[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-256787-105":53,"doc-detail-256787-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","pay-application-form-application-and-certification-for-payment","Pay Application Form - Application and Certification for Payment","","Payee application for payment form used in connection with a contract, certifying completion of the work in accordance with contract documents. Captures payer and payee details, contract information, application number, project number, and contract date, along with period coverage. Provides a financial summary including original contract sum, change order net changes, contract sum to date, total completed and stored amounts, retainage, earned less retainage, prior payments, current payment due, and remaining balance to finish.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/pay-application-form-application-and-certification-for-payment/256787/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/pay-application-form-application-and-certification-for-payment/256787.png","ImageObject",442,249,{"name":88,"@type":89},"Eden","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-31","2026-09-13",true,{"@type":98,"interactionType":99,"userInteractionCount":20},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What information does the pay application require about the parties and contract?","Question",{"text":108,"@type":109},"It includes payer and payee identification, project number, contract date, application number, and the period covered for the payment application.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"Which figures are used to calculate the current payment due?",{"text":113,"@type":109},"The form tracks original contract sum, net changes from change orders, total completed and stored, retainage, earned less retainage, subtracts previous certificates, and then computes the current payment due.",{"name":115,"@type":106,"acceptedAnswer":116},"How is retainage handled in the payment application?",{"text":117,"@type":109},"Retainage is shown as percentages of completed work and stored materials, with a total retainage figure used to determine earned less retainage and the final amount due.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},256787,1789307391,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":20,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":125,"read_time":9},1374391974468,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","TO (PAYER): PROJECT: APPLICATION NO:  \nPERIOD TO:  \nFROM (PAYEE):  \nPROJECT NO.:  \nCONTRACT DATE:  \nPAYEE APPLICATION FOR PAYMENT  \nCERTIFICATE OF THE PAYEE:  \nApplication is made for payment, as shown below, in connection with the Contract.  \nContinuation Sheet, is attached.  \n1. ORIGINAL CONTRACT SUM $    \n2. Net change by Change Orders $    \n3. CONTRACT SUM TO DATE (Line 1 ± 2) $ $    \n4. TOTAL COMPLETED & STORED TO $   DATE (Column G on G703)  \n5. RETAINAGE:  \na.   % of Completed Work $    \n(Column D + E on G703)  \nb.   % of Stored Material $    \n(Column F on G703)  \nTotal Retainage (Lines 5a + 5b or  \nTotal in Column I ofG703) $    \n6. TOTAL EARNED LESS RETAINAGE $  (Line 4 Less Line 5 Total)  \n7. LESS PREVIOUS CERTIFICATES FOR  \nPAYMENT (Line 6 from prior Certificate) $    \n8. CURRENT PAYMENT DUE $   \n9. BALANCE TO FINISH, INCLUDING RETAINAGE $  (Line 3 less Line 6)  \n\n| CHANGE ORDER SUMMARY | ADDITIONS | DEDUCTIONS |\n| --- | --- | --- |\n| Total changes approved\u003Cbr>in previous months by Payer |  |  |\n| Total approved this Month |  |  |\n| TOTALS |  |  |\n| NET CHANGES by Change Order |  |  |\n\nThe undersigned certifies that to the best ofthe PAYEE's knowledge, information and belief the  \nWork covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the above mentioned, and that current payment shown herein is now due.  \nPAYEE:  \nBy:   Date:    \nState of: County of:  \nSubscribed and sworn to before me this day of  \nNotary Public:  \nMy Commission expires:  \nPay Application Form-Page 2  \nPAGE  \nOF  \nPAGES  \nAPPLICATION AND CERTIFICATION FOR PAYMENT, containing signed certification is attached.  \nIn tabulations below, amounts are stated to the nearest dollar.  \nUse Column I on Contracts where variable retainage for line items may apply.  \nAPPLICATION NUMBER:  \nPERIOD TO: PROJECT NO:  \n\n| A | B | C | D | E | F | G |  | H | I |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| ITEM\u003Cbr>NO. | DESCRIPTION OF WORK | SCHEDULED\u003Cbr>VALUE | WORK COMPLETED |  | MATERIALS\u003Cbr>PRESENTLY\u003Cbr>STORED\u003Cbr>(NOT IN\u003Cbr>D OR E) | TOTAL\u003Cbr>COMPLETED\u003Cbr>AND STORED\u003Cbr>TO DATE\u003Cbr>(D+E+F) | %\u003Cbr>(G ÷ C) | BALANCE\u003Cbr>TO FINISH\u003Cbr>(C-G) | RETAINAGE\u003Cbr>(IF VARIABLE\u003Cbr>RATE) |\n|  |  |  | FROM PREVIOUS\u003Cbr>APPLICATION\u003Cbr>(D + E) | THIS PERIOD |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |\n|  | GRAND TOTALS |  |  |  |  |  |  |  |  |","cbCaikO4lntLmi8x","https://ap.wps.com/l/cbCaikO4lntLmi8x","pdf",191906,"English","# Pay Application Form Details\n## Contract and Payment Summary\n## Application and Certification Sections\n## Item Tabulation and Totals","[{\"question\":\"What information does the pay application require about the parties and contract?\",\"answer\":\"It includes payer and payee identification, project number, contract date, application number, and the period covered for the payment application.\"},{\"question\":\"Which figures are used to calculate the current payment due?\",\"answer\":\"The form tracks original contract sum, net changes from change orders, total completed and stored, retainage, earned less retainage, subtracts previous certificates, and then computes the current payment due.\"},{\"question\":\"How is retainage handled in the payment application?\",\"answer\":\"Retainage is shown as percentages of completed work and stored materials, with a total retainage figure used to determine earned less retainage and the final amount due.\"}]","Pay Application Form - Application and Certification for Payment | PDF"]