Bridge Construction Progress Payment Request
Project Information
Project Name
Contract Number
Location
Contractor Name
Request Date
Payment Request No.
Progress Summary
Period Covered
Work Completed (%)
Remarks
Work Item Breakdown
Item No.
Description of Work
Unit
Total Quantity
Quantity This Period
Unit Price
Amount This Period
Cumulative Amount
Summary of Payment Requested
Previous Payment
Current Payment Requested
Total To Date
Remarks / Notes
Contractor's Authorized Signature
Owner / Engineer Approval