Sheet 1: Cost Breakdown

	
	
	
	
	
	
	
	

		
Kentucky Housing Corporation
		
	

		
2. CONTRACTOR'S COST CERTIFICATION FORMS
		
	

		


		


		


		


		


		


		


	
	

		
Project Name: 
		


		
Contractor Name:
		


		
	

		


		


		


		


		


		


		


	
	

		
Owner Name:
		


		
Project Location:
		


		
	

		


		


		


		


		


		


		


	
	

		
All amounts shown below have been reduced to give effect to the amounts of any rebates, adjustments, discounts (except as allowed in the Cost Certification Guidelines), or any other devices, which if included, would have the effect of overstating the actual costs.
		
	

		
Please insert additional lines if more space is needed
		


		


		


		


		


		


	
	

		
CSI Section
		
Title
		
 New Construction 
		
 Rehabilitation 
		
 Commercial 
		
 Total 
		
Name of Subcontractor 
or Payee
	
	

		
1
		
General Requirements (Including Construction Management, Building Permit Fees, Tap Fees, Impact Fees, Construction Insurances, Bond Premiums, Site Security, Sewage Disposal Fees, etc.)
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
2
		
Existing Conditions
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
3
		
Concrete
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
4
		
Masonry
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
5
		
Metals
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
6
		
Wood, Plastics and Composites
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
7
		
Thermal and Moisture Protection
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
8
		
Openings
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
9
		
Finishes
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
10
		
Specialties
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
11
		
Equipment
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
12
		
Furnishings
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
13
		
Special Construction
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
14
		
Conveying Equipment
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
15
		
Reserved
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
16
		
Reserved
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
17
		
Reserved
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
18
		
Reserved
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
19
		
Reserved
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
20
		
Reserved
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
21
		
Fire Suppression
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
22
		
Plumbing
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
23
		
HVAC
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
24
		
Reserved
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
25
		
Integrated Automation
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
26
		
Electrical
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
27
		
Communications
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
28
		
Electronic Safety and Security
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
29
		
Reserved
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
30
		
Reserved
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
31
		
Earthwork
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
32
		
Exterior Improvements
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
33
		
Utilities
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
34
		
Transportation
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
35
		
Waterway and Marine Construction
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
36
		
Reserved
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
37
		
Reserved
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
38
		
Reserved
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
39
		
Reserved
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
40
		
Process Interconnections
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
41
		
Material Processing and Handling Equipment
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
42
		
Process Heating, Cooling, and Drying Equipment
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
43
		
Process Gas and Liquid Handling, Purification and Storage Equipment
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
44
		
Pollution and Waste Control Equipment
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
45
		
Industry-Specific Manufacturing Equipment
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
46
		
Water and Wastewater Equipment
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
47
		
Reserved
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
48
		
Electrical Power Generation
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
     Subtotal
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
49
		
Reserved
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		
50
		
Reserved
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		
Sub-Total
		
 $-   
		
 $-   
		
 $-   
		
 $-   
		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		
Total Construction Costs (Without General Requirements)
		
$0
		
$0
		
$0
		
$0
		


	
	

		


		
Total Construction Costs (Including General Requirements)
		
$0
		
$0
		
$0
		
$0
		


	



Sheet 2: Profit and Overhead

	
	
	
	
	

		
KENTUCKY HOUSING CORPORATION
		
	

		


		


		


		


	
	

		
2. CONTRACTOR'S COST CERTIFICATION FORMS
		
	

		


		


		


		


	
	

		


		


		


		


	
	

		
Project Name:
		
0
		
	

		


		


		


		


	
	

		
Owner Name:
		
0
		
	

		


		


		


		


	
	

		
Contractor Name:
		
0
		
	

		


		


		


		


	
	

		


		


		


		


	
	

		
Contractor Profit, Overhead, and General Requirements Calculation
		


		


		


	
	

		


		


		


		


	
	

		


		
General 
		
Contractor
		
Contractor
	
	

		


		
Requirements
		
Overhead
		
Profit
	
	

		
General Contractor Costs
		
$0
		
$0
		
$0
	
	

		
Allowable Percentages
		
6%
		
2%
		
6%
	
	

		
Maximum Fee
		
$0
		
$0
		
$0
	
	

		
Certified Amounts
		


		


		


	
	

		
Subcontractors* (list below)
		


		


		


	
	

		


		


		


		


	
	

		


		


		


		


	
	

		


		


		


		


	
	

		


		


		


		


	
	

		


		


		


		


	
	

		
Total**
		
$0
		
$0
		
$0
	
	

		


		


		


		


	
	

		


		


		


		


	
	

		
* - Reduce the amount of the above items payable to the General Contractor by the amounts paid for general requirements, contractor overhead and contractor profit to any identity of interest sub-contractor, material supplier or equipment lessor included within the trade item cost breakdown.
		


	
	

		


	
	

		


	
	

		


	
	

		


	
	

		


		


	
	

		
** - Totals must match amounts listed as General Requirements, Contractor Overhead and Contractor Profit on "Project Cost" breakdown on the Owner's Cost Certification.
		


	
	

		


		


		


		


	
	

		
If space is insufficient on this form for any line item, insert additional lines.
		


		


		


	



Sheet 3: Contractor Certification

	
	
	
	
	

		
KENTUCKY HOUSING CORPORATION
		
	

		


		
	

		
2. CONTRACTOR'S COST CERTIFICATION FORMS
		
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		
Project Name:
		
0
		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		
Owner Name:
		
0
		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		
Contractor Name:
		
0
		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		
General Contractor Certification
		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		
The undersigned hereby certifies that: (Check One)
		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		
There has not been and is not now any identity of interest between the general contractor on the one hand and the
		


		


		


		


		


		


		


		


		


		


	
	

		


		
owner or any subcontractor, material supplier, or equipment lessor on the other.
		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		
An identity of interest exists between the general contractor on the one hand and the owner or any
		


		


		


		


		


		


		


		


		


		


	
	

		


		
subcontractor, material supplier or equipment lessor on the other.
		


		


		


		


		


		


		


		


		


		


	
	

		


		
The following statement fully describes the identity of interest relationship(s):
		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


	
	

		


		


		


	
	

		


		


		


	
	

		


		


		


	
	

		


		


		


	
	

		


		


		


	
	

		


		


		


	
	

		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		
All amounts shown have been reduced to give effect to the amount(s) of any kickbacks, rebates, adjustments, discounts, 
		


		


		


		


		


		


		


		


		


		


		


	
	

		
(except as allowed in the Cost Certification Guidelines), or any other devices which, if included, would have the effect of
		


		


		


		


		


		


		


		


		


		


		


	
	

		
overstating the actual costs.
		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		
I hereby certify that all the information stated herein, as well as any information provided in the accompaniment herewith, is
		


		


		


		


		


		


		


		


		


		


		


	
	

		
true and accurate.
		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		
	

		


		


		


		


		


		


		


		


		
Contractor
		


		


		


	
	

		


		


		


		


		


		
By
		


		
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		
Its
		


		
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		
Date