DCP 14 Request for Final Payment
Front Page
Bottom of Sheet Do not submit an incomplete packet Ledger questions to John Fox ( ) DCP 14 questions to Mark Channer ( )
Certified to Date
Total Due Total Due + BR Bond/Misc Approp = Certified to Date Total Due under the Certified to Date Must Equal Reimbursement Request No hand-written edits
Retainage Retainage MUST be set to ZERO
Required Checklist Required if applicable Mark ALL lines. Indicate those that do not apply.
Page 2 – Sample Final Contract Voucher
Page 3 – Sample SA Payment Request Must be “Final” Include all accompanying documents
Page 4 – DCP 12 Submit to DSAE for Approval
DCP 12 – Top of Sheet
DCP 12 – Middle of Sheet
DCP 12 – Bottom of Sheet Total Increased costs cannot exceed actual cost increase Participation % Additional Federal Increased Costs. Do not submit if incomplete.
Pages 5 & 6 – Sample SA
Page 7 – Sample CO
Page 8 – Sample Work Order Work Orders are not mandatory, but should be included if they support the SA’s or CO’s.
Page 9 – Sample Overrun Justification Any time there are overruns, an Overrun Justification should be sent. The Feds what to see why there were overruns, whether you ask for additional funds or not.
Page 10 – Sample Material Certification Exception Summary Must be included even if there are no exceptions.
Page 11 – Certificate of Performance If the Final estimate voucher contains a similar statement by the engineer in charge of the work, the Certificate of Performance will not be required. State Statutes require that this Certificate is to be signed by the Engineer in Charge.
Pages 12 & 13 – Final Inspection Report
Pages 14 and 15 – Sample Certificate of Final Acceptance MUST BE NOTARIZED!
Page 16 - Sample of the Certificate of Final Acceptance
Copies Available An electronic (PDF) copy of the Request for Final Payment sample packet is available on the DCP Checklist page.
Questions?
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