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2020-193A
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2020-193A
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Last modified
3/5/2021 11:06:19 AM
Creation date
10/14/2020 12:43:44 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
09/22/2020
Control Number
2020-193A
Agenda Item Number
8.C.
Entity Name
One Source Restoration & Building Services, Inc.
Subject
Indian River County Courthouse Parking Garage Rehabilitation
Bid Number
IRC-1801A
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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: INDIAN RIVER DOUNTY COURTHOUSE <br />PARKING GARAGE REHABILITATION <br />PROJECT # IRC -1801A <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 />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 />(SURVEYOR'S SEAL) <br />DIV 0-3—Contract Forms.dou - 00634 - 1 <br />F:\PublicWorkskENGINEERING DIVISION PROJECTS\1801A IRC Courthouse Parking Garage Rehabilitation\1-Admin\Bids0d Documents\Bid Dcuments\DIV 0 3 Contract <br />Fonns.docx <br />
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