Certificate_of_partial_payment.pdf
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- Attached to
- Washington Avenue Box Culvert Restoration
- Solicitation number
- 25/26-106
- Issued by
- Clay County, Harold CDP, Florida
About this file
This is a Certificate of Partial Payment form for the Washington Avenue Box Culvert Restoration Project being conducted by the Clay County Board of County Commissioners in Florida. The project involves the removal and replacement of damaged reinforced concrete box culvert sections and associated concrete appurtenances, along with restoration of supporting embankment material and repair or replacement of roadway, drainage, and other improvements affected by Hurricane Milton (FEMA-4834-DR-FL). The work is intended to restore the facility to its pre-disaster design, function, hydraulic capacity, and structural integrity within the existing footprint. Bids were due September 14, 2026, and contractors are required to submit certificates of partial and final payment as part of project compliance documentation.
The project is federally funded disaster recovery work that triggers Davis-Bacon wage rate requirements and compliance with 2 CFR Part 200. Performance and payment bonds are required from contractors. Contractors must comply with all federal requirements associated with the FEMA-funded restoration, including submission of W-9 forms and warranty letters as specified in the RFB documents. All contractor inquiries must be submitted through the designated Question and Answer tab of the RFB, with direct contact to Board members, County employees, or the Evaluation Committee prohibited during the RFB period and any subsequent protest period.
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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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