You are on page 1of 9

APPROVED

By Jim Celyat 7:10 am, Mar 21,2012
FORM FOR BILLING OF SUBCONTRACTS
Request Number: Six Date of Request: Company Name: Job Name:
Suboontrad#:
.;;;.;;,;-'-----

3-20-12

Norvell Fixture & Equipment Company
AugustaTEE Center 10055-11.450.100/su

Original Subcontract Price:
Changes: List separatelY each Change Order (CO #1 (7,46Z.00) ) (CO #2.
(CQ #5 Subtotal All Change Orders:

$1,336,880.00
....)\
\

~~

) (CO 116'------....)\ $ $

)~~

Total Amount of Revised SUbcontrad wI Change Orders:
Percentage Subc:ontract Complete and in Place: Material stored on Job Site (Invoices if Required): Total Amount of Work in Place ancl Material Stored: . less Percentage Retained 10.00%:

1,329,418.00

(7462.00)

Net Amount Earned to Date: Less Previous BillingS:

Paymert Requested - This Invoice: FEDERAL ID 1# OR SS #: 58'()955642 STATES TAXID 1#: 036-OfiW

$ __ ~771~3,~6~86~.O~/~ $__~14~6~!2~8~9~.9~O

$_~95~5~!5~2~8n·8a6~ $__~9~5.~5~6,2.~8~9~ 859.975.97 $

$--~~mnm-----------$__~95~5~,5~2~8n·86~ __

--~~~n-----------__ __
APPROVED
By Stacey Hopkins at 10:18 am, Mar 20,2012

_ __

SUBMITTO:

R.W. AUen, LLC. 1015 Broad Street Augusta,GA 30901
PARnAL "!lEASE

9F LEN

One Hundred Forty Six Thousand

FOR AND IN CONSIDERATION .od upon receipt of the sum ofm::=-:::::::rI!Jl7:nm:-:-:::-tDr"'fatr"lDr------:-=== ... Two Hundred Eighty Nine and 801100- {$ 146,289.90 ) And when the dIedt has been 9toperfy andorsed and hel been paid by the b.M upon wI1ich It Is ctawlng, said sum being a ~al paymlft 10 NIne. FIxIIm! & Equipment Company. (hereinafter called It1e "SubQorItrador1 from R.W. ADen, U.C. (hereinafter called !he "Generat ContraClor'? agahst aubconlrad number '005~1'."50.100111u for work perfooned .neII« materials fIImlshed for Augutbl TEE Center located at 9th Blede Reynolds SIroet In AugUlta. GA (helWllnllller called It1e "Premises1, ~ SubConlr1.ctor. foI' 1tseIf,IIs SIICICOSIOIS. and assigns hereby: 1. waives and refeases any and all liens or Ifghls or &ens that mly eldat or lie dafllled In favor 01 SUbcGntrador on or against Prumlses for the amollflf nolad above. 2. Agrees 10Imlemnify and hold harmless Ihc General Contractor and Owner. and their f8SP8ClIve succeascn and assigns. from and agalnsl any and all liens and I81ated a,;penses arlslng there from, willen may be lIIed agall1$l the Premises for malariala, labor, or services fumilhod by any of this Suboonlnlclol's suppillfa fQr the amount noted above. the unclenllQned StJfm~or day of
lias causecllhls

and/or agent, IflisZUln

IN WITNESS WHEREOF,

Instrument to be ~BQlled • In the year of 20 12.

on lis behalf by 114duly autllolb:ed

oIIicef

~,/~
Slgna~&

SeclTreas.
TlIIB

Pay Application #Q

Norvell Fixture Equipment Co., Inc.

ITEM THIS PERIOD

TOTAL COMPLETED & STORED TO

DATE

The prices listed above do not reflect manufacturers retail price or actual cost. They include overhead, labor and profit and include sales tax per item. These prices reflect total contract which includes all of the above.

Pay Application #6

Norvell Fixture Equipment Co., Inc.

TOTAL COMPLETED & STORED TO DATE

The prices listed above do not reflect manufacturers retail price or actual cost. They include overhead, labor and profit and include sales tax per item. These prices reflect total contract which includes all of the above.

Pay Application

#6

Norvell Fixture Equipment Co., Inc.

MATERIALS PRESENTLY STORED

TOTAL COMPLETED & STORED TO

DATE

The prices listed above do not reflect manufacturers retail price or actual cost. They include overhead, labor and profit and include sales tax per item. These prices reflect total contract which includes all of the above.

Pay Application 1#3

Norvell Fixture Equipment Co., Inc.

The prlcesltsted above do not reflect manufacturers retail price.or actual cost. They include overhead, labor and profit and include sales tax per item. These prices reflect total contract which includes all of the above.

-I
(!)

-0 Q) -c
""0 "Q_
III :::J

:::J"

»
n 1:)"
Ol

"U

(/l

ro

....

~.
CD
(l.)

~

P-

cr
0

ro

<

~

0
::J

a.

0
;;0 A

S. ~
!l
(l.)

ro

3

«l
"0

(!) (/l

zr 0)' o

-I

::J

c:

........ro o·
....
::!!u

C -.,

Vl
(!)

~I ..., ro Q

ro
0 en
0

Z

CD .....

~ ~
0

6"

< ~
:-0

0

.....

C ia. CJ iii o !l 0 ~ ~~ :::T o· --!
:::T
()

on

C~

rn

" cx'
.0 C

;;0

0

0
U);;o»
"U .~

m 3
ro
::J

CD

'0'-

5' ,,~
(~

rr

C ::> 0. n ro E (/l 0.
(l.)

oCllm 7.)~;;o

-im-l

~
:::J

;T]-ij;

o 0

O.-r

-<(fJ

r+

8-

=a -:
([)

I'!l

fi

:::T (D

ro
tu

3-

OJ

0

~0 ....
Q)

< Ui cr
::J 0. '1J

cr -

0.

"iJ!.

3:
'0)

3

o,
:::l

::>

!2
c:
(.)

0. I'!l

,..,

q
r:l

6 (,)

C!J

.,'

3

s-

Pay Application

#6

Norvell Fixture Equipment

Co., Inc.

TOTAL COMPLETED & THIS PERlOD

The prices list.ed above do not reflect manufacturers retail price or actual cost. They include overhead, labor and profit and lncludesatec ~a:(per item. These prices reflect total contract which includes all of the above,

Pay Application #6

Norvell Fixture Equipment Co., Inc.

SCHEDULED

FROM PREVIOUS APPLICAT!ON

MATERIALS PRESENTLY THIS rCRIOD

TOTAL COMPLETED & STORED TO

STORE~

0.00

0% 0% 0%

100.00 50.00 50.00 ------~,~~~--.

50.00

0.00

The prices listed above do not reflect manufacturers retail price 0, actuai CDSt. Th~'I include overhead, labor and profit ar.:j:rc!ud2 ~8:e~ tal, per itern. These prices reflect total contract which includes all of the above.

Pay Application #6

Norvell Fixture Equipment

Co., Inc.

ITEM NO.

TOTAL COMPLETED & STORED TO DESCRIPTION OF WORK

DAT.:-E,.·""~-=~;o-:,,,~c!:-:- ..-~-....

-'-~~i*f~~~

~~.' :":::! ... ----+--,----:--~~.:::.j_.·-~::_:_:_t-- ..-~::...:.;:_~~~
__ L._. __ .__ =-=-.::"::':'.=:..i __

.. ·~~fQQJ )81 [iO!

0.001

1 Q_Q.~I _~(?J

._.
,~---

~---jf----------1-----1------I------t--~----+-·------=-.:.::..::.+---·--

_.._ ..o~L . __... o.oot._
72%
---:--<f----.-

~~9J .. _ 2:9_9.l _ ....
_._0.001

O. OQ .. . ~.. ';:iQ(J: 661

L......---L-

..L

.... •. _.-,__ _--'-"'--' __ ... . '_.

_._.L

I__ ~-- ... - ~:

I__ ..

---:-.----.j_-·~_=_J.__
M

$373,t388.8~
•••

-- ......

>.~_:-.-_ ..,.~.-J

j_---- .. -._j
$95,552.8_gj

The prices listed above do not reflect manufacturers retail price or actual cos; Tllo/ ;r.c!:jde overhead, labor and ;:;iJfit These prices reflect total contract which includes all of the above.

c.r.::l ;r,clude 38:e;,:

~G;( j:;(:r ile:i"rl.