Final Invoice Certification printable pdf download

Final Invoice Certification

FINAL INVOICE CERTIFICATION:

I certify that all services documented by this invoice and for which payment is claimed

were billed to the Department for hours actually expended by Consultant’s staff

members at the contractually specified rates for such staff members. I further certify

that overhead rate as charged to this Contract has been audited by a certified public

accounting firm, accepted by the Department, and has been properly applied to services

provided under this Contract. I further certify that all Sub-consultants, subcontractors

and others who provided labor, equipment or supplies have been fully paid

I understand that if the project which is subject of this Contract is financed in whole or in

part by federally furnished funds, that if I, the company that I represent, or any

employee or agent thereof, knowingly make any false statement, representation, report,

or claim as to the character, quality, quantity, or cost of material used or to be used, or

quantity or quality of work performed or to be performed, or make any false statement or

representation as a material fact in any statement, certificate, or report, I and the

company that I represent may be subject to prosecution under the provisions of 18

U.S.C. Section 1001 and 1020.

EC-________

Task Order Number_______

______________________

_____________________________

Signature

Printed Name

______________________

_____________________________

Position

Firm Name

Signed before me the undersigned notary this ____ day of __________, 20___,

(SEAL)

_____________________________

Notary Public

My Commission Expires: ____________

My Commission Number: _________

Final Invoice Certification