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2019-147
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2019-147
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Last modified
12/27/2019 2:21:56 PM
Creation date
10/17/2019 11:43:44 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
09/10/2019
Control Number
2019-147
Agenda Item Number
8.X.
Entity Name
Guettler Brothers Construction,
Subject
49th Street Milling and Resurfacing, 58th Avenue to 31st Avenue
FM NO. 436850-1-54-01
Project Number
IRC-1414
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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 />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: 49TH STREET MILLING AND <br />RESURFACING (58th AVENUE TO 31ST <br />AVENUE) <br />PROJECT # IRC -1414 <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 - Professional Surveyor and Mapper's Cert <br />00634 - 1 <br />F:\Public Works\ENGINEERING DIVISION PROJECTS \1414 -49th St_58th Ave to 31st Ave\1-Admin\Bids\Bid Documents\Master Contract Documents\00634 - Professional <br />Surveyor and Mapper's Cert.doc Rev. 06/01 <br />
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