Packet: Tiffin Regular City Council Meeting (05/19/2026)

CONTINUATION SHEET APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification is attached. <table> <tr> <th>A</th> <th>B</th> <th>C</th> <th>D</th> <th>E</th> <th>F</th> <th>G</th> <th>H</th> <th>I</th> </tr> <tr> <th>ITEM NO.</th> <th>DESCRIPTION OF WORK</th> <th>SCHEDULED VALUE</th> <th>WORK BILLED FROM PREV APPLICATION (D+E+F)</th> <th>WORK BILLED THIS PERIOD</th> <th>MATERIALS STORED THIS PERIOD</th> <th>TOTAL COMPLETED AND STORED TO DATE (D+E+F)</th> <th>% (G/C)</th> <th>BALANCE TO FINISH (C-G)</th> <th>RETAINAGE</th> </tr> <tr> <td>10</td> <td>Resilient & Carpet Material</td> <td>14,663.00</td> <td>0.00</td> <td>0.00</td> <td>5,665.00</td> <td>5,665.00</td> <td>39</td> <td>8,998.00</td> <td>283.25</td> </tr> <tr> <td>20</td> <td>Resilient & Carpet Labor</td> <td>6,947.00</td> <td>0.00</td> <td>0.00</td> <td>0.00</td> <td>0.00</td> <td>0</td> <td>6,947.00</td> <td>0.00</td> </tr> <tr> <td>30</td> <td>Ceramic Material</td> <td>7,423.00</td> <td>0.00</td> <td>0.00</td> <td>0.00</td> <td>0.00</td> <td>0</td> <td>7,423.00</td> <td>0.00</td> </tr> <tr> <td>40</td> <td>Ceramic Labor</td> <td>8,640.00</td> <td>0.00</td> <td>0.00</td> <td>0.00</td> <td>0.00</td> <td>0</td> <td>8,640.00</td> <td>0.00</td> </tr> <tr> <td></td> <td></td> <td>37,673.00</td> <td>0.00</td> <td>0.00</td> <td>5,665.00</td> <td>5,665.00</td> <td>15</td> <td>32,008.00</td> <td>283.25</td> </tr> </table>