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Owner: <br />Engineer:R00592-226N <br />Contractor: <br />Project: <br />Contract: <br />Application No.:Application Period: From to <br />A B C D E F G H I J K L M <br />Previous Amount <br />Stored <br />($) <br />Amount Stored this <br />Period <br />($) <br />Amount Stored to <br />Date (G+H) <br />($) <br />Amount Previously <br />Incorporated in the <br />Work <br />($) <br />Amount <br />Incorporated in the <br />Work this Period <br />($) <br />Total Amount <br />Incorporated in the <br />Work <br />(J+K) <br />($) <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br /> - - - <br />-$ -$ -$ -$ -$ -$ -$ <br />Contractor's Application for Payment <br />Materials Stored Incorporated in Work <br />C&D Landfill Phase 2 Construction <br />Materials <br />Remaining in <br />Storage <br />(I-L) <br /> ($) <br />Application <br />No. When <br />Materials <br />Placed in <br />Storage <br />Orange County <br />Draper Aden Associates <br />Owner's Project No.: <br />Engineer's Project No.: <br />Contractor's Project No.: <br />Application Date: <br />Stored Materials Summary <br />Totals <br />Storage Location <br />Description of Materials or <br />Equipment Stored <br />Submittal No. <br />(with <br />Specification <br />Section No.) <br />Supplier <br />Invoice No. <br /> Item No. <br />(Lump Sum Tab) <br />or Bid Item No. <br />(Unit Price Tab) <br />Stored Materials <br />EJCDC C-620 Contractor's Application for Payment <br />(c) 2018 National Society of Professional Engineers for EJCDC. All rights reserved.4 of 4 <br />DocuSign Envelope ID: 0844D1D6-E311-4FC5-8B5B-BB1E27A908ED