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2017-027F
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2017-027F
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Last modified
10/6/2017 11:00:52 AM
Creation date
3/21/2017 2:21:42 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
02/21/2017
Control Number
2017-027F
Agenda Item Number
12.F.1
Entity Name
Community Asphalt Corporation
Subject
Round Island Park Pavement Resurfacing
Contract & Specifications
Area
Round Island Park
Project Number
1619
Bid Number
201717
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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: ROUND ISLAND RIVERSIDE PARK <br /> PAVEMENT RESURFACING <br /> INDIAN RIVER COUNTY PROJECT# 1619 <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 <br /> isted-below--[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 Cert <br /> 00634-1 <br /> F,\Public Works\ENGINEERING DIVISION PROJECTS\1619 Round Island Facility Paving\1-Admin\bid documents\Master Contract Documents\00634-Professional Surveyor <br /> and Mapper's Cert.doc Rev.06/01 <br />
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