Subcontractor Progress Payment Application
Project Name
Project Number
Application No.
Date
Contractor
Subcontractor
Payment Summary
Description
Amount
Original Subcontract Value
Approved Change Orders
Adjusted Subcontract Value
Total Completed and Stored (to Date)
Less Previous Payments
Payment Due This Application
Retainage
Total Payment Requested
Work Details / Description
Subcontractor Representative
Date
Contractor Approval
Date