04/04/2017 (2) - Laserfiche WebLink

Home Browse Search

PAYMENT APPLICATION ENGINEER'S CERTIFICATION County of: ST. LUCIE Page 1 TO: Inidan RiverCounty BOCC PROJECT Bid # 2017018 APPLICATION # 2 Final Distribution to: 1801 27th St NAME AND LOCATION: Post Hurricane Matthew Emergency Dune Rest PERIOD THRU: 03/10/2017 OWNER Vero Beach, FL 32960 should not be made. 1801 27th St PROJECT #s: 2017018 ARCHITECT ❑ Attn: Vero Beach, FL 32960 ❑ CONTRACTOR 1 FROM: Guettler Brothers Construction, LLC ARCHITECT: DATE OF CONTRACT: 03/02/2017 0 P. O. Box 12271 11 Fort Pierce, FL 34979-2271 FOR: CONTRACTOR'S SUMMARY OF WORK Contractor's signature below is his assurance to Owner, concerning the payment herein applied for, that: (1) the Work has been performed as required in the Contract Documents, (2) all sums previously Application is made for payment as shown below. paid to Contractor under the Contract have been used to pay Contractor's costs for labor, materials Continuation Page is attached. and other obligations under the Contract for Work previously paid for, and (3) Contractor is legally entitled to this payment. 1. CONTRACT AMOUNT $217,450.00 1 CONTRACTOR: Guettler Brothers Constpudiom, LLC 2. SUM OF ALL CHANGE ORDERS $0.00I By: � X�j ' Date: 03/10/2017 3. CURRENT CONTRACT AMOUNT (Line 1 +/- 2) $217,450.00 ue ler 4. TOTAL COMPLETED AND STORED (Column G on Continuation Page) 5. RETAINAGE: a. 0.00% of Completed Work (Columns D + E on Continuation Page) b. 0.00% of Material Stored $0.00 (Column F on Continuation Page) Total Retainage (Line 5a + 5b or Column I on Continuation Page) 6. TOTAL COMPLETED AND STORED LESS RETAINAGE (Line 4 minus Line 5 Total) 7. LESS PREVIOUS PAYMENT APPLICATIONS $0.00 8. PAYMENT DUE $208,142.65 State of: FLORIDA ENGINEER'S CERTIFICATION County of: ST. LUCIE Engineer's signature below is his assurance to Owner, concerning the payment herein applied for, NiRALiZACARRION MY COMNILWON # FF 94MM Subscribed and swom to before $197,735.52 s' r EXPIRES: January 13,202o ' Bonded Thm Notary Public Underwiters me this i 0th day of March 2017 conforms with the Contract Documents, (3) this Application for Payment accurately states the amount Notary Publi-C—A an a & (2�4'vv a.,— My Commission Expires: _ should not be made. $0.00 ENGINEER'S CERTIFICATION $208,142.65 Engineer's signature below is his assurance to Owner, concerning the payment herein applied for, $0.00 that: (1) Engineer has inspected the Work represented by this Application, (2) such Work has been $197,735.52 completed to the extent indicated in this Application, and the quality of workmanship and materials $0.00 conforms with the Contract Documents, (3) this Application for Payment accurately states the amount $0.00 of Work completed and payment due therefor, and (4) Engineer knows of no reason why payment $10,407.13 should not be made. 9. BALANCE TO COMPLETION (Line 3 minus Line 6) $9,307.35 SUMMARY OF CHANGE ORDERS ADDITIONS DEDUCTIONS Total changes approved in previous months $0.00 $0.00 Total approved this month $0.00 $0.00 TOTALS $0.00 $0.00 NET CHANGES $0.00 PAYMENT APPLICATION AMOUNT......................... .:.............................................................. I(If the certfied amount is different from the payment due, you should attach an explanation. Initial all Me figures that are changed to match the certified amount.) Engineer. J11NIDIAN RIVER By: ei Neither this Application nor payment applied for herein is �i�pd omade only to Contractor, and is without prejudice to any r Contract Documents or otherwise. gVr' Act # I2i ZQ6U�1 ��00 t P05T 4wrX Air ##"V -AV of r