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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 BY THE <br />CONTRACTOR AND TO ACCOMPANY CONTRACTOR'S FINAL APPLICATION FOR 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 BOULEVARD <br />RESURFACING FROM <br />53rd STREET TO THE MERRILL <br />BARBER BRIDGE <br />PROJECT # IRC -1707 <br />I FURTHER CERTIFY that I have personally performed the survey work for the preparation of <br />Record Drawings for the CONTRACTOR for this project or that such work was performed under my direct <br />control and supervision. <br />I FURTHER CERTIFY that all constructed elevations and locations of the Work are in conformance <br />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 0-1—Bid and Contract Doc IRC-1707.docx - 00634 - 1 <br />F:\Public Works\ENGINEERING DIVISION PROJECTS\1707 Indian River Blvd Merrill Barber Bridge to 53rd St Resurfacing (SCOP)\1-Admin\Bid Documents\Bid Documents\DIV 0_S_Bid and <br />Contract Doc IRC 1707.docx <br />