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ATTACHMENT C <br /> To : Indian River County (Owner) <br /> From: Layne Christensen Company (Contractor) <br /> Contract: South County Water Treatment Plant Wellfield , Phase II <br /> OWNER'S Contract #: 5102 Engineer's Proj #: 38-392-51 <br /> For work accomplished through the date of: 1 /31 /2005 <br /> 1 Original Contract Price $ 558 ,764 . 55 <br /> 2 Net Change by Change Order and Written Amendment (+ or -) $ 11672 .26 <br /> 3 Total completed and stored to date $ 560 ,436 . 81 <br /> 4 Retainage (per Agreement) <br /> of completed work: $ 0 . 00 <br /> of Stored Material : $ 0 .00 <br /> Total Retainage : $ 0 . 00 <br /> 5 Total completed and stored to date, less retainage (3 minus 4) : $ 560 ,436 . 81 <br /> 6 Less previous Application for Payments : $ 478 ,440. 08 <br /> 7 DUE THIS APPLICATION (5 minus 6) : $ 81 ,996.73 <br /> CONTRACTOR'S Certification : <br /> The undersigned CONTRACTOR certifies that ( 1 ) all previous progress payments received from OWNER on <br /> account of work done under the Contract referred above have been applied on account to discharge ONTRACTOR'S <br /> legitimate obligations incurred in connection with Work covered by prior Applications for Payment nu bered <br /> 1 through f inclusive; (2) title of all Work, materials and equipment incorporated in said Work or otherwise listed <br /> in or covered by this Application for Payment will pass to OWNER at time of payment free and clear o all Liens , <br /> security interests and encumbrances (except such as covered by a Bond acceptable to OWNER indemnifying <br /> OWNER against any such Lien , security interest or encumbrance; and (3) all Work covered by this Application for <br /> Payment is in accordance with the Contract Documents and not defective . <br /> DLAYNE CHRISTENC MPAKY <br /> Dat6d Contr <br /> Y• <br /> Doe Go an-', 'G6neral anager <br /> State of Florida <br /> County of Escambia 77 <br /> X0005 <br /> Subscribed and sworn before me thisXO day of , �@$4 , Doyle GoodWrL who is rsonaliy known <br /> to me. <br /> 'YN Stephanie L Lowery <br /> MYCOMMISSION # DD115484 EXPIRES Notary Public <br /> 3uy 1, 2006 '! - / — <br /> ' }° os �` BONDED THRU TROY FAIN INSURANCE INC My Commission Expires : <br /> hUun • <br /> Payment of the above AMOUNT DUE THIS APPLICATION is recommended . <br /> Dated <br /> 49>>61.r * 1j> MtrrtAcat4Cry; � CD� l <br />