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ATTACHMENT "F" - APPLICATION AND CERTIFICATE FOR PAYMENT: FINAL PROJECT: Central Regional WWTF Headworks Rehab 2016023 OWNER: Indian River County FL ATTENTION: Mark Piper APPLICATION PERIOD: FROM: 31 -Jan -17 TO: 3 -Apr -17 CONTRACT DATE: Application is made for payment as shown above. The present status of the account for this contract as follows: ORIGINAL CONTRACT SUM (see page 2) $ 350,656.00 NET change by Change orders (see page 3) $ CONTRACT SUM TO DATE (see page 2) $ 350,656.00 TOTAL COMPLETED AND STORED TO DATE $ $322,656.00 Less Retainage $ - Less ,previous Certificate for Payment $ 289,423.20 CURRENT PAYMENT DUE $ 33,232.80 E & D CONTRACTING SERVICES, INC.. The undersigned Contractor certifies that to the best of his knowledge, information and belief, .the work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all accounts have been paid by him for Work which previous Certificates for Payment were leased and payments received from the Owner, and that current payment shown herein is now due. In accordance with the Contract Documents, based on on-site observation .and the data comprising the above application, the Architect certifies that the Work has progressed to the point indicated; that to the best of his knowledge, information and belief, the quality of the Work Is in accordance with the Contact Documents; and that the Contractor is entitled to payment shown herein as now due. The undersigned Owner's Representative, based observation and the data comprising the above application, certifies that the Work has progressed to the point indicated; that to the best of his knowledge, the information and belief, the quality of the Work is in accordance with the Documents; oid that the Contractor is entitled to payment shown herein as now due. OWNER 6 -Apr -17 DATE DATE 1.0 P94