Dept. of Trans. AFTER ACCEPTANCE Serial No. Contract No. 15-364-10-51 03-4F3904 PROGRESS PAYMENT VOUCHER %complete: %time: 100% 100% Location: Federal Project: 03-ED-50-71.5 HSNH-000C(394) Progress payment No. 004 Payment period ending: 11-24-15 AMERICAN CONTRACTOR'S INDEMNITY COMPANY 601 S FIGUEROA ST, SUITE 1600 LOS ANGELES, CA 90017 Escrow No. 00000 Total Estimate This Estimate 1. Contract Itms Without Mobil. 632,450.84 80,637.55 2. a. Extra Work b. Adustment Comp. 3. Materials on Hand 4. Earned Subject to Retention 632,450.84 80,637.55 5. Mobilization 6. Total Work Completed 632,450.84 7. Deductions -134,000.00 17,300.00 8. a. Contract Retentions b. Unsatisfactory Retentions c. Reduction after 95% Comp. 9. Total pay to Contractor 498,450.84 97,937.55 10. Reduction Amt to Escrow 11. Payment to Escrow 0.00 12. Net Pymt. this Estimate 97,937.55