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SECTION 00632 CONTRACTOR'S FINAL CERTIFICATION OF THE WORK (TO ACCOMPANY CONTRACTOR'S FINAL APPLICATION FOR PAYMENT) PROJECT NAME:(CR510) 85' STREET RIGHT TURN LANE EXTENSION AT 66TH AVENUE , PROJECT NO: IRC -1745 STATE OF COUNTY OF Personally before me the undersigned officer, authorized by the laws of said state to administer oaths, comes , who on oath says: That he is the CONTRACTOR with whom Indian River County, Florida, a political subdivision of said state, did on the day of 120 , enter into a contract for the performance of certain work, more particularly described as follows: Proposed project consists of the extension of the existing eastbound right turn lane along 85th Street (C.R. 510) at 66th Avenue (approximately 490 feet long). Improvements include milling and resurfacing of existing asphalt pavement, curb and gutter, pavement markings, grading and sodding. UNDER PENALTY OF PERJURY, affiant further says that said construction has been completed and the Contract therefore fully performed and final payment is now due and that all liens of all firms and individuals contracting directly with or directly employed by such CONTRACTOR have been paid in full EXCEPT: Name Description/Amount who have not been paid and who are due the amount set forth. Affiant further says that: 1. CONTRACTOR has reviewed the Contract Documents. 2. CONTRACTOR has reviewed the Work for compliance with the Contract Documents. 3. CONTRACTOR has completed the Work in accordance with the Contract Documents. 4. All equipment and systems have been tested in the presence of the ENGINEER or his representative and are fully operational with. no defects or deficiencies except as listed below. 00632-1 FAPublic Works\ENGINEERING DIVISION PROJECTS\1745 (CR510) 85th Street Right Turn Lane Extension at 66th Ave\1-Admin\Bid DocumeritsWaster Contract Documents\00632 - Contractor's.Final Certification REV 04-07.doc