Dept. of Trans. PROGRESS Serial No. Contract No. 09-294-09-03 04-1A5004 PROGRESS PAYMENT VOUCHER %complete: %time: Location: 34% 43% 04-SM-0 Federal Project: ACHS-000C(308) NHG-000C(308) Progress payment No. 01 Payment period ending: 10-20-09 STATEWIDE SAFETY 130 GROBRIC COURT FAIRFIELD CA 94533 Escrow No. 00000 Total Estimate This Estimate 1. Contract Itms Without Mobil. 162,261.00 162,261.00 2.a. Extra Work b. Adjustment Comp. 3. Materials on Hand 4. Earned Subject to Retention 162,261.00 162,261.00 5. Mobilization 57,000.00 57,000.00 6. Total Work Completed 219,261.00 7. Deductions 8. a.Contract Retentions b. Unsatisfactory Prog. c. Reduction after 95% Comp. 9. Total pay to Contractor 219,261.00 219,261.00 10. Reduction Amt to Escrow 11. Payment to Escrow 0.00 12. Net Pymt. this Estimate 219,261.00