Interim Payment Certificate Example [Edit & Download]
Certificate Information:
- Certificate Number: IPC-2026-1123
- Issued By: Project Management Office
- Issue Date: September 15, 2026
Project Information:
- Project Name: Metro Expansion Project
- Location: 3400 North Expansion Lane, City Center, Metro City
- Contract Number: MEP-2025-09
Contractor Information:
- Contractor Name: Rapid Transit Solutions Inc.
- Address: 1200 Builder’s Avenue, Metro City, MC 90909
- Contact Details: Anna White, Project Manager, (555) 778-9900
Period Covered:
- From: August 1, 2026
- To: August 31, 2026
Description of Work Completed:
- Tunnel Excavation: Completed 500 meters of tunneling for the subway extension, including primary reinforcements.
- Station Construction: Commenced construction of Station 5A; foundation and structural framing completed.
- Electrical Systems: Installation of electrical conduits and wiring in sections 400 to 450.
Certified Progress:
- Work Certified This Period: 80% of scheduled tasks for the period.
- Cumulative Work Certified: 50% of total project scope.
Value of Work Completed:
- This Period’s Claimed Value: $1,500,000
- Total Claimed to Date: $7,500,000
Amount Certified:
- Total Certified to Date: $7,000,000
- Less Previous Certificates: $5,500,000
- Amount Due This Certificate: $1,500,000
- Retention (10%): $150,000
- Net Amount Due: $1,350,000
Certifier Details:
- Certifier: Michael Johnson, Senior Quantity Surveyor
- Signature: [Signature Michael Johnson]
Date of Issue:
- Issued on: September 15, 2026
Additional Notes:
- Remarks: The work has been inspected and conforms to the specifications and standards outlined in the contract. The contractor is advised to continue adhering to the project timelines and quality requirements to ensure timely payments in future certificates.
Contact Information:
- Project Management Office Contact: Phone: (555) 890-4501, Email: pmo@metroexpansion.gov
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