7. ARS-372.pdf
PDF 31 KB Posted
- Attached to
- Install Multiplex Water Softener Federal contract opportunity
- Solicitation number
- 12505B22R0005
About this file
This document contains a federal contract solicitation for installation of a multiplex water softener system and a contractor's request for payment transmittal template.
The solicitation seeks proposals for installation of a multiplex water softener located in Ames, Iowa, issued by the US Department of Agriculture Agricultural Research Service. The estimated value is between $250,000-$500,000. The NAICS code is 238220 and it is set aside 100% for small businesses with a size standard of $16.5 million. The period of performance is 365 days from notice to proceed. Optional site visits are scheduled for June 8th and 9th, with registration required by June 7th. Questions are due by June 17th and must be submitted in writing. Proposals are due through the SAM website. The solicitation also requires use of biobased products where available.
The payment transmittal template is a standard form for contractors to request progress or final payments on a contract, including sections for contract details, work completed, materials, amounts paid to subcontractors, certification of funds requested and approval signatures.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 12505B22R0005 Amendment 02.pdf | ||
| 12505B22R0005_Install Water Softener_QAs through 6.23.22.pdf | ||
| 12505B22R0005-Amendment 01_6-14-22.pdf | ||
| Water Softener Replacement Site Visit June 8_2022.pdf | ||
| Water Softener Replacement Site Visit June 9_2022.pdf | ||
| 1. 12505B22R0005 - Install Multiplex Water Softener_26May.pdf | ||
| 5. COVID Vaccination Attestation.pdf | ||
| 4. Past Performance Questionnaire.pdf | ||
| 6. ARS-371.pdf | ||
| 8. 21037- Bldg.154- Water Softener Replacement drawings March 10 2022.pdf | ||
| 2. SOW 21037 Bldg. 154- Water Softener Replacement March 10 2022 (1).pdf | ||
| 3. Wage Determination.pdf |
Show all 12
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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 PROGRESS PAYMENT CERTIFICATION
SIGNATURE OF CONTRACTOR'S AUTHORIZED REPRESENTATIVE
RECOMMENDED FOR PAYMENT (Signature of EPM, COR, CM or A-E as appropriate)
CONCUR (Signature of EPM or COR as appropriate)
DATE SIGNED
DATE SIGNED
DATE SIGNED
Form ARS-372 (06/2011) USDA-ARS This form was electronically produced by USDA/ARS/OCIO/EASB.
% retainage
The amounts requested are only for performance in accordance with the specifications, terms, and conditions of the contract;(1)
(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 this 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 This certification is not to be construed as final acceptance of a subcontractor's performance.(4)
I hereby certify, to the best of my knowledge and belief, that -
Previous edition is not usable.
c:\\docume~1\\admini~1.for\\mydocu~1\\accounts\\usda2\\origin~1\\set3~1\\ars372.wpf Administrator D:20050417122932- 04'00' D:20050426102902- 04'00'
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 PROGRESS PAYMENT CERTIFICATION
SIGNATURE OF CONTRACTOR'S AUTHORIZED REPRESENTATIVE
RECOMMENDED FOR PAYMENT (Signature of EPM, COR, CM or A-E as appropriate) CONCUR (Signature of EPM or COR as appropriate)
DATE SIGNED
DATE SIGNED
DATE SIGNED
Form ARS-372 (06/2011)
USDA-ARS
This form was electronically produced by USDA/ARS/OCIO/EASB.
% retainage The amounts requested are only for performance in accordance with the specifications, terms, and conditions of the contract;
(1) (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 this 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 This certification is not to be construed as final acceptance of a subcontractor's performance.
(4) I hereby certify, to the best of my knowledge and belief, that - Previous edition is not usable.
| Check if Final payment.: 0 |
| Enter date for period beginning using format MM/DD/YYYY.: |
| Enter date for period ending using format MM/DD/YYYY.: |
| Item. 1. Amount of original contract.: |
| Item 2. Change orders and / or amendments.: |
| Item 3. Total adjusted contract prices.: |
| Item 4. Value of work completed to end of period.: |
| Item 5. Value of material stored at the site (Itemize below).: |
| Item 6. Total value of work completed and stored material (Line 4 plus Line 5). Value of material stored at the site (Itemize below).: |
| Item 7. Enter Percent retainage.: |
| Item 7. Less indicated percentage retainage.: |
| Item 8. Total due contractor thru end of this period.: |
| Item 9. Less previous requests.: |
| Item 10. Net amount due contractor this payment.: |
| Value. Line 1.: |
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| Value. Line 4.: |
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| Contractor's request for payment transmittal. Enter contract number.: |
| Partial payment number.: |
| Project.: |
| Requisition number.: |
| Location.: |
| Description. Line 1.: |
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| Enter date in this format MM/DD/YYYY: |
| Enter date in this format MM/DD/YYYY: |
| Enter date in this format MM/DD/YYYY: |
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