6/28/2016 11:38:18 AM
9/30/2015 11:27:43 PM
Official Document Type
Agenda Item Number
Application for Final Payment No.3
Change Order No.01 Phase III Release of retainage
CR 510, CR 512
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SECTION 00622 - Contractor's Application for Final Payment <br /> Application for Payment No. 3 - FINAL . <br /> For Work Accomplished through the period of 10-01 -07 through 11 -02-07 <br /> To : Indian River County (OWNER) <br /> From : Underground Utilities Inc (CONTRACTOR ) <br /> Contract: Labor Contract Bid No . 2007026 <br /> Project : CR 512 Utility Conflict Resolutions for 10" and 12" <br /> OWNER's Contract No . WIP No . 471 -23536-044699-06543 ENGINEER's Contract No . 2952 <br /> ENGINEER Gordon Sparks P . E . . <br /> ( 1 ) Attach detailed schedule and copies of all paid invoices . <br /> 1 . Original Contract Price : $51 , 554 . 36 <br /> 2 . Net change by Change Orders and Written Amendments (+ or $2 , 530 . 84 <br /> 3 . Current Contract Price ( 1 plus 2) . $54 , 085 . 20 <br /> 4 . Total completed and stored to date : $54 , 085 . 20 <br /> 5 . Retainage ( per Agreement): <br /> 100% of completed Work : $54 , 085 . 20 <br /> 5% of retainage : N/A <br /> Total Retainage : N/A <br /> 6 . Total completed and stored to date less retainage (4 minus 5 ): $54 , 085 . 20 <br /> L7 . Less previous Application for Payments : $46 , 527 . 81 <br /> 8. DUE THIS APPLICATION 6 MINUS 7) : JL557 . 39 <br /> CONTRACTOR'S CERTIFICATION : <br /> I hereby certify that the labor and materials listed on this request for payment have been used in the construction of this work and payment <br /> received from the last request for payment has been used to make payments to all subcontractors, laborers, material men and suppliers, except <br /> as noted below. <br /> The acceptance of final payment shall be and shall operate as a release of the OWNER from all claims and all liability to the CONTRACTOR <br /> Y <br /> AAAA - 00622 - Contractor's Application for Final Payment - 11 -7-07.doc p <br /> 00622 - 1 (� _ <br /> F:AUlilitiesWTILITV - ENGINEERINGAProjects - Utility Construction PermitsVIRC - CR 512 & CR 510 Utility Conflicts by nacelle UCP #283]VNAA - 00822 - Contractors Application for <br />Fina l Payment - ll -]-07.ran Rev. 05/01 J <br /> Attachment 1 , � � <br />
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