8 STEPS TO COMPLETE
THE PAYMENT VOUCHER RESOURCE CENTER
NJDOT LOCAL AID
A INCLUDE YOUR VENDOR ID
Be sure to complete the payee identification
field with the federal employer identification
number (example: 12-3456789) assigned to A
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 B C
payment.
D E
B CONTRACT INFORMATION
Include the Contract Agreement Date. For
Federal projects only, also include the
Agreement Number and Contract I.D.#. All
can be found in the Executed Contract
Agreement. F
C TOTAL AMOUNT LISTING
With our new and improved fillable PDF
voucher, this section will be auto populated;
however, please be sure to enter the total G
amount(s) on the payment voucher, and
make sure the final amount is tallied correctly.
D PAYEE NAME AND ADDRESS
Please be sure to include the complete name
of the individual or company to whose name
the check shall be drawn as well as the
complete and correct address to where the
check shall be mailed.
E SENDING THE COMPLETED FORM(S)
H
You will need to send your completed form(s)
to the Division or Bureau to whom the
services were furnished. The invoice will be
forwarded to the appropriate Contract
Manager as noted in the Executed Contract
Agreement.
F SIGN
As the payee, you must sign the declaration
and date the payment voucher. Don’t forget
to also print your name and title.
G PAYEE REFERENCE NUMBER
Payee must show its own invoice or billing
number or any other identification for
reference purposes. This information is DID YOU REMEMBER TO SIGN?
STOP
recorded on the check stub and aids the See Section F in above graphic
payee to identify the invoices which have To insure prompt payment of your payment voucher, you
been paid. Please do not use more than 30 must sign, date, and print your name and title!
characters. Characters must also be unique.
H COST INCURRED DATES AND CONTRACT
DESCRIPTION SUBMIT TO YOUR DISTRICT
The cost incurred dates and description of
work performed, in addition to including a
REPRESENTATIVE
Attach completed form, payment voucher PV(C) and
task order number or extra work modification
supporting summaries and progress reports to an
number is also required. If available, you can
email and send to your District Representitives to
also include a UPC Code. See page 2 of this
complete the submission process.
document for examples.
FOR MORE INFORMATION | visit us at: [Link] OR Call Information Line at: (609) 649-9395
H SECTION SAMPLES RESOURCE CENTER
NJDOT LOCAL AID
INITIAL FORM
OFFICIAL DOT USE ONLY
PARTIALS FORM
OFFICIAL DOT USE ONLY
FOR MORE
FOR MORE INFORMATION
INFORMATION || visit
visit us
us at: [Link] OR
at: [Link] OR Call
Call Information
Information Line
Line at: (609) 649-9395
at: (609) 649-9395