HomeMy WebLinkAboutB25-0164 025-200-118 Avatar Foods CF FS 03.2025 Billing APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G 702
TO(OWNER): Avatar Natural Foods PROJECT: Avatar Natural Foods APPLICATION NO: 251011-00001
1301 S.Boulder Hwy 1900 Ca 99 Gridley,CA95948
Henderson, NV 89015 PERIOD TO: 3/31/2025
michael@avatarnaturalfoods.com CONTRACT DATE: 2/21/2025
FROM (CONTRACTOR): VIA(ARCHITECT): CONTRACT:
Cen-Cal Fire Systems, Inc INVOICE#: 576324
PO Box 1284
Lodi, CA 95241-1 2 84
CONTRACT FOR: Avatar Natural Foods
Application is made Tor Payment,as shown below in connection with the Contract.
CONTRACTOR'S APPLICATION FOR PAYMENT continuation sheet,MA Document G703, is attached.
CHANGE ORDER SUMMARY 1.ORIGINAL CONTRACT SUM $ 5,885.00
2.Net change by Change Orders 1+2 $ 0.00
Change Orders approved in previous months by Owner ' ADDITIONS I DEDUCTIONS 3.CONTRACT SUM TO DATE
(Line ) $ 5,885.00
TOTAL I I 4.TOTAL COMPLETED &STORED TO DATE $ 5,885.00
(Column G on G703)
Approved this Month
5. RETAINAGE:
No. Date Approved a. %of Completed Work $ 0.00
(Column D+Eon G703)
b %of Stored Material $ 0.00
• (Column F on G703)
Total Retainage (Line 5a+ 5b or $ 0.00
TOTALS I I Total in Column I of G 703
Net change by Change Orders I I 6.TOTAL EARNED LESS RETAINAGE
$ 5,885.00
The undersigned Contractor certifies that to the best of the Contractor 's knowledge, (Line 41ess Line 5 Total)
information and belief the Work covered by this Application for Payment has been 7. LESS PREVIOUS CERTIFICATES FOR
completed in accordance with the Contract Documents ,that all amounts have been paid PAYMENT (Line 6 from prior Certificate) $ 0.00
by the Contractor for Work for which previous Certificates for Payment were issued and 8.CURRENT PAYMENT DUE $ 5,885.00
payments received from the Owner,and that current payment shown herein is now due .
9. BALANCE TO FINISH, PLUS RETAINAGE $ 0.00
CONTRACTOR: Cen-Cal Fire Systems, Inc
~1-)� State of: County of
f J / Subscribed and sworn to before me this day of
y CorporateSecretary S Z(0i Notary Public:
`E�Weis , DATE
My commission expires:
! I
f ,
AMOUNT CERTIFIED:
ARCHITECT'S CERTIFICATE FOR PAYMENT
(Attached explantion if amount certified differs from the amount applied for .)
In accordance with the Contract Documents,based on on-site observations and the data comprising the ARCHITECT/OWNER/CM:
above application,the Architect certifies to the Owner that to the best of the Architect %knowledge,
invormation and belief the Work has progressed as indicated ,the quality of the Work is in accordance By: Date:
with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT CERTIF€ED .
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor earned herein . Issuance,
payment and acceptance of payment are without prejudice to any rights of the Owner of Contractror under this Contract
AIA DOCUMENT G 702.APPLICATION AND CERTIFICATE FOR PAYMENT .MAY 1983 EDITION.AIA.1983
THE AMERICAN INSTITUTE OFARCHtTECTS ,1735 NEW YORK AVENUE,N.W.,WASHINGTON,D.C.20006
2
CONTINUATION SHEET AIA DOCUMENT G 702
AIA DOCUMENT G 702,APPLICATION AND CERTIFICATE FOR PAYMENT ,containing APPLICATION NUMBER: 251011-00001
Contractor's signed Certification is attached. APPLICATION DATE : 3/26/2025
In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 3/31/2025
Use Column Ion Contracts where variable retalnage for line items may apply . INVOICE#: 576324
A D E F G E F G H I N
ITEM NO. DESCRIPTION OF ORIGINAL OWNER CURRNT %ninny nnnnpI PTpn MATERIALS TOTAL % BALANCE RETAINAGE
WORK SCHEDULE CHANGE SCHEDULE PRESENTLY COMPLETED AND (G/C) TO FINISH
OF vALUES ORDER OF vALUES FROM PREVIOUS THIS PERIOD STORED(NOT IN STORED TO DATE (C-G)
APPLICATION(D+E) 0 OR E) (D+E+F)
00-001 _abor 3,464.00 0.00 3,464.00 3,464.00 3,464.00 100.00
00-002 Natedal 2,421.00 0.00 2,421.00 2,421,00 2,421.00 100.00
Totals 5,885.00 0.00 5,885.00 5,885.00 5,885.00 00.00
AIA DOCUMENT G 702.APPLICATION AND CERTIFICATE FOR PAYMENT .MAY 1983 EDITION.AIA.1983
THE AMERICAN INSTITUTE OF ARCHITECTS ,1735 NEW YORK AVENUE,N.W.,WASHINGTON,D.C.20006
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