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2016-110
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Last modified
2/4/2019 1:36:23 PM
Creation date
8/8/2016 10:53:34 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
07/12/2016
Control Number
2016-110
Agenda Item Number
12.F.1.
Entity Name
Barth Construction
GoLine
Subject
GoLine Bus Transfer Hub
Contract and Specifications
Area
1235 16th St.
Project Number
1330
Bid Number
2016019
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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 FORS <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: I.R.C. Go Line Transfer Hub <br /> INDIAN RIVER'COUNTY PROJECT# 1330 <br /> I FURTHER:CERTIFY'that l have personallyperformed: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 /> 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 adtlitional sheets,'as necessary]; <br /> (SURVEYOR'S•SEAL) <br /> CERTIFIED^BY:: <br /> -Phrited Name:: <br /> Florida Professional Surveyor and Mapper Registration Number:- <br /> •Date'.Signed'and°Sealed by Professional Surveyor and Mapper: <br /> _Compan--Name:, <br /> Conmpany-Address:- <br /> "Telephone <br /> s:'Telephone Number: <br /> ,o0634-Professionarsurveyor and Mappers.Certification as'to Llevations and Locations of'the work RLV 0407 <br /> 00634.1 <br /> F:\Public W"r ENGINEERING DIVISION PROJECTSM30-I.R.C.GoLine Transfer HubVidminlbld docurirentsVvtasfer C6ntrad,Documents100634_Professional Surveyor,end.; <br /> :Mappees Catificalion as to Elevations and Locations of the Wdo k REV 04-07.'66 Rev:06x01' <br />
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