Final payment certificate Quebec Fisheries Fund

Final payment certificate
Quebec Fisheries Fund

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Final payment certificate
Final payment certificate
Recipient name:		Project number:
I hereby certify that:	Yes	No
1. the project has been successfully completed in accordance with the statement of work.
2. the project was completed on	(YYYY/MM/DD)
3. the recipient has fully paid suppliers and employees for costs claimed.
4. all costs have been claimed at fair market value, net of any refunds or other consideration provided by the supplier(s).
5. the project is free from any present or potential liens or claims that could jeopardize it.
6. all terms and conditions of the contribution agreement, including environmental mitigation measures, if any, have been met.
7. project assets are on site (have not been disposed of, have not been leased to other parties or have not ceased to be used in the operation).
If you certified no to any of the above statements, please indicate the statement no. And provide comments here:
8. For all projects (Quebec Fisheries Fund) list all funding sources and the amounts received for the project, including any funds received from other government departments, municipalities, crown corporations or agencies.
I hereby solemnly declare that I have examined the contribution agreement for the above project and I certify that the above responses are true, knowing that this declaration is of the same force and effect as if made under oath and by virtue of the Canada Evidence Act.
Person authorized to sign on behalf of the recipient
Signature:		Date:
Print name and title:

Final payment certificate

Final payment certificate

Recipient name:

Project number:

I hereby certify that:

Yes

1. the project has been successfully completed in accordance with the statement of work.

2. the project was completed on

(YYYY/MM/DD)

3. the recipient has fully paid suppliers and employees for costs claimed.

4. all costs have been claimed at fair market value, net of any refunds or other consideration provided by the supplier(s).

5. the project is free from any present or potential liens or claims that could jeopardize it.

6. all terms and conditions of the contribution agreement, including environmental mitigation measures, if any, have been met.

7. project assets are on site (have not been disposed of, have not been leased to other parties or have not ceased to be used in the operation).

If you certified no to any of the above statements, please indicate the statement no. And provide comments here:

8. For all projects (Quebec Fisheries Fund) list all funding sources and the amounts received for the project, including any funds received from other government departments, municipalities, crown corporations or agencies.

I hereby solemnly declare that I have examined the contribution agreement for the above project and I certify that the above responses are true, knowing that this declaration is of the same force and effect as if made under oath and by virtue of the Canada Evidence Act.

Person authorized to sign on behalf of the recipient

Signature:

Date:

Print name and title:

Date modified:: 2019-12-06

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Final payment certificate
Quebec Fisheries Fund

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