Certificate_of_partial_payment.pdf
PDF 113 KB Posted
- Attached to
- CDBG - 2651 Sapp Lane Foundation Rehabilitation
- Solicitation number
- 25/26-006
- Issued by
- Clay County, Miramar Beach CDP, Florida
About this file
This is a Certificate of Partial Payment form used by the Clay County Board of County Commissioners for the CDBG-funded foundation rehabilitation project at 2651 Sapp Lane in Middleburg, Florida. The certificate serves as formal documentation that the vendor has completed work and applied materials in accordance with contract terms and conditions. The form requires vendor certification that all subcontractors and suppliers have received their pro rata shares from previous progress payments, with the vendor committing to remit payment to subcontractors and suppliers within 10 days of receiving payment and ensuring that subcontractors remit payment to their own subcontractors and suppliers within 7 days. The certificate includes blank fields for payment number, total amount due for the current payment period, date, vendor name, and authorized signature.
The form establishes the payment flow mechanism for the foundation rehabilitation project, which is federally funded through the Community Development Block Grant Entitlement Program and involves complete structural floor framing removal and replacement to restore the building's substructure to code-compliant conditions. Substantial completion is required within 120 days of Notice to Proceed, with final completion at least 30 days after punch list delivery and liquidated damages assessed at $100 per day for delays beyond the final completion date. The project requires Performance and Payment Bonds at 100 percent since the contract value is expected to exceed $200,000, and contractors must maintain Commercial General Liability coverage of $1,000,000 per occurrence and $2,000,000 aggregate, along with Workers' Compensation and Builder's Risk coverage at 100 percent of project value. Contractors must comply with Davis-Bacon wage requirements and OSHA regulations, with the lump-sum pricing covering all labor, materials, equipment, supervision, permits, inspections, overhead, and profit with no additional compensation available for unforeseen site conditions.
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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: ___________
File details come from the government source that posted it. Updated .