Packet: Tiffin Regular City Council Meeting (02/17/2026)

CONTINUATION SHEET AIA DOCUMENT G703 (Instructions on reverse side) PAGE OF PAGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: 1 Contractor's signed Certification is attached. TIFFIN COMM. REC CENTER APPLICATION DATE: 1/19/2026 In tabulations below, amounts are stated to the nearest dollar. 25-508 PERIOD TO: 1/31/2026 Use Column I on Contracts where variable retainage for line items may apply. MIRON SCOTT ARCHITECT'S PROJECT NO: <table><thead><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 rowspan="2">M NO.</th><th rowspan="2">DESCRIPTION OF WORK</th><th rowspan="2">SCHEDULED VALUE</th><th colspan="2">WORK COMPLETED</th><th rowspan="2">MATERIALS PRESENTLY STORED (NOT IN D OR E)</th><th rowspan="2">TOTAL COMPLETED AND STORED TO DATE (D+E+F)</th><th rowspan="2">% (G/C)</th><th rowspan="2">BALANCE TO FINISH (C-G)</th><th rowspan="2">RETAINAGE</th></tr><tr><th>FROM PREVIOUS APPLICATION</th><th>THIS PERIOD</th></tr></thead><tbody><tr><td>84113</td><td>ALUMINUM STOREFRONT & 084413 C.WALL</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>MATERIAL</td><td>$123,920.00</td><td>$0.00</td><td>$0.00</td><td>$91,000.00</td><td>$91,000.00</td><td>73.4%</td><td>$32,920.00</td><td>$4,550.00</td></tr><tr><td></td><td>LABOR</td><td>$59,535.00</td><td>$0.00</td><td>$0.00</td><td></td><td>$0.00</td><td>0.0%</td><td>$59,535.00</td><td>$0.00</td></tr><tr><td>087100</td><td>DOOR HARDWARE</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>MATERIAL</td><td>$72,125.00</td><td>$0.00</td><td>$0.00</td><td></td><td>$0.00</td><td>0.0%</td><td>$72,125.00</td><td>$0.00</td></tr><tr><td></td><td>LABOR</td><td>$14,075.00</td><td>$0.00</td><td>$0.00</td><td></td><td>$0.00</td><td>0.0%</td><td>$14,075.00</td><td>$0.00</td></tr><tr><td>088000</td><td>GLAZING</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>MATERIAL</td><td>$64,555.00</td><td>$0.00</td><td>$0.00</td><td></td><td>$0.00</td><td>0.0%</td><td>$64,555.00</td><td>$0.00</td></tr><tr><td></td><td>LABOR</td><td>$26,450.00</td><td>$0.00</td><td>$0.00</td><td></td><td>$0.00</td><td>0.0%</td><td>$26,450.00</td><td>$0.00</td></tr><tr><td>107316</td><td>CANOPIES</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>MATERIAL</td><td>$19,690.00</td><td>$0.00</td><td>$0.00</td><td></td><td>$0.00</td><td>0.0%</td><td>$19,690.00</td><td>$0.00</td></tr><tr><td></td><td>LABOR</td><td>$8,950.00</td><td>$0.00</td><td>$0.00</td><td></td><td>$0.00</td><td>0.0%</td><td>$8,950.00</td><td>$0.00</td></tr></tbody><tfoot><tr><td></td><td></td><td>$389,300.00</td><td>$0.00</td><td>$0.00</td><td>$91,000.00</td><td>$91,000.00</td><td>23.4%</td><td>$298,300.00</td><td>$4,550.00</td></tr></tfoot></table>