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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: Oslo Road Culvert Replacement <br /> INDIAN RIVER COUNTY PROJECT #1306 <br /> 1 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.doc <br /> 00634-1 <br /> F:\PublicWorks\ENGINEERING DIVISION PROJECTS\1306 Oslo Road(E of 15th Ave SW)Pipe Culvert Improvement\Admirn bid documents\00634-Professional Surveyor <br /> and Mapper's Certification as to Elevations and Locations of the Work REV 04-07.doc Rev.06/01 <br />