EXHIBIT D – APPLICATION FOR PAYMENT AND INVOICE

REQUIREMENTS

CDGB Infrastructure Improvement Project

Authority: §§ 218.72, 218.735, 255.077, 255.078, F.S.; 2 C.F.R. §§ 200.305, 200.337; Exhibit

B – Form SC-66

Contract No. CDBG-CON-01

This Exhibit establishes the content, format, certifications, and supporting documentation required for each Application for Payment submitted under the Contract. An Application for

Payment that does not satisfy the requirements of this Exhibit and applicable law is not a "proper invoice" within the meaning of § 218.72(8), F.S., and the City's review and payment periods under § 218.735, F.S., shall not commence until the deficiency is corrected. In the event of any conflict between this Exhibit and Article VIII (Payment Standards), Article VIII shall control.

1. FREQUENCY AND BASIS OF PAYMENT

a. The Contractor shall submit one (1) Application for Payment per month, covering

Work performed through a consistent cutoff date each month, unless otherwise directed by the City.

b. This is a unit-price Contract. Compensation for unit-price line items shall be based on the actual quantities of Work performed, measured and verified by the City or the

Engineer of Record (the "Engineer"), multiplied by the unit prices established in

Exhibit C – Schedule of Values. Lump-sum line items shall be paid based on the percentage of the line item completed, as approved by the Engineer. Estimated quantities stated in Exhibit C are approximate; payment shall be made only for quantities actually incorporated into the Work.

c. No payment shall be made for Work that is nonconforming, defective, not properly documented, or not performed in accordance with the Contract Documents. No payment shall be made for any change in the Work except as authorized by an approved written Change Order.

2. REQUIRED FORM AND CONTENT

Each Application for Payment shall include all of the following:

a. AIA Form G702 (Application and Certification for Payment) (Exhibit N), or a

Florida Department of Commerce-approved equivalent, signed by the Contractor and certified by the Engineer of Record serving as the inspection engineer;

b. AIA Form G703 (Continuation Sheet) (Exhibit O), or a Commerce-approved equivalent, itemizing each Schedule of Values line item, the scheduled value, the quantity and value of Work completed during the current period and to date, materials stored (if any), the total completed and stored to date, the percentage complete, the balance to finish, and retainage;

c. The Contractor's certification that the Work for which payment is requested has been completed in accordance with the Contract Documents, that the amounts requested are correct, and that all prior payments received from the City have been applied to discharge the Contractor's obligations to subcontractors and suppliers for Work covered by prior Applications for Payment;

d. A statement of the contract sum, net change by Change Orders, contract sum to date, total completed and stored to date, retainage, total earned less retainage, less previous payments, and the current payment due; and

CDGB Infrastructure Improvement Project

Authority: §§ 218.72, 218.735, 255.077, 255.078, F.S.; 2 C.F.R. §§ 200.305, 200.337; Exhibit

B – Form SC-66

Contract No. CDBG-CON-01

e. Such additional information as the City or the Engineer reasonably requires to verify quantities, value, and compliance.

3. SUPPORTING DOCUMENTATION

Each Application for Payment shall be accompanied by the following, to the extent applicable to the Work covered by the Application:

a. Certified Payrolls. Weekly certified payrolls on DOL Form WH-347 (Exhibit S), or an equivalent form, with the required Statement of Compliance under 29 C.F.R. §

5.5(a)(3)(ii), covering all payroll periods within the Application period, for the Contractor and all subcontractors, as required by Article XVI (Davis-Bacon and Related Acts);

b. Buy America / BABA Documentation. Mill certificates and manufacturer or supplier certifications demonstrating Build America, Buy America Act compliance for any iron, steel, manufactured products, or construction materials incorporated into the Work during the Application period, including component-cost substantiation where required, as required by Article XII (Buy America Preference);

c. Section 3 Labor-Hour Data. Section 3 labor-hour reporting as required by Article

XXXV and 24 C.F.R. § 75.25, to the extent a reporting period falls within or coincides with the Application period;

d. M/WBE Records. Documentation of subcontract and purchase awards to Minority- and

Women-Owned Business Enterprises, as required by Exhibit B – Form SC-66, § 9, and

Article X;

e. Stored Materials Documentation. For any materials or equipment delivered but not yet incorporated into the Work for which payment is requested, the supplier invoices and supporting documentation establishing actual cost and CDBG eligibility, evidence of proper storage, protection, insurance, and segregation, and confirmation that title transfers to the City upon payment, all as required by Section 8.4 of the Contract; and

f. Change Order Substantiation. For any Work performed under an approved Change

Order, the documentation supporting the Change Order amounts claimed.

4. RETAINAGE

a. The City will withhold retainage from each progress payment in an amount not to exceed five percent (5%), in accordance with § 255.078, F.S.

b. After the Work is fifty percent (50%) complete, the City will not withhold additional retainage from subsequent progress payments, provided the Work is progressing satisfactorily, in accordance with § 255.078, F.S.

c. Retainage shall be released in accordance with §§ 255.077 and 255.078, F.S., and Article

VIII of the Contract.

CDGB Infrastructure Improvement Project

Authority: §§ 218.72, 218.735, 255.077, 255.078, F.S.; 2 C.F.R. §§ 200.305, 200.337; Exhibit

B – Form SC-66

Contract No. CDBG-CON-01

5. SUBMISSION

a. Method. Each Application for Payment, with all required forms and supporting documentation, shall be submitted by email, in a single consolidated PDF where practicable, to all of the following City representatives:

i. Sandra Woodbery — swoodbery@miltonfl.org

ii. April Taylor — ataylor@miltonfl.org

iii. Joe Cook — jecook@miltonfl.org

b. Date of Receipt. An Application for Payment is deemed received on the date the City records it as received under § 218.74(1), F.S. Submission to all three representatives identified above is required for the Application to be considered submitted. An

Application that omits any required form or supporting documentation is incomplete, and the review and payment periods under § 218.735, F.S., shall not commence until a complete Application is received.

c. The Contractor shall direct questions regarding invoice status to the City representatives identified above.

6. REVIEW, REJECTION, AND PAYMENT

a. Engineer Certification. Because each Application for Payment must be reviewed and certified by the Engineer of Record acting as the City's agent under § 218.735(1)(a), F.S., the payment due date is determined under the agent-approval provision of that subsection.

b. Rejection of Improper Invoice. The City, through its agent, may reject an Application for Payment within twenty (20) business days after the date it is recorded as received under § 218.74(1), F.S. Any rejection shall be in writing and shall specify the deficiency and the action necessary to render the Application proper, in accordance with §

218.735(2), F.S. The Contractor shall correct and resubmit the Application for further review.

c. Payment Due Date. Payment of a proper, approved Application for Payment is due twenty-five (25) business days after the date it is recorded as received under § 218.74(1), F.S., in accordance with § 218.735(1)(a), F.S.

d. Disputed Amounts. If the City disputes a portion of an Application for Payment, the undisputed portion shall be paid timely in accordance with § 218.735(5), F.S., and the dispute shall be addressed under the applicable provisions of the Contract.

e. Interest. Interest penalties for late payment shall accrue in accordance with § 218.735(9), F.S.

7. PAYMENT TO SUBCONTRACTORS AND SUPPLIERS

The Contractor shall, within ten (10) days after receiving payment from the City, remit payment due to its subcontractors and suppliers for labor, services, and materials covered by that payment, and shall pay all undisputed amounts within the time required by § 218.735(6), F.S., and §§

255.071 and 255.073, F.S.

mailto:swoodbery@miltonfl.org mailto:ataylor@miltonfl.org mailto:jecook@miltonfl.org

CDGB Infrastructure Improvement Project

Authority: §§ 218.72, 218.735, 255.077, 255.078, F.S.; 2 C.F.R. §§ 200.305, 200.337; Exhibit

B – Form SC-66

Contract No. CDBG-CON-01

8. CDBG FUNDING ACKNOWLEDGMENT

The Contractor's right to payment under the Contract is governed solely by the Contract and the

Florida Local Government Prompt Payment Act, Chapter 218, Part VII, F.S. The Contractor is not a recipient or subrecipient of CDBG financial assistance and is not subject to grant reimbursement procedures. The Contractor's right to timely payment is not conditioned on the

City's receipt of CDBG reimbursement from the Florida Department of Commerce. The

Contractor shall cooperate with reasonable City requests for documentation necessary to support the City's CDBG reimbursement submissions, including certified payrolls, M/WBE records, Section 3 data, and Buy America certifications.

9. FINAL APPLICATION FOR PAYMENT

The final Application for Payment shall be submitted and processed in accordance with Section

8.10 of the Contract and shall be accompanied by all closeout submittals required by Article

XXIII and the CDBG Supplemental Conditions, including final certified payrolls, final lien waivers and releases, the subcontractor payment affidavit required by Section 8.11, the consent of surety to final payment, and the Engineer of Record's Project Completion Certificate.

10. RECORDS

All Applications for Payment, certifications, and supporting documentation shall be retained and made available for audit and inspection in accordance with Article IX (Public Records and

Retention) of the Contract.

Bidder/Contractor: ______________________________________

Authorized Signature: ______________________________________________

Printed Name: _____________________________________________________

Title: _____________________________________________

Date: ____________________________________________