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2006-417-2of2
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2006-417-2of2
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Last modified
9/1/2016 4:32:45 PM
Creation date
9/30/2015 10:24:29 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
12/12/2006
Control Number
2006-417
Agenda Item Number
11.I.1.
Entity Name
Kimley-Horn Associates, Inc.
Subject
Oslo Road (CR 606) Phase I, Road Widening
Project Number
9705C
Supplemental fields
SmeadsoftID
5987
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SECTION 00634 - PROFESSIONAL SURVEYOR AND MAPPER' S <br /> CERTIFICATION AS TO ELEVATIONS <br /> AND LOCATIONS OF THE WORK <br /> (TO BE COMPLETED BY A FLORIDA PROFESSIONAL SURVEYOR AND MAPPER <br /> RETAINED BY THE CONTRACTOR AND TO ACCOMPANY CONTRACTOR 'S FINAL <br /> APPLICATION FOR PAYMENT) <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 /> Oslo Road (CR 606) Phase I Roadway Widening <br /> INDIAN RIVER COUNTY PROJECT #9705C <br /> I FURTHER CERTIFY that I have personally performed the survey work for the <br /> preparation of Record Drawings for the CONTRACTOR for this project or that such work <br /> was performed under my direct control and supervision . <br /> I FURTHER CERTIFY that all constructed elevations and locations of the Work are <br /> in conformance with the Contract Documents , except for discrepancies listed below. <br /> [attach additional sheets as necessary] <br /> (SURVEYOR'S SEAL) <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 /> + + END OF SECTION + + <br /> 00634- 1 <br /> F,\Public Works\Capital Projects%Oslo Road\Oslo Widening, Old Dixie to 27th Ave\CONTRACT DOCUMENT\00634 - <br /> Professional Surveyor's Certification.doc <br />
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