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SECTION 00634 - PROFESSIONAL SURVEYOR AND MAPPER'S CERTIFICATION <br />ELEVATIONS AND LOCATIONS OF THE WORK AS TO <br />(TO BE COMPLETED BY A FLORIDA PROFESSIONAL SURVEYOR AND MAPPER RETAINED <br />BY THE CONTRACTOR AND TO ACCOMPANY CONTRACTOR'S FINAL APPLICATION <br />ATION FOR <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: 20th Avenue and 16th Street Intersection <br />Im <br />INDIAN RIVER COUNTY PROJECT # 0225ovements <br />I FURTHER CERTIFY that I have personally performed the survey work for the preparation <br />of Record Drawings for the CONTRACTOR for this project or that such work was performed under <br />my direct control and supervision. p n <br />I FURTHER CERTIFY that all constructed elevations and locations of the Work are in <br />conformance 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 />00634 - Professional Surveyor and Mapper's Certification REV 04-07 <br />Fn <br />Won 1nNGINEFr n�� NISI7� P�O.�E 75� n 00634 - 1 <br />s �r,a. nor and P1�.o:,er'� Ce (i{_�,� v" ` : n S' l e: f.or 4o <br />�'�� ,� ao Rev SS/S"., "�� �r,ir�`n a nc � nar e lnEs�c:' .. <br />