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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 I 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: Sandridge Golf Course— Driving <br /> Range Tee Renovations <br /> INDIAN RIVER COUNTY PROJECT# 1210 <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.doe <br /> 00634-1 <br /> FAPublie WorWENGINEERING DIVISION PROJECTS11210-Sandridge Driving Range Tee Renovation\Admimlbid documentsl00634-Professional Surveyor and Mapper's <br /> Certification as to Elevations and Locations of the Work REV 04-07.doc Rev.06101 <br /> SmeadSoft Reprint Date:Monday,January 11,2016-09:22:02-OfficialDocuments:9069,Attachment Id 1,Page 67 <br />