Attch 2 - ARS-372 - CONTRACTORS REQUEST FOR PAYMENT TRANSMITTAL.pdf
PDF 30 KB Posted
- Attached to
- Clinic Floor Replacement, Ames IA Federal contract opportunity
- Solicitation number
- 12905B24Q0207
About this file
This document is a Contractor's Request for Payment Transmittal form (Form ARS-372) used to request progress payments under a federal contract. It provides a standardized format for the contractor to detail the amount of the original contract, any change orders or amendments, the total adjusted contract price, the value of work completed to date, the value of materials stored on site, the total value of work and stored materials, the amount due to the contractor, and the net amount due for the current payment request. The form includes certifications by the contractor regarding compliance with contract terms and timely payments to subcontractors. It also requires signatures by the contractor's authorized representative and the government's Contracting Officer's Representative or other appropriate official for recommended payment and concurrence.
The related federal contract opportunity is for a Clinic Floor Replacement project at the USDA ARS MWA National Animal Disease Center in Ames, IA. The work involves removing existing flooring, preparing the surface, and installing new vinyl composite tiles in the clinic's waiting room, nurse's office, file room, and hallway. Bidders must provide pricing for a Base Bid and any Alternate pricing as defined in the contract documents. A mandatory site visit is scheduled for August 22, 2024 at 10:00 AM Pacific Time. The solicitation number is 12905B24Q0207 and the federal agency is the USDA Agricultural Research Service, Pacific West Area.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attch 6 - Clinic Floor Drawings_1.pdf | ||
| Attch 1 - ARS-371 - CONSTRUCTION PROGRESS AND PAYMENT SCHEDULE.pdf | ||
| Attch 3 - RFI FORM.pdf | ||
| Attch 8 - Past Performance Questionnaire (PPQ).doc | DOC document | |
| 12905B24Q0207.pdf | ||
| Attch 4 - IA20240074_7-19-2024_Rev 7.pdf | ||
| Attch 5 - 20107 SOW Clinic Floor Replacement_rev7_1_24.pdf | ||
| Attch 7 - Section 09650 re Flooring Specs.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 (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 PROGRESS PAYMENT CERTIFICATION
SIGNATURE OF CONTRACTOR'S AUTHORIZED REPRESENTATIVE
RECOMMENDED FOR PAYMENT (Signature of EPM, COR, CM or A-E as appropriate)
CONCUR (Signature of EPM or COR as appropriate)
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 -
Previous edition is not usable.
c:\\docume~1\\admini~1.for\\mydocu~1\\accounts\\usda2\\origin~1\\set3~1\\ars372.wpf Administrator D:20050417122932- 04'00' D:20050426102902- 04'00'
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 PROGRESS PAYMENT CERTIFICATION
SIGNATURE OF CONTRACTOR'S AUTHORIZED REPRESENTATIVE
RECOMMENDED FOR PAYMENT (Signature of EPM, COR, CM or A-E as appropriate) CONCUR (Signature of EPM or COR as appropriate)
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 - Previous edition is not usable.
| Check if Final payment.: 0 |
| Enter date for period beginning using format MM/DD/YYYY.: |
| Enter date for period ending using format MM/DD/YYYY.: |
| Item. 1. Amount of original contract.: |
| Item 2. Change orders and / or amendments.: |
| Item 3. Total adjusted contract prices.: |
| Item 4. Value of work completed to end of period.: |
| Item 5. Value of material stored at the site (Itemize below).: |
| Item 6. Total value of work completed and stored material (Line 4 plus Line 5). Value of material stored at the site (Itemize below).: |
| Item 7. Enter Percent retainage.: |
| Item 7. Less indicated percentage retainage.: |
| Item 8. Total due contractor thru end of this period.: |
| Item 9. Less previous requests.: |
| Item 10. Net amount due contractor this payment.: |
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