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ATTACHMENT "F",- APPLICATION AND CERTIFICATE FOR PAYMENT: FINAL <br />PROJECT: Central Regional WWTF Headworks Rehab 2016023 <br />OWNER: Indian River County FL <br />ATTENTION: Mark Piper <br />APPLICATION PERIOD: _ FROM: 31-JanA7 <br />TO: 3 -Apr -17 <br />CONTRACT DATE: <br />Application is made for payment as shown above. The present status of the account for this contract as follows: <br />ORIGINAL CONTRACT SUM (see page 2) . <br />$ <br />350;656.00 <br />NET change .by Change orders (see page 3) <br />$ <br />CONTRACT SUM TO DATE. (see page 2) <br />$ <br />350,656.00 <br />TOTAL COMPLETED AND STORED TO DATE <br />$ <br />$322,656.00 <br />Less Retainage <br />$ <br />- - <br />Less previous Certificate for Payment <br />$ <br />289,423.20 <br />CURRENT PAYMENT .DUE <br />$ <br />33,232.80 <br />E & D CONTRACTING SERVICES, INC.. The undersigned Contractor certifies that to the best of his knowledge, Information and <br />belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all <br />accounts have been paid by him for Work which previous Certificates for Payment were leased and payments received from the <br />Owner, and that current payment shown herein is now due. <br />In accordance with the Contract Documents, based on on-site observation and the data comprising the above application, the <br />Architect certifies that the Work has progressed to the point. indicated; that to the best of his knowledge, information and belief, <br />the quality of the Work Is in accordance with the Contact Documents; and .that the Contractor is entitled to payment shown herein <br />as now due. <br />The undersigned Owner's Representative, based observation and the data comprising the above application, certifies that the <br />Work has progressed to the point ind)'cated; that to the best of his knowledge, the information and belief, the quality of the Work is <br />In accordance with the Documents; qbd that the Contractor is entitled to payment shown herein as now due. <br />ti -Apr -17 <br />DATE <br />DATE <br />DATE <br />i-7 <br />P95 <br />