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2019-131
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2019-131
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Last modified
12/27/2019 2:11:40 PM
Creation date
9/9/2019 1:35:40 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
08/13/2019
Control Number
2019-131
Agenda Item Number
12.F.1.
Entity Name
Timothy Rose Contracting
Subject
Vero Lake Estates 85th Street Millings from 101st Avenue to 96th Avenue
Area
Vero Lake Estates
Project Number
IRC-1628
Bid Number
Bid 2019012
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SECTION 00634 - PROFESSIONAL SURVEYOR AND MAPPER'S CERTIFICATION AS TO <br />ELEVATIONS AND LOCATIONS OF THE WORK <br />(TO BE COMPLETED BY A FLORIDA PROFESSIONAL SURVEYOR AND MAPPER RETAINED <br />BY THE CONTRACTOR AND TO ACCOMPANY CONTRACTOR'S FINAL APPLICATION FOR <br />PAYMENT) <br />I CERTIFY that I am a Florida Professional Surveyor and Mapper retained by: <br />(Insert name of CONTRACTOR) <br />Who is the CONTRACTOR for the following Project: <br />PROJECT NAME: VERO LAKE ESTATES 85th STREET <br />MILLINGS FROM 101St AVENUE TO <br />96th AVENUE <br />PROJECT # IRC -1628 <br />I FURTHER CERTIFY that I have personally performed the survey work for the preparation <br />of Record Drawings for the CONTRACTOR for this project or that such work was performed under <br />my direct control and supervision. <br />I FURTHER CERTIFY that all constructed elevations and locations of the Work are in <br />conformance with the Contract Documents, except for discrepancies listed below. <br />[Attach additional sheets as necessary] <br />CERTIFIED BY: <br />(SURVEYOR'S SEAL) <br />Printed Name: <br />Florida Professional Surveyor and Mapper Registration Number: <br />Date Signed and Sealed by Professional Surveyor and Mapper: <br />Company Name: <br />Company Address: <br />Telephone Number: <br />00634 - 1 <br />F:\Public Works\ENGINEERING DIVISION PROJECTS\1628-85th Street_96th Ave to 101st Ave_ Roadway Improvements \1-Admin\Bids \Bid Documents\Master Contract <br />Documents\00634 - Professional Surveyor and Mappers Cert.doc Rev. 06/01 <br />00634 - Professional Surveyor and Mapper's Cert <br />
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