Public Works and Government Services Canada
Symbol of the Government of Canada

Supplementary Claim

To be used for recording costs in support of form PWGSC-TPSGC 1111.


  Current Claim Previous Claims Total to Date
(A + B)
Description: (Expenditures must be claimed in accordance with the basis and/or method of payment of the contract) (A)
3 decimal (a)
Tax
Rate a
(B)
3 decimal (b)
Tax
Rate b

Table notea Enter the applicable tax rate, for example 5 or 14 or 14.975 (do not use comma).
Table noteb Enter the applicable tax rate, for example 5 or 14 or 14.975 (do not use comma).

% %
% %
% %
% %
% %
Subtotal
Applicable taxes
Total