ARS372.pdf
PDF 24 KB Posted
- Solicitation number
- 12405B20R0039
About this file
This document includes a contractor's payment request form and details of a federal contract opportunity for construction services. The payment request form is for Contract No. 372 and includes items such as the original contract amount, change orders, total adjusted contract price, value of work completed, retained amounts, and signatures for recommendation and concurrence of payment.
The federal contract opportunity is a solicitation from the USDA Agricultural Research Service to provide all necessary equipment, labor, materials and transportation for construction of a chemical effluent drainage system at the Aquatic Animal Health Research Unit in Auburn, Alabama. Interested small businesses must attend a scheduled site visit to learn details of the chemical drainage system requirements. Proposals are due to the Contracting Officer, Randal Barnett, by email and must address an August 2020 amendment regarding telecommunications and video surveillance services or equipment.
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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 |
File details come from the government source that posted it. Updated .