APPLICATION AND CERTIFICATION FOR PAYMENT
TO CONTRACTOR: MERRILL CONTRACTORS, INC. 3205 NE 78th St., Suite 10 Vancouver, WA 98665 FROM SUBCONTRACTOR: PROJECT: APPLICATION NO:
PAGE ONE OF TWO
PERIOD TO: VIA ARCHITECT: PROJECT #:
SUBCONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. 1. ORIGINAL SUBCONTRACT SUM 2....
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Review checklist for Certifications and Statutory Requirements form. ... of Interest
form: Required to be submitted for all Contractors and their subcontractors. ... 10
00M – Notice to Bidders (Multiple Contract); Section 00 20 00 – General
Instructions ... Contractor's Payment Application: Part III – Affidavit and Partial
Lien Waiver ...