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C� <br />APPL,ICA'rION FOR PAYMENT NO. 13 �l�-f r:,, <br />To Indian River County Utilities <br />Contract for North 13each R.O. Conversion to Pump Station <br />OWNER's Contract No. — 9025 _ ENGINEER's Project No. <br />For Work accomplished through the date of <br />- - CONT,RAC <br />ITEM Unit Rdee <br />See Attacbad Schedule � 51,507,940.00 <br />of values <br />C.O. No, 1 <br />See Alloched Stored <br />Material inventory <br />Total <br />(Orifi. Contract) <br />C.O. No. 1 <br />C.Q. No, 2 <br />Accompanying Documentation: <br />Stored Materials Invoices <br />Pro rg essPtlotos _ - <br />Consent of Surety__— - <br />CONTRACTOR"s Certification; <br />31 -Jan -00 <br />R's Schedule of Values Work <br />Quantity_ Amount -- Quantity <br />1.00 $1,507,900.00 — 1o0.00% <br />085,653.00 <br />- $1.422.047 00 <br />Page i of 7 <br />(Owner) <br />08706-21739.075 <br />Amount <br />$1,422,047.00 <br />$0.00' <br />$1,422,047.001 <br />1 <br />GROSS AMOUNT DUE .......................................... <br />Si,422,047.00 <br />LESS RETENTION 0. ........... ....... 110.00% <br />$0.00 <br />AMOUNT DUE TO DATE ......, .... <br />51,422,047-00 <br />{ LESS PREVIOUS PAYMENTS....... ..... <br />$1,332,974.70 <br />AMOUNT DUE THIS APPLICATION .. <br />$89,072.3Q <br />The undersigned CONTRACTOR certifies that; (1) all previous progress payments received from OWNER on <br />account of Work done under the Contract referred to above have been applied to discharge in fullall obligations <br />of CONTRACTOR incurred in connection with Work covered by prior Applications for Payment numbered i <br />Through _42 __ inclusive; (2) title to all Work, materials and equipment incorporated in said <br />Work or otherwise listed in or covered by this Application for Payment will pass to OWNER at time of payment <br />free and Gear of all liens, claims, security interest and encumbrances (except such as covered by Bond <br />acceptable to OWNER indemnifying OWNER against any such lien, claim, security interest or encumbrance); <br />and (3) all Work covered by this Application for Payment is in accordance with the Contract Documents and not <br />"defective" as that term is defined in the Contract Documents. <br />Dated 31 -Jan , 2000 _ . TLC Diversified, Inc_. __ <br />- -- - CONTRACTOR <br />(Authorized Signature) <br />Payment of the above AMOUNT DUE THIS APPLICATION is recommended. <br />t <br />Dated ftVvcjn_: 2-4B--_ 20_4)a --I <br />0 fes_ - - - - - <br />IN]t<_ <br />BY <br />(Authorized Signature) <br />RCC Approved 04-11-2000 <br />EJCDC No. 1910 -S -E (1990 Edition) <br />Prepwad by IhO Enghee,a Jalnt Contract oDcumarft Comrelitee and andoraed by the Associated C "tal'CDnA'8Ct417 Or /UfrIOrkG <br />