10-Pay App Template.xlsx

This is a Pay Application and Certificate for Payment template used by Marion County, Florida for construction projects. The template standardizes the payment certification process between contractors and the county's Construction Division, establishing a formal mechanism for contractors to request progress payments and for the Department Project Manager to certify earned amounts. The document requires contractors to certify that work has been completed in accordance with contract documents, all previous invoices have been paid, and current payment is due. It accommodates change orders, tracks retainage at 5 percent of both completed work and stored materials, and includes space for documentation of original contract sums, cumulative changes, total earned amounts, previous payments received, and remaining balance to finish.

The payment application requires the contractor to provide project identification details, bid numbers, purchase order numbers, contract dates, and application dates while establishing certification requirements for both the contractor and the county's project manager. The template calculates payment due by subtracting previous certificates for payment and retainage from total completed and stored work to date. A change order summary section tracks monthly additions and deductions approved by the owner, with net changes reflected in the current payment certification. The document includes notarization requirements for the contractor's certification and establishes that the certification is non-negotiable and payable only to the named contractor, without prejudice to any rights of either party under the contract.