In support Application for Payment No. Project No. Period Ending: CM/GC: TYPE OF ITEM NO. NAME MATERIAL QUANTITY AMOUNT (Contractor or Subcontractor) (Dollars) TOTALS Prepared by for (Contractor) Date , and certified by him to be a true and accurate statement. Checked: By: Contract Compliance Specialist Date:
In support Application for Payment No. Project No. Period Ending: CM/GC: ITEM NO. NAME (Contractor or Subcontractor) TYPE OF MATERIAL QUANTITY AMOUNT (Dollars) TOTALS Prepared by for (Contractor) Date , and certified by him to be a true and accurate statement. Checked: By: Contract Compliance Specialist Date:
CM_Contract_-_Exhibits_thru_Supplementary_1.docx