RD 1924-18 Partial Payment Estimate

FORM APPROVED | OMB No. 0575-0042, 0575-0189
Exp. Date: 03/31/2026

Form RD 1924-18
(Rev. 6-97)

CONTRACT NO.

UNITED STATES DEPARTMENT OF AGRICULTURE
RURAL DEVELOPMENT
FARM SERVICE AGENCY

PARTIAL PAYMENT ESTIMATE NO.

PARTIAL PAYMENT ESTIMATE
OWNER:

PAGE

CONTRACTOR:

PERIOD OF ESTIMATE
FROM

CONTRACT CHANGE ORDER SUMMARY
No.

Agency Approval
Date

ESTIMATE

Amount
Additions

TO

1. Original Contract

Deductions

2. Change Orders
3. Revised Contract (1 + 2)
4. Work Completed*
5. Stored Materials*
6. Subtotal (4 + 5)
7. Retainage*
8. Previous Payments
9. Amount Due (6-7-8)

TOTALS

* Detailed breakdown attached

NET CHANGE

CONTRACT TIME
Original (days)
Revised

On Schedule

Yes

Starting Date

No

Projected Completion

Remaining

CONTRACTOR'S CERTIFICATION:

ARCHITECT OR ENGINEER'S CERTIFICATION:

The undersigned certifies that the work has been carefully
inspected and to the best of their knowledge and belief, the
quantities shown in this estimate are correct and the work has
been performed in accordance with the contract documents.

The undersigned Contractor certifies that to the best of their
knowledge, information and belief the work covered by this
payment estimate has been completed in accordance with
the contract documents, that all amounts have been paid by
the contractor for work for which previous payment estimates
was issued and payments received from the owner, and that
current payment shown herein is now due.

Architect or Engineer
Contractor
By
By
Date
Date
ACCEPTED BY AGENCY:

The review and acceptance of this estimate does not attest to
the correctness of the quantities shown or that the work has
been performed in accordance with the contract documents.

APPROVED BY OWNER:

Owner
By
By

Title

Date

Date

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control
number for this information collection is 0575-0042 and 0575-0189, which expire 3/31/2026. The time required to complete this information collection is estimated to average 30 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection information. All responses to this collection of information are voluntary. Any questions on this
burden can be sent to [email protected].

RD 1924-18 (Rev. 6-97)

TYPICAL UNIT PRICE BREAKDOWN *
CONTRACT (revised)
ITEM

DESCRIPTION

QUANTITY

UNIT
PRICE

THIS PERIOD
AMOUNT

QUANTITY

%

TOTAL TO DATE

AMOUNT

COM-

AMOUNT

QUANTITY

PLETE

TOTALS

TYPICAL STORED MATERIALS
AND RETAINAGE BREAKDOWN *

TYPICAL LUMP SUM PRICE BREAKDOWN *

ITEM

DESCRIPTION

SCHEDULED
VALUE

WORK COMPLETED
THIS PERIOD

TO DATE

%

COMPLETE

MATERIALS STORED AT END OF THIS PAYMENT PERIOD
DESCRIPTION

QUANTITY

UNIT
VALUE

AMOUNT

RETAINAGE
THIS ESTIMATE

PERCENT

RETAINED

%
WORK COMPLETED:
STORED MATERIALS:
OTHER (explain)
TOTALS

TOTAL

* As a minimum, detailed breakdowns should contain this information.

RD 1924-18
REVERSE