Form NJSDA 816
Page 1 of 1
Revised: 04/03/12
Signature
Project Manager (Printed Name)
NJSDA Program Officer (Printed Name)
Signature
Signature
NJSDA Program Director (Printed Name)
Date
Date
Date
Approved Not Approved
Recommended Not Recommended
Recommended Not Recommended
NJSDA:
Approved:
Recommended:
NJSDA:
PMF/CM:
Date:
Contract No.:
PMF/CM:
Contractor:
PMF/CM PM:
Contract Name:
REQUEST FOR REDUCTION IN RETAINAGE
NJSDA 816
A reduction in retainage is requested based on the following:
The Contractor has performed his obligations satisfactorily and has fulfilled his requirements
for application of the reduction in accordance with the General Conditions in existence at the
time of contract award.
A properly executed Consent of Surety is attached.
The Project is beyond % actual completion. This request will reduce the retainage from
% to % ($ ) of the work completed to date until all closeout
requirements are completed.
File:
/y-2
1.
2.
3.
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