Att 07 FMD_70.pdf
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- Solicitation number
- 70LGLY21RSSB00009
About this file
This document contains an invoice certification form used by the Federal Law Enforcement Training Center for construction contracts. The form requires certification of invoice amounts by both the contractor and the Contracting Officer's Technical Representative, including the amount certified for payment, previous payments made, and any deductions such as retention or liquidated damages.
The related federal opportunity is a Request for Proposal for HVAC repairs and replacements at three buildings at the Federal Law Enforcement Training Center in Glynco, Georgia. Interested offerors must attend a mandatory site visit on June 30, 2021 and have any questions submitted by July 7, 2021. The construction value is estimated between $250,000 and $500,000. Proposals must be submitted to the Department of Homeland Security Federal Law Enforcement Training Center.
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Text version
FTC-FAC-70 (9/01)
Contract No. Invoice No. Invoice Date
Delivery Order No. Work Order No.
Total Contract Amount Through Change Order No. Dated
Value of Work Completed
Total of Prior Invoices
Amount of this Invoice
Signature and Title
GOVERNMENT CERTIFICATION OF INVOICE Date
FROM: Contracting Officer's Technical Representative (COTR) THRU: (1) Chief, Design-Construction Branch (FMD/D-CB)
(2) Contracting Officer (PRO/CCB) TO: Budget and Finance Division (BFD/FIN)
CONTRACT WORK CERTIFIED COMPLETE $
LESS: Retention $
Previous Payments $
Other (Deductions) $
Liquid Damages @ $ /day X Days = $
AMOUNT CERTIFIED FOR PAYMENT $
Remarks:
Evaluated
COTR/PM (FMD) Contracting Officer (PRO/CCB) Reviewed
Chief, Design/Construction Branch (FMD)
CONTRACTOR MUST ALSO COMPLETE CERTIFICATION ON REVERSE OR PAYMENT WILL NOT BE MADE
For FLETC Use Only
OFFICIAL DATE OF RECEIPT BY GOVERNMENT
Contractor's Name and Address (As shown on Contract)
CONSTRUCTION CONTRACTOR'S
INVOICE
(Authorized Contractor Representative)
By
Payment Approved
By:By:
Front
File details come from the government source that posted it. Updated .