Title Page

  • Document No.

  • CONTRACT:

  • CONTRACTOR:

  • PERIOD:

  • ASSESSOR:

  • DATE:

  • WORK DETAILS:

  • I certify that the attached schedule of works or works completed above have been satisfactorily completed by the contractor

  • NOTE THE FOLLOWING EXCEPTIONS:

  • 1:

  • 2:

  • 3:

  • 4:

  • 5:

  • MONTHLY PAYMENT

  • Defect Notices Attached?

  • Audited by:

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