The Contract administrator must provide a copy of the “PAID” invoice for the materials, along with a copy of a “Construction Certification and Reimbursement Request” form for the same materials.
The materials must be stockpiled on the project in such a manner as to be easily verified.
Verification that the surety has been notified is not required, since this is the responsibility of the entity administering the project.
After reviewing the submittal and visually verifying that the materials exist and are properly stockpiled, the RE should sign and forward the Materials Estimate to the Construction Division for further processing.
It is hereby certified:
that the total amount paid to the City of West End paid by the Arkansas State Highway and Transportation Department, including this payment request, does not exceed the approved total Federal allotment on this project,
that the money requested has been paid to the Contractor for work performed on this Contract,
that all materials represented by this payment have been tested and approved and the documentation is on file in accordance with Arkansas State Highway and Transportation Department procedures, and
that Documentation for the payment made to the Contractor represented by this payment has been done in accordance with Arkansas State Highway and Transportation Department procedures and is on file.
JOB NO. 069288 PAYMENT REQUEST NO. 6
Attachment: City of West End Estimate No. 10
____________________________ Title: On behalf of the City of West End
State Highway the payment to
The City of West End Transportation Department in the Contractor on Current Estimate No.
hereby requests payment from the Arkansas
10 on the Job