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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 /> I CERTIFY that 1 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 : Old Dixie Hinhway Sidewalk <br /> Improvements from 8St. to S . R. 60 . <br /> INDIAN RIVER COUNTY PROJECT # 1102 <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 /> Telephone Number: <br /> 00634 = Professional Surveyor and Mapper's Certification as to Elevations and Locations of the Work REV 04=07. doc <br /> 00634 - 1 <br /> F1Public Works\ENGINEERING DIVISION PROJECTS11102-Old Dixie Hwy Swk 6th St to SR 60-LAP\Admim\bid documents\Master Contract Documents\00634 - Professional <br /> Surveyor and Mappers Certification as to Elevations and Locations of the Work REV 04M07,doc Rev. 06/01 <br />