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 4 PAGES
APPLICATION AND CERTIFICATE FOR PAYMENT, CONTAINING APPLICATION NO. 4
CONTRACTOR'S SIGNED CERTIFICATION IS ATTACHED DATE 3/26/99
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 10,379,717.00 1,153,302.00 11,533,019.00 100%
Change Order #001 7,000.00 6,300.00 700.00 7. SEB 00 100%
Change Order #003 3,704.00 3,334.00 370.00 3,704.00 100%
Change Order #004 388,804.00 349,924.00 38,880.00 388,804.00 100%
Change Order #005 117,684.00 105,916.00 11,768.00 117,684.00 100%
Change Order #006 406.00 365.00 41.00 406.00 100%
Change Order #007 (289,803.00) (260,823.00) (28,980.00) (289,803.00) 100%
Change Order #008 11,688.00 10,519.00 1,169.00 11,688.00 100%
Change Order #009 11,707.00 10,536.00 1,171.00 11,707.00 100%
Change Order #010 2,666.00 2,399.00 267.00 2,666.00 100%
Change Order #011 2,898.00 2,608.00 290.00 2,898.00 100%
Change Order #012 7,766.00 6,989.00 777.00 7,766.00 100%
Change Order #013 985.00 887.00 98.00 985.00 100%
Change Order #014 (5,216.00) (4,694.00) (522.00) (5,216.00) 100%
Change Order #015 21,234.00 19,111.00 2,123.00 21,234.00 100%
Change Order #016 18,500.00 16,650.00 1,850.00 18,500.00 100%
Change Order #017 5,042.00 4,538.00 504.00 5,042.00 100%
Change Order#019 4,636.00 4,172.00 464.00 4,636.00 100%
Change Order #020 11,000.00 9,900.00 1,100.00 11, 00 100%
Change Order #021 18,500.00 16,650.00 1,850.00 18,500.00 100%
Change Order #022 6,728.00 6,055.00 673.00 6,728.00 100%
Change Order #023 5,800.00 5,800.00 5,800.00 100%
TOTALS 11,884,748.00 10,691,053.00 1,193,695.00 11,884,748.00
NYC-WTC_000172354
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