Ars 372 PDF Details

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QuestionAnswer
Form NameArs 372
Form Length1 pages
Fillable?Yes
Fillable fields1
Avg. time to fill out27 sec
Other namesars from 372, usda ars 372, ars372 form instructions, ares download

Form Preview Example

CONTRACTOR'S REQUEST FOR PAYMENT TRANSMITTAL

 

CONTRACT NO.

 

 

PARTIAL PAYMENT NO.

 

FINAL PAYMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROJECT

 

 

 

 

REQUISITION NO.

 

 

 

 

 

 

 

 

 

 

 

LOCATION

 

 

FOR PERIOD BEGINNING

 

ENDING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ITEM

 

 

AMOUNT

 

 

 

 

 

 

 

 

 

 

 

1.

Amount of original contract

 

$

 

 

 

 

 

2.

Change orders and/or amendments

 

$

 

 

 

 

 

3.

Total adjusted contract prices

 

$

 

 

 

 

 

4.

Value of work completed to end of period

 

 

$

 

 

 

5.

Value of material stored at the site (Itemize below)

 

 

$

 

 

 

6.

Total value of work completed and stored material (Line 4 plus Line 5).

 

 

$

 

 

 

7.

Less

% retainage

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8.

Total due contractor thru end of this period

 

 

$

 

 

 

9.

Less previous requests

 

 

$

 

 

 

10. Net amount due contractor this payment

 

 

$

 

 

 

 

 

 

MATERIAL STORED AT THE SITE (See Item 5 above)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Description

 

 

Value

CONTRACTOR'S PROGRESS PAYMENT CERTIFICATION

I hereby certify, to the best of my knowledge and belief, that -

(1)The amounts requested are only for performance in accordance with the specifications, terms, and conditions of the contract;

(2)All payments due to subcontractors and suppliers from previous payments received under the contract have been made, and timely payments will be made from the proceeds of the payment covered by this certification, in accordance with subcontract agreements and the requirements of Chapter 39 of Title 31, United States Code;

(3)This request for progress payments does not include any amounts which the prime contractor intends to withhold or retain from a subcontractor or supplier in accordance with the terms and conditions of the subcontract; and

(4)This certification is not to be construed as final acceptance of a subcontractor's performance.

SIGNATURE OF CONTRACTOR'S AUTHORIZED REPRESENTATIVE

DATE SIGNED

 

 

RECOMMENDED FOR PAYMENT (Signature of EPM, COR, CM or A-E as appropriate)

DATE SIGNED

 

 

CONCUR (Signature of EPM or COR as appropriate)

DATE SIGNED

 

 

Form ARS-372 (06/2011)

USDA-ARS

This form was electronically produced by USDA/ARS/OCIO/EASB.

Previous edition is not usable.

How to Edit Ars 372 Online for Free

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entering details in form ars 372 form step 1

The application will need you to prepare the CONTRACTOR'S PROGRESS PAYMENT, I hereby certify, The amounts requested are only for, payments will be made from the, (3) This request for progress, subcontractor or supplier in, (4) SIGNATURE OF CONTRACTOR'S, RECOMMENDED FOR PAYMENT (Signature, DATE SIGNED, and DATE SIGNED section.

Entering details in form ars 372 form part 2

It is vital to put down some information within the space CONCUR (Signature of EPM or COR as, DATE SIGNED, Form ARS-372 (06/2011) This form, and USDA-ARS Previous edition is not.

step 3 to entering details in form ars 372 form

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