Certification Of Invoice Form printable pdf download

Certification Of Invoice Form

(J.3 Attachment)

CERTIFICATION OF INVOICE

I hereby certify, to the best of my knowledge and belief, that-

(1) The amounts requested are only for performance in accordance with the specifications, terms,

and conditions of the contract;

(2) Payments to subcontractors and suppliers have been made from previous payments received

under the contract, and timely payments will be made from the proceeds of the payment covered

by this certification, in accordance with subcontract agreements and the requirements of chapter

39 of Title 31, United States Code; and

(3) This request for financing payments does not include any amounts which the prime contractor

intends to withhold or retain from a subcontractor or supplier in accordance with the terms and

conditions of the subcontract.

_______________________________________________________

(Contractor Name)

_______________________________________________________

(Contractor Number)

(Title)

_______________________________________________________

(Invoice Number)

(Date)

Certification Of Invoice Form