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2022-011
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2022-011
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Last modified
2/14/2022 10:58:22 AM
Creation date
2/11/2022 10:14:33 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
01/18/2022
Control Number
2022-011
Agenda Item Number
8.A.
Entity Name
Don Hinkle Construction, Inc.
Subject
Indian River County Tax Collector’s Office Expansion
Area
1800 27th Street, Administration Building B
Project Number
IRC-2030
Bid Number
2022018
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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: TAX COLLECTOR OFFICE EXPANSION <br />PROJECT # IRC -2030 <br />I FURTHER CERTIFY that I have personally performed the survey work for the preparation <br />of Record Drawings for the CONTRACTOR for tiis 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 - 20210223 - 00634 - 1 <br />F'\Public Works\ENGINEERING DIVISION PROJECTS\2330 Tax Colector Office Expansion Bldg B\1-Admin\Bids\Bid Documents\Master Contract Documents\D IV <br />
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