Payment Request Form Clause Samples

The Payment Request Form clause establishes the requirement for a formal document or process through which a party requests payment for goods delivered or services rendered. Typically, this clause outlines the necessary information that must be included in the form, such as invoice details, descriptions of work completed, and supporting documentation. Its core practical function is to standardize and streamline the payment process, ensuring that all payment requests are clear, complete, and verifiable, thereby reducing disputes and delays in payment.
Payment Request Form. The means by which the COUNTY and the SUBRECIPIENT document project and activity expenses and requests for payment. The SUBRECEIPIENT shall utilize this form when submitting or requesting any costs for payment and the form must be accompanied by legible supporting documentation to indicate the reasonableness, allowability, and appropriate procurement of the expense(s). As noted under SECTION III. TERM OF AGREEMENT and SECTION V. COMPENSATION AND ALLOWABLE PAYMENTS, all payments are reimbursements for eligible expenses or services defined as uncompensated expenses rendered during the Agreement term and paid prior to the final payment request due date. Copies of supporting documentation are required as part of the Payment Request for review of grant compliance and before payment will be authorized by the COUNTY to the SUBRECIPIENT. Reimbursement for eligible expenses will be made after review and authorization of a correct and complete Payment Request Form and required back up documentation. In accordance with the Federal Register Guidance, the COUNTY must be payor of last resort, meaning that if services are eligible to be billed to any other entity or funding source, including but not limited to, Medicaid, third party insurance or any other entity or funding source, the COUNTY will not pay for that service. Appropriate back-up/supporting documentation may include cancelled checks, vendor invoices, authorized purchase orders, attendance/service logs, other funder invoices, expenditure spreadsheets or other original documentation, as well as a copy of the SUBRECIPIENT’S check issued with authorized signature. For construction contracts, inspection reports from qualified officials should be submitted with the appropriate monthly payment request. The SUBRECIPIENT must submit the Payment Request Form with an authorized signature. Cancelled checks, paystubs, payroll reports, bank statements, and/or other documentation from vendors that expenses have been paid or services provided may be verified. As applicable, processing of payment requests is also subject to the requirements and conditions as set forth within the COUNTY’S Hurricane Ian CDBG-DR Subrecipient Manual.
Payment Request Form. Re: (Month) (Year) Energy Performance Contract Lease-Purchase Agreement dated as of , 201_, by and between , as Lessor and the State of Maryland, acting by and through the Maryland State Treasurer’s Office, as Lessee (the “EPC Lease”) In accordance with the terms of the Escrow Agreement dated as of (the “Escrow Agreement”) by and among (“Lessor”), the State of Maryland (“Lessee”) and (the “Escrow Agent”), the undersigned hereby requests the Escrow Agent to pay the following persons the following amounts from the Equipment Acquisition Fund created under the Escrow Agreement (the “Acquisition Fund”) for the following purposes. Payee’s Name and Address Invoice Number Dollar Amount Purpose The undersigned hereby certifies as follows:
Payment Request Form i. Agency shall complete and submit one Agency Payment Request Form, via an electronic submission.
Payment Request Form. Upon completion of work, the Subgrantee shall submit to NYSERDA, or its representative, a completed Payment Request Form,attached hereto as Exhibit E with accompanying documentation and such other information as may be requested by NYSERDA.
Payment Request Form. If such notification is by telephone, Borrower must promptly confirm the notification by delivering to Bank a completed Payment Request Form in the form attached at Exhibit A. Bank shall transfer the amount of the Term Loan to the Designated Account. Bank may make the Term Loan based on instructions from a Responsible Officer or his or her designee or without instructions if the Term Loan is necessary to meet Obligations which have become due. Bank may rely on any telephone notice given by a Person whom Bank reasonably believes is a Responsible Officer or designee. Borrower shall indemnify Bank for any loss Bank suffers due to such reliance unless caused by Bank’s negligence or intentional misconduct.
Payment Request Form. The Contractor shall submit a payment Request Form (Exhibit C) and copies of the original supporting documents for payment to the County. . Payment Request Forms for work performed on the Multi-Jurisdictional Hazard Mitigation Plan shall be submitted separate from the Payment Request Forms for work performed on the Safety Element.
Payment Request Form. Schedule of Allowances.
Payment Request Form. The Contractor shall submit a Payment Request Form (Exhibit C) and copies of the original supporting documents for payment to the County. Payments based on written invoices must include a description of: Work performed, dates, and location of services performed or goods delivered.

Related to Payment Request Form

  • Payment Request The Contractor shall ensure a payment request includes documentation appropriate to the type of payment request in accordance with the payment clause, contract financing clause, or Federal Acquisition Regulation 52.216-7, Allowable Cost and Payment, as applicable.

  • Payment Requests Review applications for payment with Contractor for compliance with the established procedure for their submission and forward with recommendations to Engineer, noting particularly the relationship of the payment requested to the schedule of values, Work completed, and materials and equipment delivered at the Site but not incorporated in the Work.

  • Request for Payment A. Not more than once every thirty days the Consultant shall send electronically to ▇▇@▇▇▇▇▇▇▇▇▇.▇▇▇ its request for payment of Exhibit A Work, accompanied by evidence satisfactory to the City justifying the request for payment, including a report of Work accomplished and tasks completed, and an itemization of Eligible Expenses with copies of receipts and invoices.

  • Stop Payment Request You may ask the Credit Union to stop payment on any check drawn upon or ACH debit scheduled from your checking account. You may request a stop payment by telephone, by mail, or in person. For checks, the stop payment will be effective if the Credit Union receives the order in time for the Credit Union to act upon the order. For ACH debits, the stop payment order must be received at least three (3) banking days before the scheduled date of the transfer. You must state the number of the account, date, and the exact amount of the check or item and the number of the check or originator of the ACH debit. If you give the Credit Union incorrect or incomplete information, the Credit Union will not be responsible for failing to stop payment on the item. If the stop payment order is not received in time for the Credit Union to act upon the order, the Credit Union will not be liable to you or to any other party for payment of the item. If we recredit your account after paying a check over a valid and timely stop payment order, you agree to sign a statement describing the dispute with the payee, to transfer all of your rights against the payee or other holders of the check to the Credit Union, and to assist the Credit Union in legal action taken against the person.

  • Disbursement Requests Except as expressly provided in the Credit Agreement, Administrative Agent must receive Disbursement Requests in writing. Disbursement Requests will only be accepted from the applicable Authorized Representatives designated in the Disbursement Instruction Agreement. Disbursement Requests will be processed subject to satisfactory completion of Administrative Agent’s customer verification procedures. Administrative Agent is only responsible for making a good faith effort to execute each Disbursement Request and may use agents of its choice to execute Disbursement Requests. Funds disbursed pursuant to a Disbursement Request may be transmitted directly to the Receiving Bank, or indirectly to the Receiving Bank through another bank, government agency, or other third party that Administrative Agent considers to be reasonable. Administrative Agent will, in its sole discretion, determine the funds transfer system and the means by which each Disbursement will be made. Administrative Agent may delay or refuse to accept a Disbursement Request if the Disbursement would: (i) violate the terms of this Agreement; (ii) require use of a bank unacceptable to Administrative Agent or Lenders or prohibited by government authority; (iii) cause Administrative Agent or Lenders to violate any Federal Reserve or other regulatory risk control program or guideline; or (iv) otherwise cause Administrative Agent or Lenders to violate any applicable law or regulation.