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2022-193
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Last modified
10/27/2022 12:40:40 PM
Creation date
10/27/2022 12:40:36 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
10/04/2022
Control Number
2022-193
Agenda Item Number
12.G.1.
Entity Name
Florida Department of Transportation (FDOT)
Subject
Supplemental Agreement No. 3 to Agreement FM No. 431759-2-54-01.for
Construction of Intersection Improvements at SR 60 and 43rd Avenue.
Contract No. G-0K60
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NI F of,r 525111 06()el, S1 A I 0 F LOHIDA DFPAH IME N OF IHANSPOH IATION 525011-OC <br /> STATE-FUNDED GRANT AGREEMENT PROGRAM <br /> MANAGFMFNI <br /> 05121 <br /> rage 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 <br /> of Completion and, if applicable, Engineer's Certification of Compliance to the Department upon <br /> completion 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 SERVICES FOR INTERSECTION <br /> IMPROVEMENTS AT SR-60 AND 43RD AVENUE <br /> FPID#: 431759-2-54-01 <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 <br /> completed in compliance with the Project construction plans and specifications. If any deviations have <br /> been made from the approved plans, a list of all deviations, along with an explanation that justifies the <br /> reason to accept each deviation, will be attached to this Certification. Also, with submittal of this <br /> certification the Recipient shall furnish the Department a set of"as-built" plans certified by the Engineer <br /> of Record/CEI. <br /> By: P.E. <br /> SEAL: Name: <br /> Date: <br />
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