ARS-372.pdf
PDF 31 KB Posted
- Attached to
- Cold Room Repairs Federal contract opportunity
- Solicitation number
- 12505B24R0028
About this file
This document is a Contractor's Request for Payment Transmittal form (Form ARS-372) used for partial payments under a federal contract. It includes details such as the contract number, project location, partial payment number, requisition number, and the period covered by the payment request. The form provides line items for capturing the original contract amount, change orders, total adjusted contract price, value of work completed, value of stored materials, total value of work and materials, retainage amount, total due, previous requests, and the net amount due for the current payment. The form includes contractor certifications and signature lines for the contracting officer's representative.
The related federal contract opportunity is for Cold Room Repairs at the Plant Introduction Station in Ames, Iowa. This is a total small business set-aside with a NAICS code of 236220 (Commercial and Institutional Building Construction) and a size standard of $45 million. The estimated value of the construction work is between $25,000 and $100,000, with a period of performance of 120 days after the notice to proceed. The solicitation requires the use of biobased products, and site visits are scheduled on August 7 and 8, 2024. All questions must be submitted by August 15, 2024, and the solicitation will only be available electronically through the SAM.gov website.
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Other files for this federal contract opportunity
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| 20210111_094713.jpg | JPG image | |
| 20210111_094633.jpg | JPG image | |
| 20210111_094630.jpg | JPG image | |
| 20210111_094716.jpg | JPG image | |
| 20210111_094728.jpg | JPG image | |
| 20210111_094637.jpg | JPG image | |
| 20210111_094719.jpg | JPG image | |
| SF30 - Amend 01.pdf | ||
| Site Visit Sign-In Sheet.pdf | ||
| 20210111_094712.jpg | JPG image | |
| SF-1442.pdf | ||
| Statement of Work.pdf | ||
| Project Drawings.pdf | ||
| ARS-371.pdf | ||
| Existing Drawings.pdf | ||
| Wage Determination.pdf | ||
| Past Performance Questionnaire.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 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.: |
| Value. Line 2.: |
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| Value. Line 4.: |
| Value. Line 5.: |
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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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