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Engineer's Certification <br />of Disbursement Request <br />I, , being the Professional Engineer retained by <br />(name of Professional Engineer) <br />, am responsible for overseeing construction of the <br />(name of Grantee/Recipient) <br />project described in the Agreement and do hereby certify that: <br />1. Equipment, materials, labor, and services represented by the construction invoices have been satisfactorily purchased <br />or received and applied to the project in accordance with construction contract documents filed with and previously <br />approved by the Department of Environmental Protection; <br />2. Payment is in accordance with construction contract provisions; <br />3. Adequate construction supervision is being provided to assure compliance with construction requirements and <br />Florida Administrative Code Chapter 62-600 or Chapter 62-604, as appropriate; <br />4. Construction up to the point of this disbursement is in compliance with the contract documents; <br />5. All changes, additions, or deletions to the construction contract(s) have been documented by change order and all <br />change orders have been submitted to the Department; and <br />6. All additions or deletions to the Project which have altered the Project's performance standards, scope, or purpose <br />(since issue of the pertinent Department permit) have been identified in writing to the Department or are identified <br />and attached hereto. <br />Signature of Professional Engineer <br />Firm or Affiliation <br />(Date) (P.E. Number) <br />DEP Agreement No. LP6822, Attachment B, Page 3 of 3 <br />