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PD .SF015.R1 Payment Certificate Form

This document is a payment certificate for a construction project that provides details of the original contract value, approved variations, revised contract value, value of work completed, amounts retained, deductions, total amount certified, and net amount due. It lists the original contract value, approved variations, revised contract value, and breakdown of the value of work done. Several parties must approve the payment certificate including the contractor, construction manager, project manager, and manager of the projects department.

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Mohamed Gassem
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86 views1 page

PD .SF015.R1 Payment Certificate Form

This document is a payment certificate for a construction project that provides details of the original contract value, approved variations, revised contract value, value of work completed, amounts retained, deductions, total amount certified, and net amount due. It lists the original contract value, approved variations, revised contract value, and breakdown of the value of work done. Several parties must approve the payment certificate including the contractor, construction manager, project manager, and manager of the projects department.

Uploaded by

Mohamed Gassem
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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Client: (PMC) : Contractor:

Project :
Project No. :

Payment Certificate
Contract /PO Ref. :
Contract Name :
Contractor Name :

Certificate No : Certificate Type : Interim Final


For the Period Ending : Submittal Date :

INITIAL CONTRACT DATA


Original Contract Value : SAR
Approved Variations : SAR
Revised Contract Value : - SAR

PAYMENT DETAILS:

Value of Work Done A) As per Original Contract : SAR


B) As per Approved Variations : SAR
C) Material on Site (If Applicable) : SAR
D) Total Value of Works : - SAR

Less E) Recovery of Advanced Payment : % of (A+C) = SAR


F) Retentions : % of (D) = - SAR
G) Other Deductions : SAR
H) Total Deductions : - SAR

I) Total Amount Certified : (D) - (H) - SAR


J) Less Amount Previously Certified SAR

Net Amount Due - SAR

Submitted by Contractor : ……………………………………… Date : ………………………….

Approved by Const. Manager : ……………………………………… Date : ………………………….

Approved by Project Manager : ……………………………………… Date : ………………………….

Approved Manager, Projects Dept : ……………………………………… Date : ………………………….

Ref: PD.SF015R1
Date: Jan, 1st, 2011

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