Form CEM-5105 "Materials on Hand Summary" - California

What Is Form CEM-5105?

This is a legal form that was released by the California Department of Transportation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2018;
  • The latest edition provided by the California Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CEM-5105 by clicking the link below or browse more documents and templates provided by the California Department of Transportation.

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Download Form CEM-5105 "Materials on Hand Summary" - California

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STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
MATERIALS ON HAND SUMMARY
CEM-5105 (NEW 06/2018)
CONTRACTOR NAME AND ADDRESS
CONTRACT NUMBER/CO/RTE/PM
PROJECT IDENTIFICATION NUMBER
PROJECT INFORMATION/NAME
Net Materials
on Hand
Amount
Incorporated
Previous
Materials on
Ineligible
(MHS) Amount
Estimate
REMARKS
Progress
Requested
or Furnished
Estimate’s
Hand Account
Materials
for Contract
Number &
[include source
Calculated by
Estimate
This Estimate
Materials
Net MHS
Balance - This
Amount ($)
Transactions
Line ID for
document description
Checked by
Date
($)
Amount ($)
Amount ($)
Estimate ($)
[2]
Input - This
MHS Amount
number(s)]
[1]
[3]
[5]
[6] = [4 – 5]
Estimate ($)
[4] = [1 – 2 – 3]
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
MATERIALS ON HAND SUMMARY
CEM-5105 (NEW 06/2018)
CONTRACTOR NAME AND ADDRESS
CONTRACT NUMBER/CO/RTE/PM
PROJECT IDENTIFICATION NUMBER
PROJECT INFORMATION/NAME
Net Materials
on Hand
Amount
Incorporated
Previous
Materials on
Ineligible
(MHS) Amount
Estimate
REMARKS
Progress
Requested
or Furnished
Estimate’s
Hand Account
Materials
for Contract
Number &
[include source
Calculated by
Estimate
This Estimate
Materials
Net MHS
Balance - This
Amount ($)
Transactions
Line ID for
document description
Checked by
Date
($)
Amount ($)
Amount ($)
Estimate ($)
[2]
Input - This
MHS Amount
number(s)]
[1]
[3]
[5]
[6] = [4 – 5]
Estimate ($)
[4] = [1 – 2 – 3]
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
MATERIALS ON HAND SUMMARY
CEM-5105 (NEW 06/2018)
GENERAL INFORMATION
This form is to provide summary documentation on materials on hand requests and authorization of related payments.
Section 3-906E, “Materials on Hand,” of the Construction Manual contains related guidance on materials on hand.
FORM
Use this form to summarize materials on hand requests and authorized payments.
CONTRACT NUMBER/CO/RTE/PM: For local agency encroachment permit projects, write the encroachment permit number in the CONTRACT NUMBER field.
PROJECT IDENTIFICATION NUMBER: For local agency encroachment permit projects, write N/A in the field.
Identify the progress estimate date (for example, 04/20/18).
Identify the amount requested this estimate in dollars that have been submitted by the contractor for this estimate on Form CEM-5101, “Request for Payment for Materials on Hand.” This is
the total amount requested.
Identify if there is any ineligible materials amount that will reduce the materials on hand amount for this estimate. Ineligible materials include those that have not met those requirements
identified in Section 9-1.16C, “Materials On Hand,” of the Standard Specifications (for example, dollar value criteria not met, material does not conform to contract, storage, etc.).
Document these amounts with the contractor’s submission of Form CEM-5101, “Request for Payment for Materials on Hand” and file in Category 51.
Identify if any portions of this material has been compensated through other bid item payments including payments for “furnish” that will reduce the materials on hand amount for this
estimate (incorporated or furnished materials amount). Document these amounts with the contractor’s submission of Form CEM-5101, “Request for Payment for Materials on Hand” and file
in Category 51.
Calculate the amount to be input on the current estimate’s contract transaction input for materials on hand (net MHS amount for contract transactions input – this estimate). This amount is
based on the amount requested this estimate less any ineligible materials amount and incorporated or furnished materials amount. Verify that remaining item payment amount is sufficient to
cover remaining work including installation costs. If not, reduce material on hand payment accordingly.
Identify the estimate number and contract transaction input line number associated with the current estimate’s materials on hand entry.
Record the previous estimate’s net MHS amount or zero if this is the initial materials on hand request.
Calculate the MHS account balance – this estimate by subtracting the previous estimate’s net MHS amount from the net MHS amount for contract transactions input – this estimate. Positive
values will result in additional monies to the contractor for MHS that will be reflected on the associated payment voucher. Negative values will result in credits to the Department for MHS that
will be reflected on the associated payment voucher.
Maintain this summary form within Category 51, “Materials on Hand,” of the project records. File the supporting documentation (for example, Form CEM-5101, “Request for Payment for
Materials on Hand,” ineligible materials amount calculation and incorporated or furnished materials amount calculations) with the summary form.
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
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