199x Filetype XLS File size 0.04 MB Source: www.tfc.texas.gov
Agency Voucher No. STATE OF TEXAS PURCHASE VOUCHER FOR CONSTRUCTION PROJECT MANAGEMENT Comptroller's Vendor Number Agency No. Agency Name TFC Project Number 303 TFC e Pay to: (Name, Address, City State, Zip Code) tPeriod of Service a D From: To: Contract Date d n a n Total Voucher Amount Invoice Date Invoice Number g i S $0.00 Architect/Engineer: n o Project Cost Description Project Cost Amount i Architect/Engineer: t c ee Contract/Agreement Number n St o a i l TFC Project Manager: t aD Contract Date c v e od S rn Original Construction Cost a l p TFC Design & a pn Change Order Cost v Ag Construction Director: o i r S Fee Basis (%) p p TFC Executive Approval: A Total Basic Services Fee Description of Service Percent Previously A/E Basic Services (New Construction) Percent Fee Completed Amount Earned Approved Now Due Schematic Design/Draft Prelim Report Design Development/Final Preliminary Report Construction Documents/Final Report Bidding and Award Construction Administration Less Retainage Total A/E Fee (New Construction) (Class-871) Percent Previously 0.00 A/E Basic Services (Renovation) Percent Fee Completed Amount Earned Approved Now Due Schematic Design/Draft Prelim Report Design Development/Final Preliminary Report Construction Documents/Final Report Bidding and Award Construction Administration Less Retainage Total A/E Fee (Renovation) (Object Class 871) 0.00 Now Due Additional Services Amendment Number: Amendment Number: Amendment Number: Less Retainage Total Additonal Services (Object Class 873) 0.00 Testing & Other General Expenses (Provide detail supporting documents in accordance with your contract agreement) Now Due Testing Services (Provide Detail Supporting Documents)(884) Surveys (882) Printing and Reproduction (874) Misc. Expenses: (896) Total Testing & Other General Expenses 0.00 TOTAL AMOUNT DUE THIS PAY VOUCHER: $0.00 AGENCY CERTIFICATION PRICES ABOVE ARE APPROVED I certify that the above services were rendered or goods received; that they Texas Facilities Commission correspond every particular with the contract under which they were procured; that the invoice is true and unpaid; and that the claim was presented to the State within the applicable limitations period. Signature of TFC, FDC Accountant or Auditor: FOR STATE PAYING AGENCY FISCAL USE ONLY Batch No: Remittance Vendor ID DT Source Code (Circle One) Batch Date Send to USAS Entered By: Amount PCC Yes No Date Entered: Warrant/Direct Deposit No.: Encumbrance No. C Req # Order Date Invoice # Received Date AY Agency Fund Object Class Org Code Amount Payment Due Date Request Payment Date Interest Override Description (includes vendor account#) Descriptive / Legal Text Prepared by: Date: Approved by: Date: $0.00
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