Free Construction Pay Application Template (AIA G702/G703 format). Fill out the Summary and the Schedule of Values, print to PDF, and send to your architect or owner. No email required. Want this auto-generated from your daily progress data with retainage, change orders, and lien waivers handled automatically? Try Plan of Day.

Application for Payment

AIA G702/G703-style format — summary + schedule of values
Free template by
planofday.com
Rege Diem — Plan of Day

1. Application Header

Part 1 — Contractor's Application for Payment
(G702-style summary — all dollar amounts)
Line
Description
Amount (USD)
1
Original Contract Sum
2
Net change by Change Orders
3
Contract Sum to Date (Line 1 + Line 2)
4
Total Completed & Stored to Date (from G703 Column G)
5a
Retainage on completed work (__% of G703 Columns D+E)
5b
Retainage on stored materials (__% of G703 Column F)
5
Total Retainage (Line 5a + Line 5b)
6
Total Earned Less Retainage (Line 4 − Line 5)
7
Less Previous Certificates for Payment
8
Current Payment Due (Line 6 − Line 7)
9
Balance to Finish, incl. Retainage (Line 3 − Line 6)

2. Change Order Summary (supports Line 2)

CO # Description Approved Date Additions ($) Deductions ($) Net Change ($)
1
2
3
4
TOTALS
Part 2 — Continuation Sheet (Schedule of Values)
(G703-style — one row per line item; totals at the bottom flow into G702 Line 4)
# (B) Description of Work (C) Scheduled Value Work Completed (F) Materials Presently Stored (G) Total Completed & Stored to Date (D+E+F) (H) % (G÷C) (I) Balance to Finish (C−G) (J) Retainage
(D) From Previous Applications (E) This Period
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTALS

3. Supporting Documentation

4. Contractor's Certification

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief, the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

Contractor
Signature
Printed Name & Title / Date
Architect / Engineer
Signature — Certified Amount: $__________
Printed Name / Date
Owner (Approved)
Signature — Approved Amount: $__________
Printed Name & Title / Date