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ATTACHMENT 3 <br />APPLICATION FOR PAYMENT NO. 6 <br />To: Indian River County Department of Utilities Services (OWNER) <br />From: Timothy Rose Contracting (CONTRACTOR) <br />Contract: Bid No. 2017-045 <br />Project: North County Commercial Sewer & Water <br />OWNER's Contract No. UCP # 4119 ENGINEER's Project No. 1422 <br />For Work accomplished through the date of: 04/11/19 <br />1 Original Contract Price: $2,977,931.58 <br />2 Net change by Change Orders and Written Amendments (+ or -): $0.00 <br />3 Current Contract Price (1 plus 2): $2,977,931.58 <br />4 Total completed and stored to date $2,773,640.71 <br />5 Retainage (per Agreement): <br />0% of completed Work: $0.00 <br />0% of stored material: $0.00 <br />Total Retainage: $0.00 <br />6 Total completed to date less retainage (4 minus 5): $2,773,640.71 <br />7 Less previous Application for Payments: $2,659,743.22 <br />8 DUE THIS APPLICATION (6 MINUS 7): $113,897.49 <br />CONTRACTOR'S Certification: <br />The undersigned CONTRACTOR certifies that (1) title to all Work, materials and equipment incorporated in said Work or otherwise <br />listed in or covered by this Application for Payment will pass to OWNER at time of payment free and clear of all Liens, security <br />interests and encumbrances; (2) all Work covered by this Application for Payment is in accordance with the Contract Documents and <br />not defective; and (3) the labor and materials listed on this Application for Payment have been used in the construction of this Work <br />and payment received from the last progress payment has been used to make payments to all subcontractors, laborers, material, <br />men and suppliers except as listed below: <br />Dated 4/11/2019 Timothy Rose Contracting <br />CONTRACTOR <br />By: <br />State of FLORIDA <br />County of INDIAN RIVER <br />Subscribed and sworn to before me this 11th day of April, 2019 <br />Notary Public <br />My Commission expires: 10/03/19 <br />Payment of the above AMOUNT DUE THIS APPLICATION is recommended. <br />Dated <br />EJCDC No. C -700-E (2002 Edition) <br />MASTELLER & MOLER, INC. <br />ENGINEER <br />By: <br />Prepared by the Engineers Joint Contract Documents Committee and endorsed by The Associated General Contractors of America and the Construction Specification Institute <br />139 <br />00800-26 <br />