Primus Application for Payment Form

This worksheet can be used to create your monthly billing using Primus' payment application format.  Please complete all of the fields below & press the "Generate Application" button.  Our website will then generate your application, which can be printed by you for signiture.

Remember, Primus must receive your application at least via fax, on or before the 25th of each month to be included in the draw to the owner.

A signed Conditional Waiver and Schedule of Values (if required) must be submitted with all Applications for Payment.

Typically, only one application for each job should be submitted during each month.

Subcontractor Name:
City, State, Zip:
Phone Number: Fax:
Billing Contact:
Primus Project Name & NO.
Period: Payment Request NO.

1. Original Contract Amount $
2. Approved Change Orders Through NO. $ Only approved Primus Change Orders should be included in the billing.
3. Adjusted Contract Value $ Calculated when the application is generated
4. Total Completed and Stored to Date $ Enter the total value of work completed or to be completed by the end of the month, including prior draws.
5. Less Retainage 
(please select retainage %)
$ Calculated when the application is generated
6. Total Earned Less Retainage $ Calculated when the application is generated
7. Less Amount Previously Billed
(line 6 From Previous Application)
$ Net Amount previously billed. Enter 0.00 for the first draw.
8. Current Amount Due $ Calculated when the application is generated