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PAYMENT APPLICATION <br />Page 1 <br />TO: Inidan River <br />1801 27th S <br />Vero Beach <br />Attn: James <br />FROM: Guettler Brothers <br />P 0 Box 12271 <br />Fort Pierce, <br />FOR: <br />County BOCC PROJECT Sector 3 Dune Repair APPLICATION # 11 Final Distribution to: <br />NAME AND Beach Nourishment/Sand Replacement PERIOD THRU: 07/14/2015 <br />FL 32960 LOCATION: OWNER <br />PROJECT #s: Bid # 2014037 ARCHITECT <br />Gray CONTRACTOR <br />Construction, LLC ARCHITECT: DATE OF CONTRACT 11/01/2014 ❑ <br />❑ <br />FL 34979-2271 ❑ <br />CONTRACTOR'S SUMMARY OF WORK <br />Application is made fo payment as shown below. <br />Continuation Page is attached. <br />I <br />1. CONTRACT AMOUNT $3,076,920.00 <br />Contractor's signature below is his assurance to Owner, concerning the payment herein applied for, <br />that: (1) the Work has been performed as required in the Contract Documents, (2) all sums previously <br />paid to Contractor under the Contract have been used to pay Contractor's costs for labor, materials <br />and other obligations under the Contract for Work previously paid for, and (3) Contractor is legally <br />entitled to this payment. <br />CONTRACTOR: Guettler Brothers Construction, LLC <br />2. SUM OF ALL CHANGE ORDERS $315,343.03 <br />By: ,� Date: 07/14/2015 <br />3. CURRENT CONTRACT AMOUNT (Line 1 +1- 2) $3,392,263.03 <br />Ben Guettler <br />State of: FLORIDA <br />County of: ST. LUCIE Subscribed and sworn to before * t°s'�"P:;°moo SHARON M.MOARIS <br />! ��" * MyCOMMISSION 6 FF 136734 <br />o 'I!'' ,„ EXPIRES: July 31, 2018 <br />me this 14th day of July 2015 1tOFM ' 6on*ThruBudget July <br />tary 31, 201ices <br />Notary Public: Sharon M. Moms ,it ./ q-ir'I- /l )� �2(.t4.-! <br />My Commission Expires: 7/31/2018 <br />4. TOTAL COMPLETED AND STORED $3,392,263,03 <br />(Column G on Continuation Page) <br />5. RETAINAGE: <br />a. 0.00% of Completed Work $0.00 <br />(Columns D + Edon Continuation Page) <br />b. 0.00% of Material Stored $0 00 <br />(Column F on Continuation Page) <br />Total Retainage (Line 5a + 5b or <br />Column I on Continuation Page) $0.00 <br />ENGINEER'S CERTIFICATION <br />Engineer's signature belowis his assurance to Owner, concerning the payment herein applied for, <br />that: (1) Engineer has inspected the Work represented by this Application, (2) such Work has been <br />to the extent indicated in this Application, and the quality of workmanship and materials <br />conforms with the Contract Documents, (3) this Application for Payment accurately states the amount <br />of Work completed and payment due therefor, and (4) Engineer knows of no reason why payment <br />should not be made. <br />CERTIFIED AMOUNT <br />6. TOTAL COMPLETED AND STORED LESS RETAINAGE $3,392,263.03 <br />(Line 4 minus Line 6 Total) <br />tcompleted <br />7. LESS PREVIOUS PAYMENT APPUCATIONS $3,222,649.88 <br />8. PAYMENT DUE <br />$169,613.15 <br />9. BALANCE TO COMPLETION <br />(Line 3 minus Line <br />6) $0.00 <br />(lfthe certified amount is different from the payment due, you should attach an explanation. Initial all <br />the figures that are changed to match the certified amount.) <br />Engineer: <br />By: Date: <br />SUMMARY OF CHANGE ORDERS <br />ADDITIONS <br />DEDUCTIONS <br />Total changes approi ed in <br />previous months 1 <br />$315,343.03 <br />S0.00 <br />Total approved this month <br />$0.00 <br />$0.00 <br />Neither this Application nor payment applied for herein Is assignable or negotiable. Payment shall be <br />made only to Contractor, and is without prejudice to any rights of Owner or Contractor under the <br />Contract Documents or otherwise. <br />j TOTALS <br />$315,343.03 <br />$0.00 <br />NET CHANGES <br />$315,343.03 <br />PAYMENT APPLICATION <br />Quantum Software Solutions, Inc. Document <br />