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SECTION 00632 - CONTRACTOR'S FINAL CERTIFICATION OF THE WORK (TO ACCOMPANY CONTRACTOR'S FINAL APPLICATION FOR PAYMENT) PROJECT NAME:66TH AVENUE ROADWAY WIDENING (49TH STREET TO 69TH STREET) PROJECT NO: IRC -1505 STATE OF _ COUNTY OF Personally before me the undersigned officer, authorized by the laws of said state to administer oaths, comes , who on oath says: That he is the CONTRACTOR with whom Indian River County, Florida, a political subdivision of said state, did on the day of ,20 , enter into a contract for the performance of certain work, more particularly described as follows: The proposed improvements to 66th Avenue from north of 49th Street to north of 69th Street consisting of the widening and reconstruction of the existing roadway to a 4 - lane divided roadway section within the project limits. Curb and gutter and a raised median will be provided. An 8' wide concrete sidewalk will be provided on the west side of the roadway. There are 5 bridges within the project limits. The side streets on the east and west of the intersection approaches will be widened to a 3-1ane roadway section. Also included will be stormwater drainage improvement, pavement markings, traffic signals and landscape and irrigation improvements. UNDER PENALTY OF PERJURY, affiant further says that said construction has been completed and the Contract therefore fully performed and final payment is now due and that all liens of all firms and individuals contracting directly with or directly employed by such CONTRACTOR have been paid in full EXCEPT: Name Description/Amount who have not been paid and who are due the amount set forth. Affiant further says that: CONTRACTOR has reviewed the Contract Documents. 2. CONTRACTOR has reviewed the Work for compliance with the Contract Documents. 3. CONTRACTOR has completed the Work in accordance with the Contract Documents. Contractor's Final Certification of the Work - 00632-1 F:\PubIicWorks\ENGINEERING DIVISION PROJECTS\1505-66th Ave Widening_49th St to 69th St\1-Admin\Bid Documents\Master Contract Documents\DIV 0_3_Contract Forms.docx