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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: Old Dixie Highway Resurfacing (From <br />the I.R.F.W.C.D. North Relief Canal to <br />71st Street) <br />INDIAN RIVER COUNTY PROJECT NO: 1137 <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 />CERTIFIED BY: <br />(SURVEYOR'S SEAL) <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 Mappers Certification.doc <br />00634 - 1 <br />F \Public Works\ENGINEERING DIVISION PROJECTS \1137 -Old Dixie Hwy Resurfacing IRF North Relief Canal to 71st StWdmim\bid documents\Contract Documents\00634 - <br />Professional Surveyor and Mapper's Certification.doc Rev 06/01 <br />