Attachment 3_Pay Request Form.pdf

PDF 19 KB Posted Jun 12, 2020

Attached to: Small Task Order Construction Contract (STOCC) Federal contract opportunity
Solicitation number: 80KSC020R0028
Issued by: National Aeronautics and Space Administration Kennedy Space Center

About this file

Written by GovTribe AI · Dec 30, 2023

This document contains a draft request for proposal for a small task order construction contract at the John F. Kennedy Space Center in Florida. The National Aeronautics and Space Administration plans to issue the final RFP in mid-July 2020, with proposals due in mid-to late August 2020 and anticipated award dates to follow. The contract will have a total ceiling amount between $25,000 and $5,000,000 across multiple task orders in construction services. Competition will be limited to 8(a) small businesses located in or with a bona fide place of business in Florida. The draft RFP includes a statement of work, specifications, and CLIN structure outlining the pricing ranges for task orders. Potential offerors are asked to provide comments on all aspects of the draft by June 26, 2020 to inform revisions to the final RFP.

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Other files for this federal contract opportunity

Other files attached to Small Task Order Construction Contract (STOCC), newest first.
File	Type	Posted
Attachment 5_QA Template_ 80KSC020R0028.pdf	PDF	Jun 12, 2020
Attachment 8_Past Performance Assessment Tool.pdf	PDF	Jun 12, 2020
1_80KSC020R0028 DRAFT RFP.pdf	PDF	Jun 12, 2020
Attachment 1_Master Statement of Work.pdf	PDF	Jun 12, 2020
Attachment 2_Technical Specifications.pdf	PDF	Jun 12, 2020
Attachment 4 STOCC Questionnaire.pdf	PDF	Jun 12, 2020
Attachment 7_SAFETY AND HEALTH PLAN ATTACH.pdf	PDF	Jun 12, 2020
Attachment 6_PROPOSAL SUBMISSION CHECKLIST.pdf	PDF	Jun 12, 2020
Attachment 1_Tech Exhibit 001.pdf	PDF	Jun 12, 2020
Attachment 1_Tech Exhibit 002.pdf	PDF	Jun 12, 2020

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CERTIFICATION OF PROGRESS PAYMENTS

UNDER FIXED-PRICE CONSTRUCTION CONTRACTS

BASED ON A PERCENTAGE OR STAGE OF COMPLETION

SECTION 1 – IDENTIFICATION INFORMATION

1. TO: NAME AND ADDRESS OF CONTRACTING

OFFICE (Include Zip Code)

2. FROM: NAME AND ADDRESS OF CONTRACTOR (INCLUDE ZIP

CODE, EMAIL ADDRESS, AND PHONE NUMBER)

3. INVOICE NUMBER: 4. INVOICE DATE:

5. CONTRACT NUMBER: 6. PROJECT LOCATION:

7. PROJECT DESCRIPTION:

SECTION 2 – STATEMENT OF COSTS UNDER THIS CONTRACT THROUGH________________________________

(DATE)

8. ORIGINAL CONTRACT SUM – (Enter The Original Contract Award Amount) $

9. NET CHANGE ORDERS – (Enter The Net Dollar Amount Via Change Orders) $

10. CONTRACT SUM TO DATE – (Enter The Dollar Amount of the Contract To Date) – (ITEM 9 + 10)

11. TOTAL COMPLETED AND STORED TO DATE: $

12. RETAINANGE – (Enter The Retainage Amount) $

13. TOTAL EARNED LESS RETAINAGE – (Item 12 less 13) $

14. PROGRESS PAYMENTS PREVIOUSLY PAID: $

15. CURRENT PAYMENT DUE: (Item 14 less 15) $

16. BALANCE TO FINISH, INCLUDING RETAINAGE – (Line 11 Less 14) $

17. AMOUNT APPROVED BY THE CONTRACTING OFFICER $

18. PAYMENT CERTIFICATION:

In accordance with the FAR 52.232-5, Payments Under Fixed-Price Construction Contracts, I hereby certify, to the best of my knowledge and belief, that –

a) The amounts requested are only for performance in accordance with the specifications, terms, and conditions of the contract:

b) 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;

c) 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;

d) This certification is not to be construed as final acceptance of a subcontractor’s performance; and

e) All quality requirements associated with the progress payment CLIN , including but not limited to submission and approval of shop drawings, test reports, Operation and Maintenance (O&M) documentation, equipment and material verification, etc, have been satisfied.

(Name) (Date)

(Title)

NAME AND TITLE OF CONTRACTOR REPRESENTATIVE

SIGNING THIS FORM:

SIGNATURE:

NAME AND TITLE OF CONTRACTING OFFICER:

SIGNATURE:

STATEMENT OF VALUES

Project/Job Name: Payment/Application Number:

Contract Number: Payment/Application Date:

PCN Number: Period Through Date:

Item No.

Description of Work

Scheduled Value

Work Completed Total Completed and Stored to

Date % Balance to

Finish Previous

Application

Completed This

Period

Materials Presently

Stored

0.00 0.00% 0.00

Totals 0 0 0 0 0 0 0

SUBCONTRACTOR PAYMENT SCHEDULE

DATE: PROGRESS PAYMENT #:

CONTRACTOR:

CONTRACT #: DELIVERY ORDER #:

SUBCONTRACTOR

NAME

SUBCONTRACT

AMOUNT

PAID TO

DATE

DUE

THIS

PERIOD

TOTAL

PAYMENTS

File details come from the government source that posted it. Updated Jun 12, 2020.