Laserfiche WebLink
Exhibit C <br />CERTIFICATION AS TO ACCURACY OF PAYMENT <br />The undersigned <br />of, on behalf of and as a duly authorized representative <br />(herto the best of Agency's knowledge, information and belief, to the inafter referred to as the "Agency") hereby certifies,. <br />Florida Department of Transportation <br />(hereinafter referred to as the "Department") as follows: <br />1. That the Invoice/Reimbursement Request package for Joint Partici ati <br />Financial Project Number(s) p on Agreement Number <br />the "Invoice") is in compliance with the Agreement, FHWA ER Manual or other raccet (hereinafter accrefeptable <br />planrred astas <br />developed by the Agency; andp able plan <br />2. That the Invoice is true and correct as determined by the Agency 's reasonable and <br />independent investigation, measurements and verification of work performed; and <br />3. That the Agency hereby recommends that the Department make <br />attached attached Invoice and supporting documentation; and p yment based on the <br />4. That the Agency hereby agrees to indemnify and hold the Florida Department <br />Transportation, its officers and employees harmless from all liabilities, damages, costs, and attorney <br />fees incurred and paid as a result of the negligence, recklessness, or intentional wrongful miscondu <br />the Agency and persons employed or utilized by the Agency in the preparation and/or audit Scope of Sereduct of <br />Invoice, supporting documentation, and execution of the work as outlined in the ofv the <br />--- - --------_____vices. <br />The Department also reserves the right to recover from the Agency any increased costs, delays or <br />other damages to the Department due to errors and/or omissions under applicable Florida Statutes <br />(334.044(2); 334.048.20.23(3)(a) and 337.015). <br />5. Monetary Amount Submitted <br />State of Florida <br />County of A false statement or omission made in <br />Sworn to and subscribed before me this day of connection with this certification is sufficient <br />by cause for suspension, revocation or denial of <br />payment, and may subject the person and/or <br />(Print name of the person signing the Certification) entity making false statement to any or all civil <br />and criminal penalties available pursuant to <br />applicable Federal and State Law: <br />Notary Public <br />Commission Expires <br />Personally Known OR Produced Identification. <br />Type of Identification Produced <br />Authorized Agency Official <br />By <br />Title <br />