Construction Payment Request Checklist



Construction Payment Request ChecklistNational Park Service (NPS) - Denver Service Center (DSC) | 9-11-17Checklist Completed By:NameChecklist Completion Date:MM/DD/YYProject: Park, PMIS #, DescriptionContract No.:P17PCXXXXXPay Estimate:No._____Contractor:Company NameCompleted Work:Does the invoiced work meet contract requirements: FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX N/AUninstalled Material:Does supporting documentation for uninstalled materials meet DSC requirements: FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX N/APrevious Invoiced Amount:Is the previous amount invoiced correct: FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX N/AUnit Priced Work:Is invoiced quantity no greater than contract quantity: FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX N/APayroll Reports:Are all Certified Payroll Reports provided for the invoiced period of service: FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX N/AIs the Payroll Report PII Certification / Transmittal Form complete: FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX N/AAre the Payroll Reports in compliance with contract requirements: FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX N/ALimitation on Subcontracting Report (required for socio-economic set-aside & sole source contracts):Is the form complete and does the noted % meet the contract requirements: FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX N/AAre the following documents updated and current:Project Schedule: FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX N/AWaste Management Worksheet: FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX N/ACQC Reports (Daily, Test, Accessibility Inspection): FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX N/AClose-Out Submittals (Project Record Drawings, O&M Manuals, etc.): FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX N/ADoes the invoice include the correct amounts for:Retainage: FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX N/ALiquidated Damages: FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX N/A% of total contract value invoiced & paid:XX%% of Contract Period of Performance elapsed:XX%Do you recommend payment of the amount requested: FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX N/AComments / Notes:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ................
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