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Publications and Procurement Documents > Acquisitions Forms > Request for Progress Payment - Construction Contracts
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Contractor (Name and Address):
Contractor Request No.:
Contractor Contract No.:
Contractor Project No.:
Contractor Description and Location of Work:
NOTE: All amounts are to be entered without taxes.
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:
Authorized Signing Officer Title:
Authorized Signing Officer Date (YYYY-MM-DD):
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 (YYYY-MM-DD):
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 (YYYY-MM-DD):
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.
The quantities shown on the attached cost breakdown are the final measurement of this contract.
Final Certificate of Measurement Consultant:
Final Certificate of Measurement1 Date (YYYY-MM-DD):
Final Certificate of Measurement Departmental Representative:
Final Certificate of Measurement2 Date (YYYY-MM-DD):
Cost Breakdown Request No.:
Cost Breakdown Contract No.:
Cost Breakdown Project No.:
Cost Breakdown Description and Location of Work: