Laserfiche WebLink
APPLICATION FOR PAYMENT NO.2 FINAL <br />To: Indian River County Utilities �m �, <br />From: Blue Goose Growers, LLC (CONTRACTOR) c <br />Contract: — NOV 2 Y 2011 y <br />PO #: <br />Project: Heron Cay MHP - Longpointe Ct - WM & Service Replacement Received <br />For Work completed through the date of November 15, 2017 F�nanc <br />6 <br />7 <br />8 <br />Original Contract Price: <br />Net change by Change Orders and Written Amendments (+ or <br />Current Contract Price (1 plus 2) <br />Total completed and stored to date: <br />Retainage (per Agreement) <br />of completed work <br />of stored material $ <br />Total Retainage: <br />Total complete and stored to date less retainage (4 minus 5) <br />Less previous Application for Payments <br />DUE THIS APPLICATION (6 MINUS 71 / <br />\\A 00o I <br />—� i3 <br />$ 59,334.17 <br />59, 334.17 <br />53,940.15 <br />53,940.15 <br />20 669.33 <br />33.,270. <br />ti <br />CONTRACTOR'S Certification: <br />The undersigned CONTRACTOR certifies that (1) all previous progress payments received from OWNER on <br />account of Work done under the Contract referred to above have been applied on account to discharge <br />CONTRACTOR's legitimate obligations incurred in connection with Work covered by prior Applications for <br />Payment numbered 1 through 1 inclusive; (2) title of all Work, materials and equipment incorporated in <br />said Work or otherwise listed in or covered by this Application for Payment will pass to OWNER at time of <br />payment free and clear of all Liens, security interests and encumbrances (except such as are covered by a Bond <br />acceptable to OWNER indemnifying OWNER.against any such Lien, security interest or encumbrance); and (3) <br />all Work covered by this Application for Payment is in accordance with the Contract Documents and not <br />defective. <br />Dated: 1/. 20.1 9L <br />State of nDykA(, <br />County of S -k Lu c i 2 <br />Blue Goose Growers, LLC <br />CONTRACTOR <br />By: . nVWKL�_ <br />Greg Hampton, ontroll <br />Subscribeda d sworn to befor me this Z- day of 0 D ✓ e-f*K 61( 2017 <br />Notary Public�"Y"`"" <br />My Commission expires: <br />Payment of the above AMOUNT DUE THIS APPLICATION is recommended. <br />Dated: A <br />MY CA &WSION t FF9458't9 <br />EXPIRES: December 22.2619 <br />8uded Thm Nofary PWk Und1=1W <br />ENGI <br />By: �— <br />P50 <br />