X hits on this document

930 views

0 shares

0 downloads

0 comments

94 / 220

2003 SPECIFICATIONS

SECTION 107

ARKANSAS STATE HIGHWAY AND TRANSPORTATION DEPARTMENT CERTIFICATE OF PAYMENT

JOB JOB NAME ORIGINAL CONTRACT AMOUNT $

F.A.P.

DBE GOAL $

FINAL PAYMENT TO DBEs The undersigned Contractor on the above mentioned project hereby certifies that the following amount(s) were paid to:

DBE Subcontractor(s)

Amount Paid

Total Paid to DBEs

$ $ $ $ $ $ $ $ $ $ $ $

Only payments related to work, services, or material actually provided by DBE firms should be shown. Payments under second tier subcontracts from DBE firms to non-DBE firms should not be included. DBE prime Contractors should include the value of work performed by its own forces.

Contractor: Signature: Typed or Printed Name: Title:

Date:

This certificate shall be submitted through the Resident Engineer who will attach it to the original copy of the final estimate for payment.

  • *

    If goal not met, brief explanation:

Figure 107-17

Page 100-77

7-1-03

Document info
Document views930
Page views930
Page last viewedSat Dec 10 12:55:04 UTC 2016
Pages220
Paragraphs6755
Words74435

Comments