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SECTION 00634 = PROFESSIONAL SURVEYOR AND MAPPER' S CERTIFICATION AS TO <br /> ' ELEVATIONS AND LOCATIONS OF THE WORK <br /> (TO BE COMPLETED BY A FLORIDA PROFESSIONAL SURVEYOR AND MAPPER RETAINED <br /> ' BY THE CONTRACTOR AND TO ACCOMPANY CONTRACTOR' S FINAL APPLICATION FOR <br /> PAYMENT) <br /> 1 I CERTIFY that I am a Florida Professional Surveyor and Mapper retained by: <br /> ( Insert name of CONTRACTOR) <br /> Who is the CONTRACTOR for the following Project: <br /> ' PROJECT NAME : 26TH STREET BRIDGE REPLACEMENT <br /> INDIAN RIVER COUNTY PROJECT # 0378 <br /> I FURTHER CERTIFY that I have personally performed the survey work for the preparation <br /> of Record Drawings for the CONTRACTOR for this project or that such work was performed under <br /> my direct control and supervision . <br /> ' I FURTHER CERTIFY that all constructed elevations and locations of the Work are in <br /> conformance with the Contract Documents , except for discrepancies listed below. <br /> [Attach additional sheets as necessary] <br /> (SURVEYOR'S SEAL) <br /> ' CERTIFIED BY: <br /> Printed Name : <br /> Florida Professional Surveyor and Mapper Registration Number: <br /> ' Date Signed and Sealed by Professional Surveyor and Mapper: <br /> ' Company Name : <br /> Company Address : <br /> ' <br /> Telephone Number: <br /> 0378-00634 - Professional Surveyor and Mapper's Certification as to Elevations and Locations of the Work <br /> ' <br /> 00634 - 1 <br /> FAEngineering\Capital Projects\0378-26th Street Bridge\0378-26th Street Bridge CONTRACT DOC\0378-00634 - Professional Surveyor and Mappers Certification <br /> as to <br /> Elevations and Locations of the Work.doc Rev. 06/01 <br />