PROJECT NAME:_________________ APPLICATION NUMBER: __________________

PROJECT NUMBER:_________________ APPLICATION DATE: ___________________

FACILITY:_________________________ PERIOD TO: ________________________

CONTRACT DATE :___________________ CONTRACTOR: ______________________

Schedule No 1

Cost Breakdown

A

B

C

D

E

F

G

H

Item

Quantity

Unit

Price

Total

Cost

(B X C)

TOTAL

AMOUNT

COMPLETED

TO DATE

TOTAL AMOUNT COMPLETE

ON PREVIOUS

APPLICATION

AMOUNT THIS PERIOD

(E-F)

RETENTION

%E

CONCRETE 150 100 15000 5000 3000 2000 500
WINDOWS 10 350 3500 1500 500 1000 150