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APPLICATION FOR FINAL PAYMENT NO, 22 <br />To Indian River County <br />Contract for Hobart Park Reverse Osmosis Plant <br />OWNER's Contract No. 6081 ENGINEER's Project No. <br />For Work accomplished through the data of <br />ITEM <br />Attached Schedule of Valvas <br />Attached Stored Materials Inventory <br />5 <br />Tow <br />(06g. Contract) <br />G.O. No,1 $ <br />C.O. No. 2 <br />C.O. No. 3 <br />Now Contract Amount <br />Accompanying Documentation: <br />Schedule of Values <br />Stored Materials Inwento <br />CONTRACTOR'S Cert#Ication: <br />12f311$6 <br />$ 6,812,000.04 <br />$ 6,612.040.00 <br />$ {1,859.44; <br />$ 26,260.00 <br />66,312.25 <br />6,722,733.25 <br />GROSSAMOUNTDUE <br />LESS 01 Relainage <br />AMOUNT DUE TO DATE <br />LESS PREVIOUS PAYMENTS <br />AMOUNT DUE THIS APPLICATION <br />(OWNER) <br />6706.13876.050 <br />We Completed <br />gvantit r Amount <br />i 6,559,2000 <br />0.90 <br />$ 6,559,200.00 <br />$ 110,733.25 <br />$ 6,669,93.3.25 <br />W <br />0.00 <br />........$ <br />.. <br />$ 6,669;933.25_ <br />...,....,.Y....... .... <br />_. $ 9,195.735.15 <br />$ 474,196.10 <br />The undersigned CONTRACTOR cedifies that: (1) all previous progress payments received from OWNER on account of Work done under the <br />Contract referred to above have been applied to discharge in lull all obligations of CONTRACTOR incurred in connection with Work covered by <br />prior Applications for Payments numbered I through 21 inclusive; (2) title to all Work, materials and equiprneal incorporated in said <br />Work or otherwise listed in or covered by this Application lar Payment will pass to OWNER at time of payment tree and clear of all liens, claims, <br />security interest and encumbrances (except such as are covered by Bond acceptable to OWNER Indemnifying OWNER against any such lien, <br />claim, security interest or encumbrance); and (3) all Work coveted by this Application for Payment is in accordance with the Contract Documents and <br />not defective as that term is defined in the Contract Documents. <br />Dated ,fan 25.99 <br />ARTON-SMITH, INC. <br />-COP41HACTOR <br />IndinpRlrrrto Approys+l _ <br />�► <br />DYrjtrut 1 -j <br />t/ �% By <br />A1st.Diresler <br />a <br />Ronald F. Davoli <br />Senior Vice President - Operations <br />EnginArr <br />Payment of the a .I11lQUNT Dt{l THIS APP I <br />ON 11 ended. <br />Dated '�,I 11 i49 <br />Camp Crosser" McKee, Inc. <br />ENGINEEfi <br />By <br />s <br />{A arize SYgnahrre} <br />00800-27 <br />EJCDC No. 191&8-E (19th] Edition) <br />>'sww0,N[•O_Ameuar:C.-C. w9."wb 17 T4MtR wOA c�dw}.wa <br />