Sample Certificate for Payment				(revised - BGL)	07-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 less cumulative holdbacks   _______________________.
Statement of Account
Original Contract Price				$    3,200,000.00	a	known
Authorized Change Orders to Date				$       110,000.00	b	known
Current Total Contract Price				$    3,310,000.00	c	a+b
Total Certified Construction Completion to Date				$    1,778,000.00	d	determined
Holdback		10%		$       177,800.00	e	10% of d
Total Certified Construction less Current Holdback				$    1,600,200.00	f	d-e
Previous approved payment certificate #__________				$    1,153,625.00	g	known
	( Cumulative Total - incl. all holdbacks)
Current Contract Amount Payable under this Certificate				$       446,575.00	h	f-g
GST Payable		7%		$         31,260.25	I	7%of h
Amount Payable under this Certificate				$       477,835.25	j	h+I
Balance of Contract unpaid after payment under this Certificate				$    1,263,225.00	k	c-f-h
NOTE:
Holdback is cumulative throughout contract and applies to all completed works to be held pending completion of
contract in full.
Previous example showed roll over of holdback releaesable with each payment after prescrbed period
but which leaves the owner with effective holdback of only the current amount payable from time to time and at the
end of the project holding only 10% of final payment.