HUD-51003 Schedule of Materials Stored

Schedule of Materials Stored

U.S. Department of Housing

OMB Approval No. 2577-0157

(exp. 1/31/2017)

and Urban Development

Office of Public and Indian Housing

Public reporting burden for this collection of information is estimated to average 1.5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless that collecton displays a valid OMB control number.

This information is collected under the authority of Section 6(c) of the U.S Housing Act of l937 and HUD regulations. HAs are responsible for contract administration to ensure that the work for project development is done in accordance with State laws and HUD requirements. The contractor/subcontractor reports provide details and summaries on payments, change orders, and schedule of materials stored for the project The information will be used to ensure that the total development costs, identified in the ACC, are kept as low as possible and consistent with HUD construction requirements. Responses to

the collection are necessary to obtain a benefit. The information requested does not lend itself to confidentiality.

Instructions: This form is to be used to support the Periodic Estimate for Partial Payment (form HUD-51001). The contractor must prepare a separate schedule for his/her materials and for those of his/her subcontractors. Attach an original (or a copy ) to each copy of the Summary of Materials Stored (form HUD-51004). Enter all identifying data and list materials stored. The listing of materials stored must correspond to the arrangement established on the Schedule of Contract Payments (form HUD-51000) and each item will be keyed by corresponding item number. This form must be signed as noted.

Name of Public Housing Agency

Supporting Periodic Estimate for Partial Payment Number

Period

From (mm/dd/yyyy)

To (mm/dd/yyyy)

Item Number*

Description and Quality

Quantity

Unit of Measure

Unit Price at Site

Total Price

Amount Carried Forward

$

Total Amount or Amount Carried Forward

$

Prepared by (Contractor's Representative)

Date (mm/dd/yyyy)

Checked by (Owner's Representative)

Date (mm/dd/yyyy)

Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802)

As identified in Schedule of Amounts for Contract Payments, form HUD-51000.

form HUD-51003 (1/2014)

Name and Location of Project

Project Number

Name of General Contractor

Contract Number

Name of Subcontractor

Subcontract Number