STATE OF EXAMPLE FORM 1FS CONSTRUCTION FUND Page 3 REIMBURSABLE EXPENSES AND EXTRA COMPENSATION (Full Service Agreements) Complete items A through D and H for all requests. Complete items E, F and G as applicable. Refer to the Fund’s “Bulletin on Payment of Consultant Fees” for detailed instructions. A PAYEE B INVOICE DATE D SUCF PROJECT NO. C CONTRACT NO. D- CONSULTANT’S PROJECT NO. E REIMBURSABLE EXPENSES: AUTHORIZATION LETTER NO. CURRENT REQUEST SUCF USE 1. Transportation, Meals and Lodging $ 1,123.00 2. Long Distance Telephone 25.00 3. Reproductions / Postage 546.50 4. Advertisement for Bids 150.00 5. TOTAL $ (To Page 1) 1,844.50 F COMPENSATION: 1. Models, Photos, Renderings $ 1 500.00 2. Drawings 2 1,625.00 3. Special Technical Engineering and Consultant Services 7 100.00 4 800.00 4. Testing Labs, Surveys, Borings and Photos 5. Significant Program Changes 6. Change Orders 7. Site Representative and Field Expense 8. Alternates 9. Contractor Default and Casualty 10. TOTAL $ (To Page 1) 3,025.00 G SPECIAL COMPENSATION $ (To Page 1) 0 H TOTAL (Add Lines E5, F10 and G) $ 4,869.50 FOR SUCF USE: I hereby certify that supporting documents and/or records have been with the Fund. The documents have been examined in accordance with contract terms, Fund standards, and those standards set forth by the State Comptroller. Payment in the amount indicated has been found to be a proper State charge and is therefore approved. SUCF Auditor: Date:
Appendix B CONSULTANT’S APPLICATION FOR PAYMENT (BLANK) FULL SERVICE AGREEMENTS, FORM 1FS CONSULTANT’S APPLICATION FOR PAYMENT (Full Service Agreements) Submit application in duplicate to SUCF Controller together with required paid-up bills and schedules. On this page, complete parts 1-6. Refer to the Fund’s “Bulletin on Payment of Consultant Fees” for detailed instructions. 1 PAY TO: (Name and Address) 2 PAYEE REFERENCE NUMBERS a. Contract Number D- b. SUCF Project Number c. Consultant’s Project Number d. Payee Identification Number 3 I hereby make application for payment upon my contract with the University Construction Fund for: at 4 SUMMARY OF PAYMENT REQUEST Fill in applicable lines only. Include details and computations on pages 2 and 3. 5 CONSULTANT’S CERTIFICATION I hereby certify that I am the person in whose name the foregoing account is rendered; that the services and property charged have been performed or delivered; that the sums charged are reasonable and just; that all requirements of said contract have been complied with; and, that that no part of the foregoing account has been previously paid. Schematic Payment $ Design Manual Payment $ Construction Documents Payment $ Signature Date Construction Phase Payment $ Additional forms required. Interior Design Payment $ SUCF AUDITOR APPROVAL
Appendix C – Form 1FSa CONSULTANT’S APPLICATION FOR PAYMENT (Full Service Agreements) Submit application in duplicate to SUCF Controller together with required paid-up bills and schedules. On this page, complete parts 1-6. to the Fund’s “Bulletin on Payment of Consultant Fees” for detailed instructions. 1 PAY TO: (Name and Address) 2 PAYEE REFERENCE NUMBERS a. Contract Number D- b. SUCF Project Number c. Consultant’s Project Number d. Payee Identification Number 3 I hereby make application for payment upon my contract with the University Construction Fund for: at 4 SUMMARY OF PAYMENT REQUEST Fill in applicable lines only. Include details and computations on pages 2 and 3. 5 CONSULTANT’S CERTIFICATION I hereby certify that I am the person in name the foregoing account is rendered; that the services and property charged have been performed or delivered; that the sums charged are reasonable and just; that all requirements of said contract have been complied with; and, that no part of the foregoing account has been previously paid. Program Verification Payment $ Concept Phase Payment $ Schematic Payment $ Design Manual Payment $ Construction Documents Payment $ Signature Date Construction Phase Payment $ Additional forms required.
Interior Design Payment $ 6 SUCF AUDITOR APPROVAL Reimbursable Expenses $ Voucher Number: Compensation $ Checked as to calculations and provisions of contract. Special Compensation $ Signature Date TOTAL PAYMENT DUE THIS VOUCHER $ Total payments to date, including this request $ BASIC FEE COMPUTATIONS (Full Service Agreements) Complete payment sections as applicable. A BASIC DESIGN FEE A BASIC DESIGN FEE PROGRAM VERIFICATION PAYMENT 1. Budget $____________ Total Fee $____________ Program Verification Phase Fee $____________ 1. 2. 3. 4. %
BASIC FEE COMPUTATIONS (Full Service Agreements) Complete payment sections as applicable. Refer to the Fund’s “Bulletin on Payment of Consultant Fees” for detailed instructions. A BASIC DESIGN FEE B BASIC CONSTRUCTION PHASE FEE SCHEMATIC PAYMENT CONSTRUCTION PHASE PAYMENT 1. Schematic Cost Estimate $1,800,000.00 1. Original Construction Contract Amount $1,950,000.00 2. Total Fee $171,195.00 2. Not Used) 3. Schematic Fee (20% of Line 2) $34,239.00 a. Less Credit – Stated in Contract $2,000.00 3. Construction Cost (Line 1 minus Line 2) $1,950,000.00 b. Net Schematic Fee (Line 3 Line 3a) $32,239.00 4. Total Fee $184,357.50 4. % of Schematic Completed 100% 5. Construction Phase Fee (25% of Line 4) $46,089.38 5. Progress Fee Earned (Line 3b x Line 4) $32,239.00 6. % of Construction Phase Completed 25% 6. Less Previous Schematic Payments $15,000.00 7. Progress Fee Earned (Line 5 x Line 6) $11,522.34 7. Net Amount Now Due $17,239.00 8. Less Previous Construction Phase Payments 0 9. Net Fee (Line 7 minus Line 8) $11,522.34 DESIGN MANUAL PAYMENT 10. Less Retention 0 1. Design Manual Cost Estimate $1,900,000.00 11. Net Amount Now Due $11,522.34 2. Fee $179,970.00 3. Design Manual Fee (15% of Line 2) $26,995.50 REMARKS 4. % of Design Manual Completed 5. Progress Fee Earned (Line 3 x Line 4) 100% 6. Less Previous Design Manual Payments 7. Net Amount Now Due $1995.5.0 CONSTRUCTION DOCUMENTS PAYMENT 1. Final Cost Estimate $2,005,000.00 2. Total Fee $189,165.00 3. Construction Documents Fee (40% of Line 2) $75,666.00 4. % of Design Manual Completed 100% 5. Progress Fee Earned (Line 3 x Line 4) $75,666.00 6. Less Previous Construction Doc. Payments $45,000.00 7. Net Amount Now Due $30,666.00