Attachment 4 - ARS-372.pdf
PDF 233 KB Posted
- Attached to
- TTFVRU Prosser Site Head House Remodel Project
- Solicitation number
- 1232SA25Q0092
About this file
The document is a Contractor's Request for Payment Transmittal form (ARS-372) used by contractors to request progress payments during a federal contract. The form allows detailed tracking of contract value, work completed, materials stored, and payment calculations, with specific certification statements by the contractor. Key elements include spaces for contract number, project details, payment period, and line items documenting original contract amount, change orders, work value, and net amount due. The form requires signatures from the contractor's authorized representative and government representatives to certify and approve the payment request, with specific legal certifications about subcontractor payments and contract compliance.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment 2 - WA20250102.pdf | ||
| Attachment 1 - SOW Prosser head house case repair project.pdf | ||
| SOL_1232SA25Q0092.pdf | ||
| Attachment 3 - ARS-371.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
6. Total value of work completed and stored material
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
Description Value
CONTRACTOR'S PROGRESS PAYMENT CERTIFICATION
SIGNATURE OF CONTRACTOR'S AUTHORIZED REPRESENTATIVE
RECOMMENDED FOR PAYMENT
CONCUR
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 -
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File details come from the government source that posted it. Updated .