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Last modified
3/2/2021 11:51:41 AM
Creation date
5/28/2020 12:51:50 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
05/19/2020
Control Number
2020-105
Agenda Item Number
12.F.2.
Entity Name
State of Florida - Florida Department of Transportation
Subject
45th Street Improvements-43rd Avenue to 58th Avenue FDOT Small County Outreach Program
for FM No. 436848-1-54-01, IRC-1722
Area
45th Street Improvements-43rd Avenue to 58th Avenue
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A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION J.R. SMITH, CLEo10-so <br />STATE -FUNDED GRANT AGREEMENT PROGRAM MANAGEMENT <br />Dain <br />Page 1 of 1 <br />EXHIBIT "C" <br />ENGINEER'S CERTIFICATION OF COMPLIANCE <br />Engineer's Certification of Compliance. The Recipient shall complete and submit the following Notice of <br />Completion and, if applicable, Engineer's Certification of Compliance to the Department upon completion <br />of the construction phase of the Project. <br />NOTICE OF COMPLETION <br />STATE -FUNDED GRANT AGREEMENT <br />Between <br />THE STATE OF FLORIDA, DEPARTMENT OF TRANSPORTATION <br />and INDIAN RIVER COUNTY <br />PROJECT DESCRIPTION: Construction and CEI (Milling and resurfacing) of 45"' Street/CR-611 <br />from 58"' Avenue/CR-613 to 43rd Avenue. <br />FP I D#: 436848-1-54-01 <br />In accordance with the Terms and Conditions of the State -Funded Grant Agreement, the undersigned <br />provides notification that the work authorized by this Agreement is complete as of , 20_ <br />By: <br />Name: <br />Title: <br />ENGINEER'S CERTIFICATION OF COMPLIANCE <br />In accordance with the Terms and Conditions of the State -Funded Grant Agreement, the undersigned <br />certifies that all work which originally required certification by a Professional Engineer has been completed <br />in compliance with the Project construction plans and specifications. If any deviations have been made <br />from the approved plans, a list of all deviations, along with an explanation that justifies the reason to accept <br />each deviation, will be attached to this Certification. Also, with submittal of this certification the Recipient <br />shall furnish the Department a set of "as -built" plans certified by the Engineer of Record/CEI. <br />SEAL: <br />By: P.E. <br />Name: <br />Date: <br />
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