Request for Progress Payment - Construction Contracts

Contractor (Name and Address):

Request No.:

From:

To:

Contract No.:

Project No.:

Description and Location of Work:

NOTE: All amounts are to be entered without GST/HST.

Progress Claim - Contractor		This Period	Total to Date
Contract Amount Claimed:		$	$
Percentage Rate:	GST / HST	$	$
TOTALS		$	$

This claim is submitted in accordance with the Terms of Payment of the above contract for work completed and material delivered to the site but not incorporated into the work, the whole as described in the attached "Cost Breakdown".

Contractor's Authorized Signing Officer:

Title:

Date:

Progress Report - PWGSC	Total Amount	(Less) Holdback	Net Amount
Totals to Date:	$	$	$
Less Previous Payments			$
Contract Amount Payable			$
GST / HST			$
TOTAL			$

I hereby certify that the work done and material delivered to site up to the date of this request for payment are as listed on the attached cost breakdown. Work and material are according to plans, specifications and contract, that the prices are according to contract or, if not specified by contract, are reasonable.

Consultant:

Date:

The value of the portion of the work completed and material delivered to site, described in the above Progress Claim, is as shown in the Progress Report. Certified pursuant to Section 34 of the Financial Administration Act.

Departmental Representative:

Date:

NOTE: Complete the following part for contracts subject to a Unit Price Arrangement once the portion of the Work subject to a Unit Price Arrangement is complete.

Final Certificate of Measurement

The quantities shown on the attached cost breakdown are the final measurement of this contract.

Consultant:

Date:

Departmental Representative:

Date:

Cost Breakdown

Request No.:

Contract No.:

Project No.:

Description and Location of Work:

Item No.	Description	Unit of Measure (Unit Prices Only)	Quantities		Unit Price/ Value of Item	Value to Date
			Enter Quantity or % (eg. 0.25)
			This Period	To Date
Total This Page
Total All Pages