Public Works and Government Services Canada
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Acquisitions Forms

Form Number Form Title
PWGSC-TPSGC 186

Please note that the Private Sector Organization Screening (PSOS) Form is no longer available as form PWGSC-TPSGC 186.

To request a copy of the PSOS Form, please contact the Industrial Security Program's Security and Information Services at ssi-iss@tpsgc-pwgsc.gc.ca.

Request For Private Sector Organization Screening (PSOS)
ARC 0203

Shawn Roy
Disposition Officer
Library and Archives Canada

Telephone: 613-954-4178
Fax: 613-952-3973
E-mail:
shawn.roy@lac-bac.gc.ca

Request For Non-Accessioned Disposal
PWGSC-TPSGC 229

If you require additional information about this form, please contact:

Contract Cost Analysis, Audit and Policy Directorate
E-mail address: DGAIntegrite.ABIntegrity@tpsgc-pwgsc.gc.ca

Consent to a Criminal Record Verification
PWGSC-TPSGC 450

Form PWGSC-TPSGC 450, Claim for Exchange Rate Adjustments, must be used for requirements involving exchange rate fluctuation provisions.

If you require additional information about this form, please contact the Procurement Process Tools Division:

E-mail: Outilsd'approvisionnement.ProcurementTools@tpsgc-pwgsc.gc.ca

Claim for Exchange Rate Adjustments

Form used to calculate the exchange rate adjustment amount for each line item for which an adjustment is claimed, by identifying the applicable Foreign Currency Component (FCC), generally in Canadian dollars and the applicable foreign currency.

PWGSC-TPSGC 1111

If you require additional information about this form, please contact:

E-mail: DPPApublications.APPDpublications@tpsgc-pwgsc.gc.ca

Claim for Progress Payment
PWGSC-TPSGC 1112

If you require additional information about this form, please contact:

E-mail: DPPApublications.APPDpublications@tpsgc-pwgsc.gc.ca
Supplementary Claim

To be used for recording costs in support of progress payment, Form PWGSC-TPSGC 1111.

PWGSC-TPSGC 1686

If you require additional information about this form, please contact:

Stan Ouimet
Marine Systems Directorate
Ship Construction
6C2, Phase III, Place du Portage
11 Laurier Street
Gatineau, Quebec
K1A 0S5

Telephone: 819-956-0693
Facsimile: 819-956-0897
E-mail: stan.ouimet@tpsgc-pwgsc.gc.ca

Quotation for Design Change or Additional Work

Form is used for describing agreed design changes, identifying time and cost revisions and providing authorization to the Contractor to proceed with the Work

PWGSC-TPSGC 5116

If you require additional information about this form, please contact:

E-mail: DPPApublications.APPDpublications@tpsgc-pwgsc.gc.ca

Information on Incumbent Employees

To be used when information is to be provided by the Contractor in accordance with the requirements of Ontario's Employment Standards Act for janitorial, food catering and security service contracts.

PWGSC-TPSGC 9038

If you require additional information about this form, please contact:

E-mail: DPPApublications.APPDpublications@tpsgc-pwgsc.gc.ca

Design Change/Deviation

Form is to identify design changes and/or deviations.

PWGSC-TPSGC 9143

If you require additional information about this form, please contact:

E-mail: DPPApublications.APPDpublications@tpsgc-pwgsc.gc.ca

Contract Plan and Report Form

Form to be used for planning and estimating the cost of work and reporting actual progress and cost against the plan during contract performance.

PWGSC-TPSGC 9411

As of November 2013, form PWGSC-TPSGC 450, Claim for Exchange Rate Adjustments, must be used for new requirements which include exchange rate fluctuation provisions. Form 9411 is still available should it be needed in present contracts involving claims for exchange rate adjustments.

If you require additional information on form 9411, please contact the Procurement Process Tools Division:
E-mail: Outilsd'approvisionnement.ProcurementTools@tpsgc-pwgsc.gc.ca

Claim for Exchange Rate Adjustments

Form is to identify the value in foreign funds of the foreign currency component.

Construction and Consultant Services Contract Administration Forms
Real Property Contracting

Form Number Form Title
PWGSC-TPSGC 150

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

Construction Supervisors Weekly Project Report

To be filled out by project supervisors or managers.

PWGSC-TPSGC 357

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

Insurer's Certificate of Insurance

To be filled out by the Contractor's insurer and submitted to the contracting officer as a proof of insurance, in accordance with the insurance coverage requirements of the Insurance Terms.

PWGSC-TPSGC 442

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

Statutory Declaration for Consultants services

To be completed by consultants

PWGSC-TPSGC 500

Please note this form has been moved to the Forms Catalogue Public Service logo (This link is available only to clients with access to Publiservice, Government of Canada Extranet)

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

Construction Tender Request

To be filled out by PWGSC Project Manager and submitted to RPCD

PWGSC-TPSGC 504

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

Bid Bond

This is the standard form to be completed for construction bids when bid security is required and is being provided in the format of a bid bond.

PWGSC-TPSGC 505

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

Performance Bond

This is the standard form to be completed for construction contracts where performance security is required and is being provided in the format of a performance bond.

PWGSC-TPSGC 506

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

Labour and Material Payment Bond

This is the standard form to be completed for construction contracts where labour and material payment security is required and is being provided in the format of a labour and material payment bond.

PWGSC-TPSGC 599

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

On Site Instruction

Should be used by the Departmental Representative for any formal instructions given to the Contractor on site. On site instructions are to ensure and facilitate compliance with the contract requirements.

PWGSC-TPSGC 610

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

Change Order

Should be used where a change in the scope of work (increase or decrease) has been approved.

PWGSC-TPSGC 611

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

Contemplated Change Notice

Should be issued every time a Contractor is asked to price a potential change in the scope of the work.

PWGSC-TPSGC 1792

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

Request for Progress Payment - Construction Contracts

Should be submitted by the Contractor only for work that has been successfully completed and any materials delivered to the site but not yet installed. This form includes a cost breakdown.

PWGSC-TPSGC 1793 Cost Breakdown for Unit Price or Combined Price Contract

REPLACED by form 1792, which now includes a cost breakdown that applies to combined price or lump sum contracts.

PWGSC-TPSGC 1794 Cost Breakdown for Lump Sum Contract

REPLACED by form 1792, which now includes a cost breakdown that applies to combined price or lump sum contracts.

PWGSC-TPSGC 1795 Inspection and Acceptance

CANCELLED - the signature fields for the inspection and the acceptance of the work are now found in forms 1796 and 1797.

PWGSC-TPSGC 1796

Please note this form has been moved to the Forms CataloguePublic Service logo (This link is available only to clients with access to Publiservice, Government of Canada Extranet)

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

Certificate of Substantial Performance (Interim)

Issued by the Departmental Representative when the work, as described in the contract documents and any amendments, has reached substantial completion, in accordance with GC 5.5 or GC44. The signature fields for the inspection and the acceptance of the work are included in this form.

PWGSC-TPSGC 1797

Please note this form has been moved to the Forms CataloguePublic Service logo (This link is available only to clients with access to Publiservice, Government of Canada Extranet)

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

Certificate of Completion (Final)

Issued by the Departmental Representative once satisfied that the work, as described in the contract documents and any amendments, is 100% complete. The signature fields for the inspection and the acceptance of the work are included in this form.

PWGSC-TPSGC 1801

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

Extension of Time on Contracts

Should be used by the Contractor when submitting an application for an extension of time, in accordance with GC6.5 or GC36.

PWGSC-TPSGC 2835

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

Statutory Declaration

Must accompany each request for payment (including the first and final payment) received from the Contractor. It is required for all construction contracts of $25,000 or more.

PWGSC-TPSGC 2913

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

SELECT - Contractor Performance
Evaluation Report Form (CPERF)

Performance of the Contractor during and upon completion of the work shall be evaluated using this form.

PWGSC-TPSGC 2913-1

If you require additional information about this form, please contact:

Luc D'Aoust

Telephone: 819-956-6149
Facsimile: 819-956-3160
E-mail: luc.daoust@pwgsc-tpsgc.gc.ca

SELECT - Consultant Performance Evaluation Report Form (CPERF)

Performance of the Consultant during and upon completion of the work shall be evaluated using this form.