
Consultant Invoice Number
A B C D E F G H I J K L M N O
CONSULTANT DESCRIPTION OF WORK
WORK
COMPLETE
D
PREVIOUS
APPLICATI
ON
WORK
COMPLETE
D THIS
APPLICATI
ON
TOTAL
AMOUNT
INVOICED
TO DATE
THIS
INVOICE
RETAINAGE
HELD
THIS
INVOICE
RETAINAGE
RELEASED
TOTAL TO
DATE
RETAINAGE
HELD
TOTAL TO
DATE
RETAINAGE
RELEASED
CONTINUATION SHEET - Schedule of Values
Consultant's Payment Request
The Consultant's Payment Request, containing the Consultant's signed Certification, is attached.
Use the final column on contracts where retainage is applicable.
Exhibit 3
Page 254 of 278
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