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SECTION 00622 - Contractor's Application for Final Payment <br />Application for Payment No. 1 -Final. <br />For Work Accomplished through the period of 06/19/2014 through 08/06/2014. <br />To: INDIAN RIVER COUNTY UTILITIES (OWNER) <br />From: MELVIN BUSH CONSTRUCTION, INC. (CONTRACTOR) <br />Contract: WATER, SEWER AND RECLAIM WATERLINE REPLACEMENT/ EXTENSIONS, AND <br />MISCELLANEOUS LABOR CONTRACT, BID NO 2010052 AWARDED <br />Project: YOUNGS MARKET- US1 SOUTH 12" HDPE DIRECTIONAL BORE REPLACEMENT OF <br />EXISTING 10" AC WATERMAIN FROM 21S1 STREET SW 1000' TO THE NORTH AND <br />10" PVC FORCE <br />OWNER's Contract No. 4096 <br />ENGINEER N/A. <br />(1) Attach detailed schedule and copies of all paid invoices. <br />ENGINEER's Contract No. N/A <br />1. Original Contract Price: <br />2. Net change by Change Orders and Written Amendments (+ or -): <br />3. Current Contract Price (1 plus 2): <br />4. Total completed and stored to date: <br />5. Retainage (per Agreement): <br />$106.000,00 <br />$0.00 <br />$106,000.00 <br />$80,250.50 <br />100% of completed Work: $0.00 <br />0% of retainage: $0.00 <br />Total Retainage: $0.00 <br />6. Total completed and stored to date Tess retainage (4 minus 5): $80,250.50 <br />7. Less previous Application for Payments: $0.00 <br />6. DUE THIS APPLICATION (6 MINUS 7): X80,250.50 <br />CONTRACTOR'S CERTIFICATION: <br />I hereby certify that the labor and materials listed on this request for payment have been used in the <br />construction of this work and payment received from the last request for payment has been used to <br />make payments to all subcontractors, laborers, material men and suppliers, except as noted below. <br />The acceptance of final payment shall be and shall operate as a release of the OWNER from all <br />claims and all liability to the CONTRACTOR other than claims in stated amounts as may be <br />specifically excepted by the CONTRACTOR for all things done or furnished in connection with this <br />Work and for every act and neglect of the OWNER and others relating to or arising out of this Work. <br />Any payment, however, final or otherwise, shall not release the CONTRACTOR or his sureties from <br />any obligations under the Contract Documents or the Payment and Performance Bonds. <br />Dated 61-21 Ili <br />Slate of FLORIDA <br />County of ST, LUCIE <br />Subscribed@nd sworn to before me this -th <br />of <br />otary Public <br />My Commission expires: 06/16/2017 <br />CERTIFICATION OF ARCHITECT OR CONSULTING ENGINEER (WHERE APPLICABLE): <br />I certify that I have checked and verify the above and foregoing Periodic, stimate for Partial <br />Payment; that to the best of my knowledge and belief it is . rue an ,».rrec ateme of the work <br />performed and/or material supplied by the Contractor. <br />By: <br />theluinhab <br />Dated K',. Pr. <br />E GINEER) SIGNATURE <br />00622 - Contractor's Application for Final Payment - Per Marian (2) <br />00622 - 1 <br />FAucersMtary1ACTNE PROJECTS and CONTRACTS 2012-2013WROJECTS COMPLETE DAIS 1 OIRECTIONAL BORE100622 - Contractor's Application for Final Payment -Per <br />Mariann {21.doc Rev. 06!01 <br />173 <br />ATTACHMENT 1 <br />