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SECTION 00622 Contractor's Application for Payment — Page 1 <br /> Application for Payment #: 8. <br /> For Work Accomplished through the period of 4 / l /07 through 7 /26 /07 <br /> Indian River County Board of FROM Sheltra & Son Const., Inc. <br /> TO OWNER: County Commissioners CONTRACTOR: <br /> 184025th Street PO Box 336 <br /> Vero Beach, FL 32960 Indiantown, FL 34956 <br /> Project Name: West W'abasso Water Main Extension Project (Phase I) <br /> County Project #: UCP-2447 Contractor's Project #: 0521 <br /> County Bid #: 2006051 Notice of Award: May 8, 2006 <br /> CDBG Contract #: 06DB-3C- 10-40-01 -W 14 Notice To Proceed: June 26, 2006 <br /> Grant Funding #: 13813054033190 Substantial Completion March 27, 2007 <br /> Date: 270 days from NTP) <br /> Engineer of Record: Himanshu H. Mehta, PE Final Completion Date: April 27, 2007 <br /> 300 days from NTP <br /> North of County Road 510, Designated Parcels East & West of 64th Avenue, <br /> Project Location: Designated Parcels East & West of 63rd Avenue, and Designated Parcels East & <br /> West of 61st Drive. <br /> 1 . Original Contract Price: $575,000. 00 <br /> 2. Net change by Change Orders and Written Amendments (+ or -) : ($ 195916. 50) <br /> 3. Current Contract Price (1 plus 2) : $555,083.50 <br /> 4. Total Work Completed and Stored to Date: 100% Complete (t) $ 555,083 . 50 <br /> 5 . Total Retainage (per Agreement) : 0% $ 0 <br /> 6. Total Work Completed and Stored to Date Less Retainage $555,083. 50 <br /> 7. Less Previous Application for Payments $4955600.00 <br /> 8 . AMOUNT DUE THIS APPLICATION (6 MINUS 7) : $595483.50 <br /> 9. Contract Balance to Finish Plus Retainage (3 minus 4 plus 5) : $ 0 <br /> (1) Attach detailed schedule, copies of all paid invoices, and CDBG related documents. <br /> CONTRACTOR'S CERTIFICATION: <br /> The undersigned CONTRACTOR certifies that (1 ) I hereby certify that the labor and materials listed <br /> on this request for payment have been used in the construction of this work and payment received from <br /> the last request for payment has been used to make payments to all subcontractors, laborers, material <br /> men and suppliers except as listed below. (2) title of all Work, materials and equipment incorporated in <br /> said Work or otherwise listed in or covered by this Application for Payment will pass to OWNER at time <br /> of payment free and clear of all Liens, security interests and encumbrances (except such as are covered <br /> by a Bond acceptable to OWNER indemnifying OWNER against any such Lien, security interest or <br /> encumbrance. <br /> Fina I PaymentApplication 110207 <br /> 00622 - 1 <br />