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Payment Voucher PV(C) (Invoice)


The Payment Voucher PV(C) (rtf 293k) form is used for consultants, Right of Way and construction payments. For all other payments, please use the Payment Voucher PV form.

Payee instructions

Shaded areas (A-H) are required to be completed by Payee.
  1. Vendor identification number

    Complete the payee identification field with the federal employer identification number assigned to the business or the social security number if the payee is an individual.
    Note: You must be registered with the State of New Jersey Department of Treasury in order to receive payment.

  2. Contract information

    Contract Agreement date, Agreement Number assigned within contract and Contract identification number are in the Executed Contract Agreement.

  3. Total amount

    Enter the total amount of this payment voucher.

  4. Payee name and address

    The name of the individual or company to whose name the check shall be drawn and the complete address where the check shall be mailed.

  5. Send completed form to:

    Division or Bureau to whom the services were furnished. Forward two copies of the invoice to the appropriate Contract Manager as noted in the Executed Contract Agreement.

  6. Payee declaration

    Payee must sign the declaration and date the payment voucher. Print name and title.

  7. Payee reference number

    Payee must show its own invoice or billing number or any other identification for reference purposes. This information is recorded on the check stub and aids the payee to identify the invoices which have been paid. Do not use more than 30 characters and must be unique.

  8. Cost incurred dates and contract description

    Cost incurred dates and description of work performed, including task order number or extra work modification number, UPC Code if available.

To insure prompt payment, send the completed Payment Voucher PV(C), with supporting summaries and progress report and be sure to include payee signature.

Vendors may be entitled to interest on properly executed submitted payment vouchers that are past the State of New Jersey's deadline for eligible statutory prompt payment interest.

Sample form
When you roll your mouse over the yellow shaded areas on the form below, additional guidance information will appear:

Form PV(C) Instructions Enter the appropriate Vendor identification (ID) number (Federal ID number) which includes the location code. The location code will direct where the payment will be remitted to such as an address or automatic clearing house (ACH). All vendors and consultants must complete the proper paperwork (W-9 Form) and submit this to the New Jersey Department of Treasury in order to obtain a Vendor ID number.  Without a Vendor ID Number, payment cannot be made. Enter your company name and address. It should match the name and address that you used on the W-9 form that you submitted to the New Jersey Department of Treasury. The consultant must clearly sign, print and date the Payee Declarations area. If this area is not complete the invoice will be returned and the prompt payment start date will be adjusted accordingly. The Payee Reference Number must be accurately and correctly completed by the consultant. This is the reference that is put on your check/Automatic Clearing House (ACH) payment for you to use to match your receivables to your payables. The Agreement Date should be for the contract you are currently billing for and associated with the Agreement Number that you are entering as well as the Contract ID Number. By assuring that the Agreement Date, Agreement Number and Contract ID Number are correct and valid and are associated with the contract you are billing for, this will expedite your payment. This information will be included on all your agreements.  Personnel preparing the billing should be familiar with this information. This area represents the total payment due as calculated below. Send the completed form to your Contract Manager at the New Jersey Department of Transportation. The Cost Incurred Dates must coincide with the basic agreement or contract modification that you are billing for. In accordance with Article 24, billings are monthly. The Contract Description should clearly indicate the billings from the basic agreement or the contract modification, including the modification number. Each invoice must include supporting documentation showing the summary of costs incurred by period for both the Prime and Subconsultants indicating the Contract Ceiling Amounts by basic and extra work. The amount due must coincide with the basic agreement or contract modification that you are billing for and must be within the current ceiling of your contract. Enter the total amount.

 
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  Department of Transportation
  P.O. Box 600
  Trenton, NJ 08625-0600
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  Last Updated:  May 5, 2015