Aia Form G702 - Application And Certificate For Payment Page 2

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CONTINUATION SHEET
AIA DOCUMENT G703
PAGE
OF
PAGES
APPLICATION NUMBER:
AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing
Contractor’s signed Certification is attached.
APPLICATION DATE:
PERIOD TO:
In Tabulations below, amounts are stated to the nearest dollar.
Use Column 1 on Contracts where variable retainage for line items may apply.
WORK COMPLETED
A
B
C
D
E
F
G
H
I
ITEM
DESCRIPTION OF WORK
SCHEDULED
FROM
THIS PERIOD
MATERIALS
TOTAL
%
BALANCE TO
RETAINAGE
NO.
VALUE
PREVIOUS
PRESENTLY
COMPLETED
(G + C)
FINISH
APPLICATION
STORED
AND STORED
(C - G)
(D + E)
(NOT IN D OR
TO DATE
E)
(D + E + F)

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