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Dgs 30 104 form co 12 2026
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- Click ‘Get Form’ to open the dgs 30 104 form co 12 in the editor.
- Begin by entering your FEIN and Contractor name in the designated fields. This information is crucial for identification and processing.
- Fill in the Payment Request Number, Period Beginning Date, and Period Ending Date at the top of Part A. Ensure these dates accurately reflect the billing period.
- In the Schedule of Values section, input the total value of work completed to date, including original contract line items and approved change orders. Be meticulous to avoid discrepancies.
- Complete the Contractor Certification section by signing and typing your name. This certifies that all information provided is accurate and that you are entitled to payment.
- Proceed to Part B and C for Original Contract Line Items and Approved Change Orders. Fill out each line item with corresponding values, ensuring clarity on retainage percentages.
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