Sample Certificate for Payment					04-Jan-02
To: Acme Development
Project: MNOP Building
This is to certify that in accordance with the contract dated _________________, the Contractor __________________
has completed work to the value of $____________________ not including GST or other taxes as of the date _________________
The Contractor is entitled to payment of $__________________________ plus GST of $______________
for work performed and holdback release due for the period _______________________.
Statement of Account
Original Contract Price				$3,200,000.00		a
Authorized Change Orders to Date				$   110,000.00		b
Current Contract Price				$3,310,000.00		c = a + b
Total Certified Construction to Date				$1,778,000.00		d
Holdback		10%		$   177,800.00		e = d * 10%
Holdback Released to Date				$     52,000.00		f
Current Holdback				$   125,800.00		g = e - f
Total Certified Construction less Current Holdback				$1,652,200.00		h = d - g
Total Certified Construction less Current Holdback from last Certificate				$1,027,825.00		i
Amount of Current Contract Price Payable under this Certificate				$   624,375.00		j = h - i
GST Payable		7%		$     43,706.25		k = j * 7%
Amount Payable under this Certificate				$   668,081.25		l = j + k
Balance of Contract unpaid after payment under this Certificate				$1,033,425.00		m = c - h - j