10 steps to fill out application for payment
DESCRIPTION
Application for payment APPLICATION NO: APPLICATION DATE: TO GENERAL CONTRACTOR: PROJECT: PERIOD TO: Hunt's Taylor Creek Contractors, Inc. PROJECT NO: 12074 S 141st Street E CONTRACT FOR: CONTRACT DATE: Gore, OK. 74435 FROM CONTRACTOR: Name Address: ____________________________________ CONTRACTORS APPLICATION FOR PAYMENT Application is made for payment, as shown in connection with the Contract. Continuation Sheet is attached. 1 ORIGINAL CONTRACT SUM 2 Net change by Change Orders 3 CONTRACT SUM TO DATE (Line 1 & 2) $0.00 4 TOTAL COMPLETED AND STORED TO DATE (Column G on Continuation Sheet) 0.00 5 RETAINAGE a. 10 % of Completed Work (Column D+E on Continuation Sheet) b. % of Stored Materials (Column F on Continuation Sheet) Total Retainage (Lines 5a + 5b or Total in Column I of Continuation Sheet) 6 TOTAL EARNED LESS RETAINAGE 7 LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificates) 8 CURRENT PAYMENT DUE (Line 3 less line 6) CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS The undersigned Contractor certifies that to the best of the Total changes approve in Contractor's knowledge, information and belief the work covered previous months by owner by this Application for Payment has been completed in accordance Total approved his month with the Contract Documents, that all amount have been paid by TOTALS the Contrctor for Work which previous Cerfificates for Payment NET CHANGES by Change Order were issued and payments received from the Owner, and that current payment shown herein is now due Contractor: By:________________________________________________ Date:______________________________ State of_________________________ County of___________________________ Subscribed and sworn to before me this _____________ day of Notary Public:____________________________________ My Commission expires________________TRANSCRIPT
10 Steps to fill out application for payment.
For Hunts Taylor Creek Contractors, Inc. Application for
payment
APPLICATION NO: APPLICATION DATE: TO GENERAL CONTRACTOR: PROJECT:
PERIOD TO: Hunt's Taylor Creek Contractors, Inc. PROJECT NO: 12074
S 141st Street E CONTRACT FOR: CONTRACT DATE: Gore, OK FROM
CONTRACTOR: Name Address: ____________________________________
CONTRACTORS APPLICATION FOR PAYMENT Application is made for
payment, as shown in connection with the Contract. Continuation
Sheet is attached. 1 ORIGINAL CONTRACT SUM 2 Net change by Change
Orders 3 CONTRACT SUM TO DATE (Line 1 & 2) $0.00 4 TOTAL
COMPLETED AND STORED TO DATE (Column G on Continuation Sheet) 0.00
5 RETAINAGE a. 10 % of Completed Work (Column D+E on Continuation
Sheet) b. % of Stored Materials (Column F on Continuation Sheet)
Total Retainage (Lines 5a + 5b or Total in Column I of Continuation
Sheet) 6 TOTAL EARNED LESS RETAINAGE 7 LESS PREVIOUS CERTIFICATES
FOR PAYMENT (Line 6 from prior Certificates) 8 CURRENT PAYMENT DUE
(Line 3 less line 6) CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS The
undersigned Contractor certifies that to the best of the Total
changes approve in Contractor's knowledge, information and belief
the work covered previous months by owner by this Application for
Payment has been completed in accordance Total approved his month
with the Contract Documents, that all amount have been paid by
TOTALS the Contrctor for Work which previous Cerfificates for
Payment NET CHANGES by Change Order were issued and payments
received from the Owner, and that current payment shown herein is
now due Contractor:
By:________________________________________________
Date:______________________________ State
of_________________________ County of___________________________
Subscribed and sworn to before me this _____________ day of Notary
Public:____________________________________ My Commission
expires________________ Step 1 Fill in the project name, the
project number, and who the contract is for. Step 2 Fill out
application number, and application date. (For example,if this is
your first pay application for a specific project, then you would
put a 1 next to application number) Step 3 Put the 15th of the
month as the day that you are billing through. DO NOT BILL AHEAD.
The date that you signed the contract needs to be put next to
Contract Date. Step 4 Write the name of your company, and your
companys address. Step 5 Fill in the amount that is on your
original contract in the first box. Fill in the total amount of
your approved change orders to date in the second box. Then press
enter, and it will automatically fill in the correct amount in the
third box. Step 6 On the Breakdown sheet, Columns A, B, and C, put
the exact Cost Code, Description, and Scheduled Value that is found
on your contract.WE WILL NOT ACCEPT IT UNLESS THIS INFORMATION IS
TAKEN DIRECTLY FROM YOUR CONTRACT. Step 7 Complete Column D, E, and
F on the Breakdown sheet, and it will automatically fill in the
correct amounts on columns G-I and also lines 4, 5a, 5b, total
retainage, 6, 7 and 8 on the 1st page. Step 8 Follow directions in
this table. Step 9 Sign and date the pay application. Then have it
notarized. Step 10 The deadline for turning in each pay application
is the 15th of every month. If the 15th falls on a weekend, then it
is due the Friday before. Send in pay applications to and You can
also send it to our fax at