ARS_Form-372-MASTER.xls

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UPGRADE FIRE ALARM SYSTEM AT KEARNEYSVILLE, WV
Solicitation number
12305B190001
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SECITON J- ATTACHMENT 8, ARS-372

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AMEND._02_-_SF-1442_PAGE_1.docx DOCX document
AMEND_02_-__PGS_2-3_-_SF-30_CONT.__KVILL_FIRE_ALARM_answered.docx DOCX document
AMEND_02_-__REVISED_TRANSMITTAL_LETTER.docx DOCX document
AMEND_02_-___SF-30__KVILL_FIRE_ALARM_PG_1.docx DOCX document
MOD_1_-_EXTENSION_T0_04-24-19.pdf PDF
SPECIFICATIONS_Fire_Alarm_System_Upgrades-_Kearneysville_WV.pdf PDF
12305B190001_-_UPGRADE_THE_FIRE_ALARM_SYSTEM_AT_KVILLE_WV_FINAL.doc DOC document
ARS_Form-371-MASTER.xls XLS spreadsheet
FINAL_DRAWINGS_-_Fire_Alarm_System_Upgrades-_Kearneysville_WV.pdf PDF
IFB_COVERLETTER_12305B190001_UPGRADE_FIRA_ALARM_KVILLE.docx DOCX document
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Sheet1

CONTRACTOR'S REQUEST FOR PAYMENT TRANSMITTAL
CONTRACT NO.PARTIAL PAYMENT NO.
FINAL PAYMENT
PROJECTREQUISITION NO.
LOCATIONFOR PERIOD BEGINNINGENDING
ITEMAMOUNT
1. Amount of original contract$
2. Change orders and/or amendments$
3. Total adjusted contract prices$
4. Value of work completed to end of period$
5. Value of material stored at the site (Itemize below)$
6. Total value of work completed and stored material (Line 4 plus Line 5)$
7. Less______ % retainage$
8. Total due contractor thru end of this period$
9. Less previous requests$
10. Net amount due contractor this payment$
MATERIAL STORED AT THE SITE (See Item 5 above)
DescriptionValue
CONTRACTOR'S CERTIFICATION OF PAYMENT
By signing this request for payment, I certify that I have made payment from the proceeds of prior payments, and that I will make
timely payment from the proceeds of this payment, of amounts due my subcontractors and suppliers in accordance with my con-
tractural arrangements with them.
SIGNATURE OF CONTRACTOR'S AUTHORIZED REPRESENTATIVEDATE SIGNED
RECOMMENDED FOR PAYMENT (Signature of EPM, COR, CM or A.E. as appropriate)DATE SIGNED
CONCUR (Signature of EPM or COR as appropriate)DATE SIGNED
Form ARS-372 (11/84)Replaces SEA-372 (1/79) which may be usedUSDA-ARS

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