RD 1924-18 Partial Payment Estimate

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FORM APPROVED
OMB NO. 0575-0042
Exp. Date: MM/DD/YY

Form RD 1924-18
(Rev. 6-97)

CONTRACT NO.

UNITED STATES DEPARTMENT OF AGRICULTURE
RURAL DEVELOPMENT
FARM SERVICE AGENCY

PARTIAL PAYMENT ESTIMATE NO.

PARTIAL PAYMENT ESTIMATE
OWNER:

PAGE

CONTRACTOR:

PERIOD OF ESTIMATE
FROM

CONTRACT CHANGE ORDER SUMMARY
No.

Date

ESTIMATE

Amount

Agency Approval
Additions

TO

1. Original Contract

Deductions

$0.00

2. Change Orders

$0.00

3. Revised Contract (1 + 2)
4. Work Completed*
5. Stored Materials*

$0.00

6. Subtotal (4 + 5)
7. Retainage*
8. Previous Payments
TOTALS
NET CHANGE

$0.00
$0.00

$0.00

9. Amount Due (6-7-8)

$0.00
$0.00

* Detailed breakdown attached

CONTRACT TIME
Original (days)
Revised

On Schedule

Yes

Starting Date

No

Projected Completion

Remaining

ARCHITECT OR ENGINEER'S CERTIFICATION:

CONTRACTOR'S CERTIFICATION:

The undersigned certifies that the work has been carefully
inspected and to the best of their knowledge and belief, the
quantities shown in this estimate are correct and the work has
been performed in accordance with the contract documents.

The undersigned Contractor certifies that to the best of their
knowledge, information and belief the work covered by this
payment estimate has been completed in accordance with
the contract documents, that all amounts have been paid by
the contractor for work for which previous payment estimates
was issued and payments received from the owner, and that
current payment shown herein is now due.

Architect or Engineer
Contractor
By
By
Date
Date
ACCEPTED BY AGENCY:

The review and acceptance of this estimate does not attest to
the correctness of the quantities shown or that the work has
been performed in accordance with the contract documents.

APPROVED BY OWNER:

Owner
By
By

Title

Date

Date

RD 1924-18 (Rev. 6-97)

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A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a
collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control
Number. The OMB Control Number for this information collection is 0575-0042. Public reporting for this collection of information is estimated to be approximately 30
minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, completing and
reviewing the collection of information. All responses to this collection of information are voluntary. However, in order to obtain or retain a benefit, the information in
this form is required under Section 7 CFR 1924-A, Planning and Performing Construction and other Development. Rural Development has no plans to publish
information collected under the provisions of this program. Send comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden to: Information Collection Clearance Officer, Rural Development Innovation Center, Regulations Management Division
at ICRMTRequests@usda.gov

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TYPICAL UNIT PRICE BREAKDOWN *
CONTRACT (revised)
ITEM

DESCRIPTION

QUANTITY

UNIT
PRICE

THIS PERIOD
AMOUNT

TOTALS

QUANTITY

AMOUNT

SCHEDULED
VALUE

DESCRIPTION

COM-

AMOUNT

QUANTITY

PLETE

$0.00

$0.00

$0.00

0

$0.00

$0.00

$0.00

0

$0.00

$0.00

$0.00

0

$0.00

$0.00

$0.00

0

$0.00

$0.00

$0.00

0

$0.00

$0.00

$0.00

0

$0.00

$0.00

$0.00

0

$0.00

$0.00

$0.00

0

$0.00

$0.00

$0.00

0

$0.00

$0.00

$0.00

0

$0.00

$0.00

$0.00

0

$0.00

$0.00

$0.00

0

TYPICAL STORED MATERIALS
AND RETAINAGE BREAKDOWN *

TYPICAL LUMP SUM PRICE BREAKDOWN *

ITEM

%

TOTAL TO DATE

WORK COMPLETED
THIS PERIOD

MATERIALS STORED AT END OF THIS PAYMENT PERIOD

%

TO DATE

COMPLETE

DESCRIPTION

QUANTITY

UNIT
VALUE

AMOUNT

0

$0.00

0

$0.00

0

$0.00

0
0

THIS ESTIMATE

0
0 WORK COMPLETED:
0
0

$0.00

RETAINAGE
PERCENT

RETAINED

%

STORED MATERIALS:

0 OTHER (explain)
$0.00

TOTALS

$0.00

$0.00

0

TOTAL

$0.00

* As a minimum, detailed breakdowns should contain this information.

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RD 1924-18
REVERSE