ITB-2026-04__Pine_Straw_Supply_Delivery_and_Installation_Services_-_EXHIBIT_C.pdf

CITY OF MILTON

EXHIBIT C – APPLICATION FOR PAYMENT AND

INVOICE REQUIREMENTS

Pine Straw Supply, Delivery, and Installation Services

Contract No.: PW-PS-2026-01

1. PURPOSE

This Exhibit establishes the minimum information and supporting documentation required for each Application for Payment submitted under this Agreement. A payment application that includes the information required by this Exhibit may be processed by the City as a payment request or invoice under the Local Government Prompt Payment Act, Chapter 218, Part VII, Florida Statutes. The Contractor shall submit all payment applications to the City representative designated in the Agreement, because the Act requires the contract or written notice to identify the agent, employee, facility, or office to which payment requests are submitted.

2. SUBMISSION METHOD

Applications for Payment shall be submitted electronically in searchable PDF format to the following recipients:

a. Landscape Dept. Head: Lee Willingham – lwillingham@miltonfl.org

b. Contractor Coordinator: April Taylor – ataylor@miltonfl.org

The email subject line shall read: Contract No. PW-PS-2026-01 – Application for Payment #___

The City may update submission recipients by written notice without requiring a formal amendment to this Agreement.

3. SUBMISSION FREQUENCY

The Contractor shall submit no more than one Application for Payment per calendar month unless otherwise approved in writing by the City.

4. PROPER INVOICE — REQUIRED CONTENT

Each Application for Payment shall include, at a minimum, the following:

a. Contractor's legal name, address, and remittance information;

b. City’s Contract number (PW-PS-2026-01);

c. Invoice number and invoice date;

d. Billing period;

e. For each Work Authorization being billed:

1. Copies of the applicable Work Authorization(s) and any delivery documentation;

2. City-Designated Location;

3. Applicable Exhibit B line items:

i. Line Item 1 – Pine Straw Supplied

ii. Line Item 2 – Pine Straw Delivered

iii. Line Item 3 – Pine Straw Installed

4. Number of rolls;

5. Applicable unit price from Exhibit B; and

6. Total amount due for the payment application.

mailto:lwillingham@miltonfl.org mailto:ataylor@miltonfl.org

CITY OF MILTON

EXHIBIT C – APPLICATION FOR PAYMENT AND

INVOICE REQUIREMENTS

Pine Straw Supply, Delivery, and Installation Services

Contract No.: PW-PS-2026-01

5. REQUIRED CERTIFICATIONS

Each Application for Payment shall include a Contractor Certification, and if subcontractors were used in the performance of any Work invoiced, a Subcontractor and Supplier Payment

Certification. Submission of required certifications is a condition precedent to the City's obligation to process payment.

5.1 Contractor Certification

The undersigned hereby certifies, under penalty of perjury under the laws of the State of Florida, that this Application for Payment is true, correct, and complete, and that:

a. The Work for which payment is requested was expressly authorized by a valid City-issued

Work Authorization and was performed in accordance with this Agreement;

b. The roll quantities invoiced accurately reflect the quantities of pine straw delivered and installed at each City-Designated Location;

c. The amounts requested are calculated in accordance with the unit prices in Exhibit B;

d. No amounts included duplicate amounts previously billed or paid under this Agreement;

and

e. Supporting records for the Work invoiced are maintained and available for City inspection or audit upon request.

Contractor Signature: __________________________ Name: __________________________

Title: ___________________________ Date: ___________________

5.2 Subcontractor and Supplier Payment Certification

The undersigned hereby certifies, under penalty of perjury under the laws of the State of Florida, that all subcontractors and suppliers utilized in the performance of the invoiced Work have been paid all undisputed amounts due, except for amounts subject to a bona fide dispute or lawful withholding.

Contractor Signature: __________________________ Name: __________________________

Title: ___________________________ Date: ___________________