NOTE User to complete info shown in RED. Text shown in BLUE are fields. Select the fields and update by pressing F9. Change font colour to Black. DELETE THIS NOTE.

Date

To:	Owner's Company NameContractor's Company NameConstruction Lien ActOwner's Company Name

Street Address

Suite number

City, Province or State

Postal Code

Country

Attention:	Name

Re:	Certificate for Payment

Project Description

Project Location

Proj No:	nn.nnnnn.nn

Dear Owner’s Rep,

Enclosed is Certificate for Payment number XX dated yyyy mm dd as well as the following supporting documents:

Contractor's Company Name’s Application for Payment dated yyyy mm dd,

Contractor's Company Name’s invoice dated yyyy mm dd,

Schedule of Values for this application for payment dated yyyy mm dd,

Statutory Declaration dated yyyy mm dd.

Workplace Safety & Insurance Board (WSIB) Clearance Certificate dated yyyy mm dd.

This Certificate for Payment indicates to you that we have reviewed the Contractor’s application for payment based on our general review of the project and that, in our opinion, to the best of our knowledge, information and belief, the Contractor is entitled to payment in the amount certified.

The amount certified is consistent with the amount of the invoice accompanying the application for payment.

OR

The amount certified is less than the amount of the invoice accompanying the application for payment. The reasons for the difference are as follows:

Under the prompt payment provisions of the Construction Act, where the Owner does not intent to pay the full amount requested in the application for payment, notice must be given by the Owner to the Contractor. We recommend that Owner's Company Name consult their legal counsel regarding the timing and requirements of any such notice of nonpayment.

NOTE: Re: STATUTORY DECLARATION. Delete the following paragraph for the first claim and for others when you receive a Stat Dec.

The Contractor has not submitted a Statutory Declaration with this Progress Claim. The reason cited is that they have not yet received payment for the previous claim.

We recommend that Owner's Company Name consult their legal counsel prior to issuing this and each subsequent payment to Contractor's Company Name. There are legal considerations such as the requirements of the Construction Lien Act, and the Personal Property Security Act which may affect payment.

Please forward a copy of the attached Certificate for Payment, prepared by Consultant’s Firm Name, along with your payment to Contractor's Company Name.

USER NOTE: Ascertain if the client intends to submit the certificate for payment and site reports to a lender and if so, keep the following paragraph as a disclaimer otherwise delete the paragraph and this note.

It is understood and agreed that the information contained herein is for Owner's Company Name’s use, without any responsibility or liability of Consultant’s Firm Name to any lending institution, person or entity (lender) who may rely on the said information in relation to the lender’s financing of the project.

We trust that the above is understood. Should you have any questions with regard to the above, or have any information that would alter our recommendation please contact the undersigned.

Yours Truly,

Consultant’s Firm Name

per:

Your Name

Working Title

Officer Status

cc:	Contractor’s Rep, Contractor's Company Name