Ars372_(with_Certs)-RequestforPaymentTransmittal.xls
XLS spreadsheet 35 KB Posted
- Solicitation number
- 123K2518R0010
About this file
ARS-372 - Payment Transmittal
View the file
Other files
| File | Type | Posted |
|---|---|---|
| FBO Award Notice - BARC 307.pdf | ||
| Short_Listed_Offerors_Phase_II_FBO_Notice.pdf | ||
| PhaseIPresentation.pptx | PPTX presentation | |
| SignInSheet.pdf | ||
| RFIForm.doc | DOC document | |
| RegistrationForm.docx | DOCX document | |
| AmendmentForm.doc | DOC document | |
| QuestionForm.doc | DOC document | |
| SFLLL.pdf | ||
| ARS242-01m-DesignStandards.pdf | ||
| ARS-371-ProgressandPaymentSchedule.pdf | ||
| SF1442.pdf | ||
| SF25-PerformanceBond.pdf | ||
| SF24-BidBond.pdf | ||
| SF25A-PaymentBond.pdf | ||
| Solicitation.docx | DOCX document | |
| WageDetermination.txt | TXT text file |
Show all 17
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Sheet1
| CONTRACTOR'S REQUEST FOR PAYMENT TRANSMITTAL | |||
| CONTRACT NO. | PARTIAL PAYMENT NO. | FINAL PAYMENT | � |
| PROJECT | REQUISITION NO. | ||
| LOCATION | FOR PERIOD BEGINNING | ENDING | |
| ITEM | AMOUNT | ||
| 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 through end of this period | $ | ||
| 9. Less previous requests | $ | ||
| 10. Net amount due contractor this payment | $ | ||
| MATERIAL STORED AT THE SITE (See Item 5 above) | |||
| Description | Value | ||
| CONTRACTOR'S CERTIFICATION OF PAYMENT | |||
| I hereby certify, to the best of my knowledge and belief, that - | |||
| (1) The amounts requested are only for performance in accordance with the specifications, terms, and conditions of the contract; | |||
| (2) All payments due to subcontractors and suppliers from previous payments received under the contract have been made, and timely | |||
| payments will be made from the proceeds of the payment covered by the certification, in accordance with subcontract agreements | |||
| and the requirements of Chapter 39 of Title 31, United States Code | |||
| (3) This request for progress payments does not include any amounts which the prime contractor intends to withhold or retain from a | |||
| subcontractor or supplier in accordance with the terms and conditions of the subcontract; and | |||
| (4) This certification is not to be construed as final acceptance of a subcontractor's performance. | |||
| SIGNATURE OF CONTRACTOR'S AUTHORIZED REPRESENTATIVE | DATE 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 not be used. | USDA-ARS |
Sheet2
Sheet3
File details come from the government source that posted it.