Consultant Certification. I certify that to the best of my knowledge the work as listed above has been completed, represents no duplication of payments, and any and all costs are in compliance with the contract items. _______________________________________________ Consultant Name _______________________________________________ Signature FOR OFFICE USE ONLY P.O. Order #: Invoice #: Supplier #: Project ID: Account (LN): Activity: Total: Authorized by & Date: BUREAU APPROVAL. This invoice has been reviewed for accuracy and compliance and is approved for payment. Note any exceptions. Partial Payment Date Invoice Approved: ________________ Final Payment Amount Approved for Payment $_________________________________ _____________________________________________________________ BOA Airport Land Program Manager BOA LAND 04/2019 ATTACHMENT A Land Services Contract Consultant Name and Address Airport Name BOA Project Number Contract Date Consultant Invoice Number and Date Time Period Covered by this Invoice: _____________________________________________________________________
Appears in 2 contracts
Samples: wisconsindot.gov, wisconsindot.gov
Consultant Certification. I certify that to the best of my knowledge the work as listed above has been completed, represents no duplication of payments, and any and all costs are in compliance with the contract items. _______________________________________________ Consultant Name _______________________________________________ Signature FOR OFFICE USE ONLY P.O. Order #: Invoice #: Supplier #: Project Proj. ID: Account (LN): Activity: Total: Authorized by & Date: BUREAU APPROVAL. This invoice has been reviewed for accuracy and compliance and is approved for payment. Note any exceptions. Partial Payment Date Invoice Approved: ___________________ Final Payment Amount Approved for Payment $______________________________________ __________________________________________________________________ BOA Airport Land Program Manager BOA LAND 04/2019 Name 606adev.doc r.12/03/19 ATTACHMENT A Land Services Construction Contract Consultant Lump Sum Section 1 Consultant Name and Address Airport Name BOA Project Number ID Contract Date Consultant Invoice Number and Date Time Period Covered by this Invoice: ______________________________________________________________________ LUMP SUM - SECTION 1 ITEM LUMP SUM AMOUNT PERCENT COMPLETE TOTAL TO DATE 1. Pre-Construction
Appears in 2 contracts
Samples: wisconsindot.gov, wisconsindot.gov