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Page 4of5 <br /> CERTIFICATION OF ENGINEER : <br /> I certify that I have reviewed the above and foregoing Periodic Estimate for Partial <br /> Payments that to the best of my knowledge and belief it appears to be a reasonably accurate <br /> statement of the work performed and /or material supplied by the Contractor. I am not <br /> certifying as to whether or not the Contractor has paid all subcontractors , laborers , <br /> materialmen and suppliers because I am not in a position to accurately determine that issue . <br /> Dated <br /> SIGNATURE <br /> CERTIFICATION OF INSPECTOR : <br /> I have checked the estimate against the Contractor ' s Schedule of Amounts for Contract <br /> Payments and the notes and reports of my inspections of the project. To the best of my <br /> knowledge , this statement of work performed and/or materials supplied appears to be <br /> reasonably accurate , that the Contractor appears to be observing the requirements of the <br /> Contract with respect to construction , and that the Contractor should be paid the amount <br /> requested above , unless otherwise noted by me. I am not certifying as to whether or not the <br /> Contractor has paid all subcontractors , laborers , materialmen and suppliers because I am not <br /> in a position to accurately determine that issue. <br /> Dated : <br /> SIGNATURE <br /> [The Remainder of This Page Was Left Blank Intentionally] <br /> 30 <br /> F :\Public Works\ENGINEERING DIVISION PROJECTS\ 1042 V13 Sports Village Lighting\Admim\bid documents\13id Docs V13SV Lighting revised <br /> 12- 13 - IO .doe <br />