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NEC3 New Engineering Contracts 3

Contract No:
Employers Assessment
(Payment Certificate)
Task No:

This certificate is issued in terms of Clause 50 of the Conditions of Contract.

TITLE OF THE CONTRACT:

CONTRACTOR: EMPLOYER:
Contact Person: Contact Person:
Address: Address:

Telephone No.: Telephone No.:


Fax No.: Fax No.:
Contractors Invoice No: Employers certificate No:
Contractors VAT No: Employers cost allocation (WBS):

CUMULATIVE CUMULATIVE
DESCRIPTION THIS PREVIOUS NOW DUE
CERTIFICATE CERTIFICATE
(1) Price for Work Done to Date
(2) Compensation Events (to be deducted from DCF)
(3) Modifications
(4) Price adjustment for inflation
(5) Other amounts due to/by the Contractor
(6) Sub-totals
(7) Less Retention on (1 - 4) : 0.00%
(8) Sub-totals
(9) Add half Retention released
(10) Sub-totals
(11) Less delay damages
(12) Sub-totals
(13) Less low performance damages
(14) Sub-totals
Add VAT @ 14%
TOTALS
R 0.00 R 0.00 R 0.00

Total Contract Value = DCF Amount Approved = R 0.00


Total Value of work to date = Compensations to date =
Contract Amount Available = R 0.00 DCF Amount Available = R 0.00

Notes:
Assessment prepared by:

.......................................................
PRINT NAME
....................................................... ..................................
SIGNATURE DATE

Certified by the Employer:

....................................................... ....................................................... ..................................


PRINT NAME SIGNATURE DATE

Eskom Holdings Soc Limited Reg No. 2002/015527/06 NEC Payment Certificate Employers Assessment template Dec2009
Rev0.doc