Attachment J-12 - Appendix A - Declaration of Completion - Final.pdf
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- Solicitation number
- FTA_2024_PMO_0005
About this file
This document is a declaration of completion template for invoicing under a federal contract. It includes sections for direct labor costs by labor category and hours billed, consultants' fees, general and administrative expenses, overhead expenses, fringe benefits expenses, FCCM expenses, and fixed fees. The contractor must certify that the declaration is correct and payment has not been received. Supporting information requires a subtotal before FCCM and the fee due on the invoice not to exceed 85% of the fee earned. This declaration of completion appears to be an appendix to support invoicing for costs and fees under a federal contract for project management oversight services solicited by the Department of Transportation Federal Transit Administration.
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Text version
RFP Number 69319524R000001
Attachment J-12 Appendix A - Declaration of
Completion
Cost Elements
1) Direct Labor
Labor Category Staff Assigned Hours Billed Rate Total Cumulative Category Hours Billed
Total - -$
2) Consultants' Fee -$
3) General and Administrative (G&A) Expense Total G&A Expense -$ Prime - G&A XXX.XX% of Total Direct Costs = -$ Sub - G&A XXX.XX% of Total Direct Costs = -$ Sub - G&A XXX.XX% of Total Direct Costs = -$ Sub - G&A XXX.XX% of Total Direct Costs = -$
4) Overhead Expense Total Overhead Expense -$ Prime - Overhead XXX.XX% of Total Direct Costs = -$ Sub - Overhead XXX.XX% of Total Direct Costs = -$ Sub - Overhead XXX.XX% of Total Direct Costs = -$ Sub - Overhead XXX.XX% of Total Direct Costs = -$
5) Fringe Expense Total Fringe Expense -$ Prime - Fringe XXX.XX% of Total Direct Costs = -$ Sub - Fringe XXX.XX% of Total Direct Costs = -$ Sub - Fringe XXX.XX% of Total Direct Costs = -$ Sub - Fringe XXX.XX% of Total Direct Costs = -$
6) FCCM Expense -$
7) Fixed Fee (Perecntage) #NAME?
Fixed Fee Withholding -$
Fixed-Fee Calculations:
i. Total contract fixed-fee -$
ii. 85% allowable fee -$
iii. Total Cumulative fee billed on prior invoices -$
Total Fee Less Withholding #NAME?
#NAME?
Authorized Signature Name (Please Print)
Email Number/Extension
Total DOC Claim Amount
“I hereby certify that the above Declaration of Completion is correct and just, that payment therefore has not been received, and that the information is presented with the knowledge that the amount requested is passable to invoice the United States Government for payment."
Contractor’s Declaration of Completion
This notice is given in support of the request to invoice for the *Direct Productive Labor Hours (DPLH) for work completed under Task Order . The voucher represents reimbursable costs for the billing period from (START DATE) through (END DATE). Direct Labor consists of salaries and wages paid (or Billed Previously) for direct performance of the contract itemized as follows:
Direct Labor consists of salaries and wages paid (or Billed Previously) for direct performance of the contract itemized as follows: Labor Hours | Rate | Total Dollars | Cumulative Category Hours Billed.
SUPPORTING INFORMATION:
Subtotal (before FCCM)
iv. Fee due this invoice (not to exceed 85% of fee earned )
| Cover Letter |
| Attachment J-12 - Appendix A - Declaration of Completion |
| DOC |
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