cont_cert.pdf

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Epoxy bathroom floor
Solicitation number
70Z04218Q5CV45500
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CONT CERT

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ENCLOSURE ( )

Contractor certification:

Along with each request for payment, the Contractor shall furnish the following certification, or payment shall not be made: (However, if the Contractor elects to delete paragraph (4) from the certification, the certification is still acceptable.)

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 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

(4) This certification is not to be construed as final acceptance of a subcontractor’s performance.

(Name)

(Title)

(Date)

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