ARS372.pdf
PDF 24 KB Posted
- Attached to
- North Campus Electric Distribution Upgrade Federal contract opportunity
- Solicitation number
- 12505B19R0003
About this file
ARS-372
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| DUCT_BANK_DETAIL_(2x1).pdf | ||
| Q&A.pdf | ||
| ADDEN_1_20190722.pdf | ||
| 12505B19R0003_Amendment_01.pdf | ||
| ARS371.pdf | ||
| Specifications.pdf | ||
| Drawings.pdf | ||
| SOW-North_Campus_Electric_Disribution_Upgrade.pdf | ||
| 12505B19R0003.pdf | ||
| Wage_Determination.pdf |
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Text version
CONTRACTOR'S REQUEST FOR PAYMENT TRANSMITTAL
CONTRACT NO.
PROJECT
LOCATION
PARTIAL PAYMENT NO.
REQUISITION NO.
FOR PERIOD BEGINNING ENDING
FINAL PAYMENT
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).
8. Total due contractor thru end of this period
9. Less previous requests
10. Net amount due contractor this payment
7. Less
MATERIAL STORED AT THE SITE (See Item 5 above)
Description Value
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 contractual arrangements with them.
SIGNATURE OF CONTRACTOR'S AUTHORIZED REPRESENTATIVE
RECOMMENDED FOR PAYMENT (Signature of EPM, COR, CM or A.E. as ppropriate)
CONCUR (Signature of EPM or COR as appropriate)
DATE SIGNED
DATE SIGNED
DATE SIGNED
Form ARS-372 (11/84) Replaces SEA-372 (1/79) which may be used. USDA-ARS This form was electronically produced by USDA/ARS/OCIO/ADB.
% retainage
| RFP - TOC USNA FH.pdf |
| SECTION B - SUPPLIES OR SERVICES AND PRICE/COSTS |
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