Certificate of Substantial Performance (Interim)

Contractor (Name and Address):

Description and Location of Work:

Contract No.:

Project No.:

Effective Date:

Amounts

1. Authorized Contract Amount to Date $:
2. Less Total to be Retained (as per Attached List) $:
3. Gross Amount Payable (1 - 2) $:
4. Assessments (as per Attached List) $:
5. Previous Payments (Net Amount to Date of Previous Progress Report) $:
6. Total Deductions (4 + 5) $:
7. Contract Amount Payable (3 - 6) $:
8. GST/HST $:
9. Amount of Security Deposit Not Returned to Contractor $:

Inspection

The undersigned certify that the work has been inspected and is complete except the portion of work described on the attached list.

Architectural - PWGSC or Consulting Architect

Position or Title:

Representing:

Signature:

Date:

Civil - PWGSC or Consulting Civil Engineer

Position or Title:

Representing:

Signature:

Date:

Electrical - PWGSC or Consulting Electrical Engineer

Position or Title:

Representing:

Signature:

Date:

Mechanical - PWGSC or Consulting Mechanical Engineer

Position or Title:

Representing:

Signature:

Date:

Contractor

Position or Title:

Representing:

Signature:

Date:

Acceptance of Work

I certify that the work is substantially complete except for the portions described on the attached list. Certified pursuant to Section 34 of the Financial Administration Act.

Departmental Representative:

Date: