERAL CONSTRUCTION
-1^
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 1,240,237.00
PREVIOUS MONTHS BY OWNER 954,748.00 (30,681.00) 3. CONTRACT SUM TO DATE $ 12,773,256.00
APPROVED THIS MONTH 4. TOTAL COMPLETED (COL G) $ 12,773,256.00
# |DATE APPROVED 5. RETAINAGE
316,170.00
TOTAL 1,270,918.00 (30,681.00) 6. TOTAL EARNED LESS RETAINAGE $ 12,773,256.00 /
7. LESS PREVIOUS z
THE UNDERSIGNED CONTRACTOR CERTIFIES THAT TO THE BEST OF THE j PAYMENT 11,684,322.00
CONTRACTOR'S KNOWLEDGE, INFORMATION AND BELIEF THE WORK
8. CURRENT PAYMENT DUE $ 1,088,934.00
COVERED BY THIS APPLICATION FOR PAYMENT HAS BEEN COMPLETED IN
9. BALANCE TO FINISH (LINE 3 LESS LINE 6) $
ACCORDANCE WITH THE CONTRACT DOCUMENTS, THAT ALL AMOUNTS
HAVE BEEN PAID BY THE CONTRACTOR FOR WORK FOR WHICH PREVIOUS
CERTIFICATES FOR CURRENT PAYM^T SHOWN HEREIN IS NOW DUE.
CONTRACTOR:/MWIBASS^OBfCONSTRUCTION CO., INC.
STATE OF: NEW YORK COUNTY OF: NEW YORK
SUBSCRIBED AND SWORN TO BEFORE ME THIS V DAY OF Jan. 2000 j
NOTARY PUBLICtcQ^^>,|yj, C AMY B. DEUTSCH
V
nJot*ry Publie, State of New VbA
NO. 01DE4696273
—Qualified In New Yoi^ County
ARCHITECT'S CERTIFICATE FOR PAYMENT IN ACCORDANCE WITH THE Commisiion Expiree June 30,2001
AMOUNT CERTIFIED, ,$
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.
NYC-WTC_000171530
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