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2010-111
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Last modified
2/10/2016 4:30:25 PM
Creation date
10/1/2015 2:47:04 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
05/04/2010
Control Number
2010-111
Agenda Item Number
12.J.1.
Entity Name
Timothy Rose
Subject
North Water Treatment and Raw Water Transmission System
Project Number
2422
Bid Number
2010024
Supplemental fields
SmeadsoftID
10136
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`0171W� 7IFFIF��-1W71TW Fee, -SI 11 fee IF IF v <br /> w�' r ad z sIV <br /> III le <br /> IF <br /> P . E . CERTIFICATION FORM <br /> The undersigned hereby certifies that he/she is a professional engineer registered in the State <br /> of Florida and that he/she has been employed by <br /> (Name of Contractor) to design <br /> ( Insert P . E . Responsibilities) <br /> in accordance with Section for the <br /> North WTP Raw Water Transmission System <br /> (Name of Project) <br /> The undersigned further certifies that he/she has performed the design of the North WTP Raw Water <br /> Transmission System , that said design is in conformance <br /> (Name of Project) <br /> with all applicable local , state and federal codes , rules , and regulations, and that his/her signature and P . E . <br /> stamp have been affixed to all calculations and drawings used in , and resulting from , the design . <br /> The undersigned hereby agrees to make all original design drawings and calculations available to the <br /> Indian River County Board of County Commissioners <br /> (Insert Name of Owner) <br /> or the Owner' s authorized representative within seven days following written request therefor by the <br /> Owner. <br /> P . E . Name Contractor' s Name <br /> S ignature Signature <br /> Address Title <br /> Address <br /> END OF SECTION <br /> 01340 - 6 <br /> y <br /> I IF <br /> 7 IF <br /> IF I <br />
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