Certificate_of_partial_payment.pdf
PDF 113 KB Posted
- Solicitation number
- 26/27-004
- Issued by
- Clay County, Harold CDP, Florida
About this file
This is a Certificate of Partial Payment form for use in a milling and resurfacing project in Orange Park neighborhoods, Clay County, Florida. The certificate serves as a payment authorization document for contractors performing work on multiple residential roadways requiring milling of existing asphalt pavement, placement of SP-9.5 Traffic Level C asphaltic concrete, application of tack coat, pavement markings, maintenance of traffic, and associated work in accordance with contract documents and FDOT standards. The form requires the vendor to certify that all work has been performed in full compliance with contract terms and conditions and that all items and amounts are accurate.
The certificate includes mandatory payment distribution requirements whereby the contractor must remit payment to all subcontractors and suppliers within 10 days of receipt, and subcontractors must further distribute payment to their subcontractors and suppliers within 7 days thereafter. The form requires certification that all subcontractors and suppliers have received their pro rata shares from previous progress payments for completed work and furnished materials, accounting for any retainage withheld by the prime contractor pursuant to existing subcontractor agreements. The certificate must be signed and dated by an authorized representative of the vendor and identifies the payment number and total amount due for the current payment period.
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Other files
| File | Type | Posted |
|---|---|---|
| Orange_Park_Neighborhoods_-_Milling_and_Resurfacing.pdf | ||
| Orange_Park_Neighborhood_Maps_2.pdf | ||
| Orange_Park_Neighborhood_Maps.pdf | ||
| W-9_(2024).pdf | ||
| Certificate_of_final_payment.pdf | ||
| EFT_FORM.pdf | ||
| Chapter_8_Section_I.pdf | ||
| Warranty_Letter_.pdf | ||
| Owner_Direct_Purchase_Program.pdf | ||
| Performance_&_Paymt_Bond.doc | DOC document |
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Text version
CERTIFICATE OF PARTIAL PAYMENT
PAYMENT # __________
TOTAL DUE THIS PAYMENT_______________
CERTIFICATE OF THE VENDOR: According to the best of my knowledge and belief, I certify that all items and amounts shown on the face of this certificate are correct and that all work has been performed and/or material applied in full accordance with the terms and conditions of the contract. I further certify that all subcontractors and suppliers having an interest in the contract have been provided their pro rata shares of the payment out of previous progress payments received for all work completed and materials furnished in the previous period, less any retainage withheld by the prime contractor pursuant to an agreement with a subcontractor. I further certify that within 10 days after receipt of payment hereon the contractor shall remit payment due to those subcontractors and suppliers hired by the contractor that furnished labor, services, or materials, the undisputed cost of which to the contractor is reflected in the payment application for which this certificate is issued. I further certify that the contractor will ensure that any subcontractor receiving such payment shall within 7 days thereafter remit payment due to subcontractors and suppliers hired by the subcontractor that furnished labor, services, or materials, the cost of which to the subcontractor is reflected in the payment application for which this certificate is issued.
Date: __________ Vendor: ________________________________________ By: ___________
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