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C> i INDIAN RIVER COUNTY, FLORIDA 76 APPLICATION FOR PAYMENT NO. NINE PROJECT NO.= PROJECT: Round Island Oceanfront Park Project CONTRACTOR NAME/ADDRESS: l" Very E}gacli. rlorida 32965 APPLICATION DATE -AUG -UST 14.2400 FOR PERIOD ENDING: AMUST 14. 2000 The undersigned CONTRACTOR hcrchy certifies that all ilents and amounts on the face of this applicalion fur payment are correct; that all work has becn performed andfor ala(edals supplied in full accordance with the lernts and conditions of the contract. The undcrsitpicd CONTRACTOR hereby swears under penalty that (1 ) all prcvioua progress pa Inerts rereivcd from OWNER on account of work perforated under Ihl: contract rcrerenced to above have bccn applied by the u c ignud to d' full all obligations of (he undersigned incurred in conncet.inn with work covered by prior Applicalind�s fo Paynxnt er s ontr ct, being APplicahons for Payn�nt numbered I through 3 inclusive: and (2) all materials and cyuiltntent it ale in -sal pr :el or otherwiso listed in or covered by [his Application for Payrmol are free and clear of all liens, c ' ,. see interest al encumbrances. ] Doted Summit ConstrucloQn Management, Inc, (Contractor) By: SL r >`� � --ire 5. (NanlerMIL) COUNTY OF INDIAN ft1VI R; STATE OF PL4RIDA Refor"e this --,P I— day of 4.20 e." j that (s) he is the f _AJ_4_"�Q-4/ of ll above Application for,J;lty,[nt I.oW-Statcmcni on behalTn&said fi G)4 true,correctandcoTP4bard of Coon y Commission Approved for Payment Se & ]?, gnnn _Date i Fran t; , Adams,- _ Chairman Division Approval W , 1'Hlblie Work$ 171reeHOr sotnally nppcarLLl rain to me, who being duly Sworn, deposes and says ACTOR abuv ^ ntcntinnc^tl; Ilial (s]frc csrcotcd the and that . o (be slalumenls contained lure in ur Notary Public AGNES&H ssl OMyCommiMYMISSicln8lt0lClOxCTi8lOSg kkkt li; iBcd�nhPJAC ItMn STATEMENT OF WORK Original Contract Price S831,084.41 Materials Stored 5 {A(lachcd detailed scheJule) Net Change Orders 53,893.32 Total WorldMalcrial to Date $834,977.73 Current Contract Price $834,977.73 Less 10% Retainage $0,00 Work to Date: $834,977.73 Sub Total $0,00 Under Orig. Contract 5831,084.41 Less Prior Payments $751,479.96 Under Change larder $3,893.32 Percent of Work connimo date: 100% BALANCE DUE THIS PAYMENT $83,497,77 RETAINAGE The undersigned CONTRACTOR hcrchy certifies that all ilents and amounts on the face of this applicalion fur payment are correct; that all work has becn performed andfor ala(edals supplied in full accordance with the lernts and conditions of the contract. The undcrsitpicd CONTRACTOR hereby swears under penalty that (1 ) all prcvioua progress pa Inerts rereivcd from OWNER on account of work perforated under Ihl: contract rcrerenced to above have bccn applied by the u c ignud to d' full all obligations of (he undersigned incurred in conncet.inn with work covered by prior Applicalind�s fo Paynxnt er s ontr ct, being APplicahons for Payn�nt numbered I through 3 inclusive: and (2) all materials and cyuiltntent it ale in -sal pr :el or otherwiso listed in or covered by [his Application for Payrmol are free and clear of all liens, c ' ,. see interest al encumbrances. ] Doted Summit ConstrucloQn Management, Inc, (Contractor) By: SL r >`� � --ire 5. (NanlerMIL) COUNTY OF INDIAN ft1VI R; STATE OF PL4RIDA Refor"e this --,P I— day of 4.20 e." j that (s) he is the f _AJ_4_"�Q-4/ of ll above Application for,J;lty,[nt I.oW-Statcmcni on behalTn&said fi G)4 true,correctandcoTP4bard of Coon y Commission Approved for Payment Se & ]?, gnnn _Date i Fran t; , Adams,- _ Chairman Division Approval W , 1'Hlblie Work$ 171reeHOr sotnally nppcarLLl rain to me, who being duly Sworn, deposes and says ACTOR abuv ^ ntcntinnc^tl; Ilial (s]frc csrcotcd the and that . o (be slalumenls contained lure in ur Notary Public AGNES&H ssl OMyCommiMYMISSicln8lt0lClOxCTi8lOSg kkkt li; iBcd�nhPJAC ItMn