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CERTIFICATION OF OWNER'S CONSTRUCTION OBSERVER: <br />To the best of my knowledge and belief: the Work has progressed to the point <br />indicated on this Application for Payment; the quality of the Work is generally in <br />compliance with the Contract Documents; and the conditions precedent to the <br />CONTRACTOR being entitled to such payment appear to have been fulfilled in so far as <br />it is my ability to observe the Work. I am not certifying as to whether or not the <br />Contractor has paid all subcontractors, laborers, materialmen, and suppliers because I <br />am not in a position to accurately determine that issue. <br />Dated <br />SIGNATURE <br />CERTIFICATION OF ENGINEER: <br />To the best of my knowledge and belief: the Work has progressed to the point <br />indicated on this Application for Payment; the quality of the Work is generally in <br />compliance with the Contract Documents; and the conditions precedent to the <br />CONTRACTOR being entitled to such payment appear to have been fulfilled in so far as <br />it is my ability to observe the Work. I am not certifying as to whether or not the <br />Contractor has paid all subcontractors, laborers, materialmen, and suppliers because I <br />am not in a position to accurately determine that issue. <br />Dated <br />SIGNATURE <br />[The Remainder of This Page Was Left Blank Intentionally] <br />Last Revised 6/20/2017 Attachment 1 <br />00622 - 4 <br />F:\Public Works\KeithM\Stormwater Projects\Main Relief Canal Operation\2015-2016 Modifications\Agenda Items\Conveyors\Attachment 1.doc Rev. 05/01 <br />33 <br />