Atch_3_-_Ars372.pdf
PDF 19 KB Posted
- Attached to
- Fiber Optic Cable Install at NAL Federal contract opportunity
- Solicitation number
- AG-32SC-S-17-0018
About this file
Invoice Form
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Amendment_0005.pdf | ||
| Amendment_0004.pdf | ||
| RFI_1_RR_ROW_Drawing.pdf | ||
| Amendment_0003.pdf | ||
| Amendment_0002.pdf | ||
| NAl_to_307_Path_Snapshot.jpg | JPG image | |
| Amendment_0001.pdf | ||
| FCA243624-00000.pdf | ||
| Atch_2_-_Ars371.pdf | ||
| Solicitation_AG-32SC-S-17-0018_Install_Fiber_Optic_Cable,_NAL.pdf | ||
| Atch_1_-_DOL_Wage_Determination_MD58_Mod_01_dated_1-13-2017,_8_Pages.pdf | ||
| Atch_17_-_SOW_NAL_TO_307_Final_fiber_connection.pdf |
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Text version
CONTRACT NO. PARTIAL PAYMENT NO. FINAL PAYMENT
PROJECT REQUISITION NO.
LOCATION FOR PERIOD BEGINNING
ITEM
1. Amount of original contract $
2. Change orders and/or amendments $
3. Total adjusted contract prices $
7. Less % retainage
USDA-ARS
ENDING
AMOUNT
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 through end of this period
MATERIAL STORED AT THE SITE (See Item 5 above)
Description Value
10. Net amount due contractor this payment
9. Less previous requests
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 DATE SIGNED
FORM ARS-372 (11/84) Replaces SEA-372 (1/79) which may not be used.
CONTRACTOR'S REQUEST FOR PAYMENT TRANSMITTAL
DATE SIGNED
DATE SIGNED
RECOMMENDED FOR PAYMENT (Signature of EPM, COR, CM, or A.E. as appropriate)
CONCUR (Signature of EPM or COR as appropriate)
File details come from the government source that posted it. Updated .