Certificate for Progress Payment
Date of original contract: ___________________________
Progress payment number: ____________________________
Time period covered: ________________________________
Upon inspection and the provision of all necessary certificates, lien affidavits and other materials required under the contract described above, we hereby certify that has performed work and provided materials entitling to a partial payment of $ ( & no/100 dollars).
Provided that pursuant to the contract, that per cent be deducted from the sums stated above as retainage. The net payment shall be $ ( & no/100 dollars).
Certified on _______.