Standard Construction Document CCDC 24  1996
CERTIFICATE FOR PAYMENT
Consultant:
Certificate number:
Owner:
Reference number(s):
Contractor:
Work:
title and location
This is to certify that the value of Work performed and Products delivered to the Place of the
Work as of
is $
(exclusive of Value Added Taxes).
date
Certified by the Consultant
name and title of person signing
signature
date of issue
Contract Summary
Original Contract Price
Change Orders (numbers
)
$
Current value of Change Directives
included in the certified amount
$
Value of Contract on the last day of the payment period (1+2+3)
Value Added Taxes at
%
Total amount payable for the construction of the Work including
Value Added Taxes (4+5)
$
(1)
$
$
(4)
$
(6)
$
(7)
$
(10)
$
Amount from previous certificate for payment (number
) $
Amount of Contract Price payable current period (1112)
$
Value Added Taxes at
%
$
Total amount payable current period including Value Added Taxes
$
(11)
(2)
(3)
(5)
Certification Summary
Value of Work performed and Products delivered
to the Place of the Work
Total holdback at
%
Holdback released
Holdback retained (89)
Amount (value of Work performed and Products delivered
to the Place of the Work less holdback retained)
$
$
(8)
(9)
(710)
(13+14)
(12)
(13)
(14)
(15)